The Hospice Guide

Hospice for ALS

When hospice may be right for ALS and how it supports breathing, swallowing, communication and family caregivers.

Updated October 15, 2026 · Based on Medicare.gov and CMS sources

Hospice can support people with ALS (amyotrophic lateral sclerosis, also called Lou Gehrig’s disease) when breathing, swallowing or movement decline significantly, and the person chooses comfort-focused care. Because ALS affects every part of daily life, hospice support for the family is especially important.

When hospice may be right for ALS

ALS progresses at different speeds for different people. Doctors often consider hospice when there is:

• Breathing decline: shortness of breath at rest, weakening breathing muscles, or needing breathing support, when the person decides not to use a tracheostomy and long-term ventilator.
• Swallowing and nutrition problems: trouble swallowing, weight loss or dehydration, especially if the person chooses not to have a feeding tube.
• Rapid loss of function: moving quickly from walking to needing a wheelchair, or from speaking clearly to being hard to understand.
• Serious complications: such as repeated pneumonia from food or saliva going into the lungs.

These are deeply personal decisions. The person can make choices about feeding tubes and breathing support ahead of time with their ALS team, and record them in an advance directive.

How hospice helps with ALS

• Breathing comfort: medicines such as low-dose morphine, positioning, suction for secretions, and help using non-invasive breathing devices for comfort if wanted.
• Secretions and drooling: medicines and equipment to manage saliva.
• Swallowing: guidance on safe eating for comfort and preventing choking.
• Communication: help keeping communication tools working as speech becomes harder.
• Equipment: hospital bed, lift, wheelchair, commode and other equipment as needed.
• Caregiver support: training, respite care, emotional support and bereavement care.

Working with your ALS clinic

Many people with ALS are followed by a specialty clinic. Hospice can work alongside that team, and the person’s neurologist can remain involved. Ask the hospice how it coordinates with ALS clinics and whether it has cared for ALS patients before.

Next steps

• Read when is it time for hospice.
• Learn how to choose a hospice.
• Find a hospice near you.

Sources

• The ALS Association
• Medicare.gov: Hospice care coverage

This guide is general information, not medical advice. Talk with your ALS care team and hospice about your own situation.