7 Signs It May Be Time for Hospice or Palliative Care
Updated August 2025
In this article
All of us get concerned and worried when our loved one is diagnosed with a serious illness. As the disease progresses, we notice signs that specialized care, such as hospice or palliative care, may be needed. We hate to think our loved one is getting worse, so we may keep telling ourselves this is just a temporary setback and that our loved one will improve.
Many times, we don’t even want to consider these types of care unless a doctor tells us it is necessary.
It’s important to know that anyone can refer someone for hospice or palliative care to improve quality of life for themselves or someone they know.
What Are the Differences in the Roles of Palliative Care vs. Hospice Care?
- Palliative care is for people of any age and any stage of illness while curative treatment is ongoing and can begin at time of diagnosis. This type of specialized medical care helps control pain, manage symptoms, and reduce stress while someone receives the treatment they need for their illness. It does its best work when added to the patient’s care plan as early in the disease process as possible.
- Hospice care is for those living with a serious illness whose current prognosis indicates a life expectancy of six months or less. At its core is an interdisciplinary team that develops an individualized plan of care based on what is most important to the patient and their loved one.
Getting assessed for care and starting hospice care early is important. Studies prove that hospice care may also lengthen life expectancy. Unfortunately, most people wait until it is too late to reap many of the benefits hospice care offers.
When Should Hospice or Palliative Care be Considered for a Loved One?
If your loved one is exhibiting the following symptoms or signs, we encourage you to contact us:
- Unexplained weight loss
- Spending more time confined to a bed or chair – decreased alertness and increased time sleeping
- More frequent falls
- Increased need for medication due to uncontrolled pain or symptoms
- Shortness of breath
- Difficulties performing the tasks of daily living: bathing, getting out of bed, getting dressed, walking, or preparing and eating meals
- Increased number of trips to the ER and multiple hospitalizations
If you are noticing these signs in yourself or a loved one, you should consider talking to one of our professionals by calling us at 800-733-1476. We can schedule an assessment to determine if either of these types of care could benefit you or your loved one.
Or, you can take our short quiz Which Care is Right? [link to: https://lifecare.org/which-care-is-right/ ] It can help you determine if hospice or palliative care may be appropriate for you or your loved one.
Don’t Hesitate: Make Sure You or a Loved One Gets The Care Needed
We understand there are concerns around infectious diseases like the flu or COVID or pneumonia. We also realize that you or your loved one may be hesitant to go to a doctor’s office for fear of catching an infection.
Don’t let fear keep you from getting the care you need. Our team is experienced in preventing the spread of infectious diseases and goes through CDC-recommended screening procedures to reduce the chance of spread of the coronavirus. Care and support can be provided while precautions are taken to keep patients, family members and our team members as safe as possible.
If hospice care is indicated, we can often provide the needed care and support in the patient’s home. Palliative care patients have the option of TeleCare, where virtual regular visits are used to manage pain and symptoms.
Another benefit of hospice and palliative care is that they are proven to reduce hospitalizations and trips to the emergency room for symptom management.
Many families say they wish they had called hospice sooner. Don’t wait to get the care you or your loved one need. You can start by simply making a referral here.
We’ve reviewed the signs that it may be time for hospice. However, we’d like to go a bit further into this topic, now shifting our focus to the details surrounding when you should consider hospice care.
When Should You Consider Hospice Care?
For many people, the idea of hospice care lasting more than a few days or weeks seems counterintuitive. That’s because all too often, patients are already in steep decline, if not actively dying, when they are admitted for care. Therefore, many people have been conditioned to think that hospice care, which is a Medicare benefit, is only for the last days of life. That is simply not true.
The key to improved quality of life lies in getting hospice care early.
As soon as a patient is given a life expectancy of six months or less, it is time to start receiving hospice care. Which agency provides the care is totally your choice. However, your doctor can assist in the referral process.
The goal of hospice care is to manage pain and symptoms of illness. This in turn helps relieve stress and anxiety. Our interdisciplinary team includes:
- The doctor
- Registered nurse
- Nursing assistant
- Chaplain
- Social worker
- Volunteer
This team provides for a whole-body approach that cares for the patient’s physical, mental and spiritual needs. The team, along with the patients and their loved ones, define the goals of care, thereby putting the patient’s wishes first.
Many patients respond exceptionally well to hospice care and gain improved quality of life – for themselves and their loved ones. This includes Lower Cape Fear LifeCare patient Mr. Jones (not his real name).
Two Happy Years Filled with Travel, Family and Friends
Mr. Jones was a 91-year-old man who was referred to us after three hospital admissions within a six week period for congestive heart failure (CHF). Following the first hospital admission, he returned home. Following the second admission, he returned home with home health. Upon the third admission, he returned home to be admitted to hospice care and was given three to six months to live. He was admitted to Lower Cape Fear LifeCare in September.
Mr. Jones lived alone. However, his daughter lived just across the street. The LCFL liaison met with Mr. Jones and his caregiver (his daughter) and developed a plan of care to minimize his CHF symptoms.
Mr. Jones’ family wanted to take him on a trip to the North Carolina mountains for four days. The entire family, including grandchildren and great grandchildren, enjoyed this special time together. They visited Grandfather Mountain’s Mile-High Swinging Bridge and enjoyed going out to dinner almost every night.
In November, Mr. Jones enjoyed a large family Thanksgiving dinner. At Christmas, he celebrated with family as they shared Christmas dinner and presents. He teased his family that he planned to give out cash as presents and those who did not come would forfeit their gift.
Mr. Jones’s symptoms were being well-managed, and he continued doing all the things he enjoyed. He spent time people-watching and visiting with friends on the benches outside JC Penney and Walmart. He called family members to see who was available to join him out for dinner on Friday or Saturday nights. He went with his son on Saturday mornings to Roberta’s Diner and to church on Sunday mornings. He drove his golf cart across the street to visit his daughter regularly.
The care team started weaning unnecessary medications in the fall of the following year but added medication to help him sleep. He was still able to live on his own.
Mr. Jones was readmitted to the hospital only once, and it had been nearly a year since his last admission. He received treatment as a comfort measure, and he was able to return home.
In October, the family returned to the mountains to a house purchased by his daughter after their last trip. They made a couple more trips until April, when Mr. Jones said he thought that would be his last trip. He said the trips had started to wear him out.
On