How Long Do People Live In Hospice?

Ana Safarian • August 3, 2024

It's never an easy thing dealing with the possibility of a loved one passing away, and the process of enduring this emotional time is always undoubtedly anxiety-inducing. 


While sending them into hospice care may alleviate some of these worries, it's pretty normal to still have a lot of questions regarding what to expect—including wondering how long do people live in hospice.


Knowing the typical duration of a terminally ill person's stay can help families ensure that their loved ones receive the best possible care despite the looming deadline. 


But what happens if someone lives longer than expected while staying in a hospice? How does a hospice determine life expectancy? How do the hospice nurses know when the time is near? Let's find out.


How Long Does The Average Person Live In Hospice?


The duration of hospice care can vary greatly depending on a variety of factors, including the patient's specific illness, overall health, and how they respond to the care provided. 


According to the National Hospice and Palliative Care Organization (NHPCO) Facts and Figures 2023 Edition, the average length of stay for Medicare patients in hospice was 92.1 days in 2021. 


While this is a slight decrease from previous years, it shows a wide range of experiences. The median stay is much shorter at 17 days, which means many patients enter hospice very late in their illness.


It's common for patients to start hospice care just days or weeks before passing. Approximately 10% of patients are in hospice for two days or less, and 50% for 17 days or less. However, about 12-15% of patients stay in hospice care for six months or more.


Hospice care can be provided in various settings, including private homes, nursing facilities, and assisted living facilities, with average stays of 95, 109, and 165 days, respectively. The holistic approach of hospice care addresses not only physical symptoms but also emotional and spiritual needs, which can contribute to longer life spans for some patients. 


What Happens If You Live Longer Than 6 Months On Hospice?


Hospice care is usually for patients expected to live six months or less. 


However, some patients outlive this period. If that happens, hospice care doesn't stop automatically. Instead, the hospice team reassesses to see if the patient still qualifies for hospice care.


If the patient's condition still requires hospice, they will continue receiving care. This re-certification process can go on as long as the patient remains eligible. 


Remember, hospice care always focuses on providing comfort and improving the quality of life, no matter how long the patient lives. There's no guarantee nor accuracy in the predictions of a patient's life expectancy—but the organization will always be there to offer support for as long as needed. 


How Does Hospice Determine Life Expectancy?


A hospice determines life expectancy using medical evaluations and clinical judgment. 


Doctors assess a patient’s overall health, age, and specific illness to estimate how much longer they have. For Medicare-covered hospice, a doctor needs to certify that the patient is likely to live six months or less. This estimate is based on clinical signs and the doctor’s experience, though it's not always precise.


Various tools and markers refine these predictions—for instance, specific criteria for heart failure and dementia can indicate shorter life spans. The Functional Assessment Staging Test (FAST) helps with dementia, while risk scores assess heart failure prognosis. 


How Do Hospice Nurses Know When Death Is Near?


Hospice nurses can tell when death is approaching by observing several key signs and symptoms:


Physical Changes


  • Patients often become less responsive, sleep more, and resist movement.
  • There's usually a reduced interest in food and fluids, and swallowing can become difficult. Nurses keep the mouth moist and use alternative ways to give medication.
  • Reduced intake can lead to constipation and loss of bladder control. Nurses manage these issues to keep patients comfortable.
  • Hands and feet may feel cold, body temperature can drop, or mild fevers can occur. Nurses use warm blankets or cool cloth for comfort.
  • These vital signs often decrease and become irregular as death nears.


Skin Changes


  • Skin may turn purplish, pale, or mottled, indicating that death is near.
  • Immobility and weight loss can cause pressure sores. Nurses focus on pain management and preventing infection.


Breathing Changes


  • Breathing patterns can include rapid breaths followed by pauses (Cheyne-Stokes respiration) and noisy and shallow breaths.
  • Breathing may stop for more extended periods before resuming briefly.


Cognitive Changes


  • Patients may become less aware of their surroundings and show little interest in activities or interactions.
  • Terminal agitation can occur, sometimes managed with medication.
  • Illusions, hallucinations, and delusions are common. Patients might express awareness of their imminent death.


Consciousness Fades


  • Patients often enter a coma-like state, unable to communicate but possibly still able to hear and feel.


How Long Can Someone Last On The End-Of-Life?


The end-of-life phase can vary widely, lasting anywhere from a few days to a couple of weeks. During this time, the body gradually shuts down, and patients may react differently. Some pass away peacefully, while others seem to resist. Reassuring your loved one that it's okay to let go can be comforting for both of you.


Decisions about hydration, breathing support, and other medical interventions should respect the patient's wishes. Hospice care focuses on honoring these preferences, making the patient's final days as comfortable and peaceful as possible. 


What Happens When Hospice Patient Dies?


When a hospice patient passes away, the first step is to have the death officially pronounced by a registered nurse, physician, coroner, or medical examiner—and this needs to happen as soon as possible. 


The person who pronounces the death will complete the paperwork certifying the time, place, and cause of death, which is necessary for the death certificate. If the death occurs in a facility, there may be extra protocols they follow during this process.


Conclusion


Facing the end-of-life phase of a loved one is incredibly challenging and filled with uncertainty. 


Hospice care helps ease this transition by focusing on comfort, dignity, and quality of life, no matter how long it lasts. While the average hospice stay is about three weeks, this can vary widely based on many factors. 


If you're wondering how long do people live in hospice—don't worry, hospice care is provided as long as needed, no matter the duration of their stay.



That said, if you're considering hospice care for your loved one, contact Olympia Hospice Care. We're here to answer your questions and support you every step of the way, ensuring your loved one receives the compassionate care they deserve.

By Ana Safarian June 3, 2025
Caring for a loved one with a terminal illness often raises difficult questions, including financial ones. Many families want to provide care in a familiar setting, but one of the most common concerns is this: how much does in-home hospice care cost? While this option offers comfort, dignity, and personalized support at home, the price can vary based on location, service needs, and insurance coverage. This guide explains what’s typically included, what to expect out-of-pocket, and how to plan ahead so you can focus on care, not just costs. What Does In-Home Hospice Care Include? In-home hospice care provides a variety of services focused on making your loved one’s final days as comfortable as possible. Common services offered include routine nursing visits, pain and symptom management, home visits from the hospice team , supplies, and other resources. Unlike hospital care, which aims to cure your illness, hospice care shifts the focus to managing your symptoms and providing extra support for everyday tasks. The goal is to alleviate discomfort and provide support with daily living tasks, such as bathing, dressing, and eating. Care is delivered wherever the patient resides, whether in their own home, a relative’s residence, an assisted living facility, or a nursing home. Most services are coordinated through a hospice agency, which works closely with family caregivers to match you with a care plan that meets your loved one’s specific needs. What is the Average Cost of In-Home Hospice Care? Learning the answer to how much does in-home hospice care cost can vary widely depending on factors such as location, provider rates, the patient’s needs, and the level of insurance coverage. While many families don’t pay the full amount due to Medicare , Medicaid, or other private insurance, starting financial planning can reduce the strain of the process of affording end-of-life care. Instead of charging for every individual service, hospice care is billed through a daily rate that covers a full range of services. Based on the benchmarks for hospice care costs set by the Centers for Medicare and Medicaid Services , here’s an in-home hospice cost breakdown for care in the United States using the Medicaid’s FY2024 hospice payment rates as a guide: Nursing Visits Routine home care that includes scheduled nursing visits amounts to $218.61 on average per day for the first 60 days, and $172.57 starting day 61. This covers care coordination, health monitoring, and symptom assessments. Medical Supplies and Equipment Medical supplies and items such as hospital beds, oxygen tanks, and wound care supplies are covered by the hospice agency as part of the daily rate. There are no additional charges under Medicaid or Medicare . Medication Pain and symptom control medications are included in the hospice benefit daily rate under Medicaid/ Medicare . Some small payments may apply under specific private insurance plans but the hospice agency generally covers these medications in full. Emotional and Spiritual Support Chaplain services, social workers, and counseling are part of the hospice team and offer emotional and spiritual care at no additional cost. These services are available to both patients and their families. Does Medicare Cover Hospice at Home? Yes, Medicare provides extensive support for hospice patients who wish to receive home hospice services through the Medicare Hospice Benefit. This benefit covers essential services such as routine nursing visits, medical equipment, pain and symptom control medications, and counseling services for both patients and families at a per-day price. To qualify for hospice care , a patient must be certified by a physician or doctor as having a terminal illness with a prognosis of six months or less to live. Enrollment in a Medicare-approved hospice program and accepting comfort care are also requirements. While most services are fully covered under the benefit, there may be small copayments for medications or other additional services. For individuals without Medicare , Medicaid, and other private insurance plans can also serve as alternatives depending on the provider and policy. Out-of-Pocket Costs and What’s Not Covered While Medicare and Medicaid benefits cover most hospice services, there are some costs that families may need to pay out of pocket. These fall outside standard coverage and can add up, depending on your loved one’s needs, namely: 24/7 Home Health Aides If your loved one requires round-the-clock assistance for everyday tasks, families may need to hire private caregivers outside of their Medicare or Medicaid benefits. Room and Board in a Facility If hospice is provided in an assisted living facility or a nursing home, the hospice benefit may cover care services but not housing or meals. These costs can vary depending on the facility and are typically paid for by the family unless other funding sources are used. Personal Care Services Some non-medical support services, such as housekeeping, laundry, meal preparation, and others, may not be included in the hospice benefit coverage. Private-Pay Options Families who choose a non-network provider may need to pay privately, either per service or through a flat daily rate, and can have significantly increased total expenses without insurance. Is In-Home Hospice More Affordable Than Facility Care? In many cases, in-home hospice care is a more affordable alternative to nursing home care or full-time facility care. Staying at home helps avoid room and board fees associated with care facilities. Families can also control additional expenses based on their loved one’s needs, choosing whether to hire extra help or rely on the core hospice team. However, while home care can reduce some additional costs, it can shift more of the responsibility to families. Assistance tasks like caregiving, supervision, and daily chores may fall to loved ones, which can affect time, stress, and long-term planning. Personalized Support from Olympia Hospice for In-Home Care Decisions At Olympia Hospice Care , we understand that making end-of-life care decisions often comes with the task of asking difficult questions, like how much does in-home hospice care cost. These concerns can feel heavy, but you don’t have to face them alone. Our team is here to provide clarity, empathy, and expert advice every step of the way. We are committed to delivering care that respects your loved one’s comfort, preserves their dignity, and brings peace of mind to those around them. If you’re considering in-home hospice care and have any questions about care plans or symptom management, connect with us today .  We’re here to help you move forward with strength and understanding.
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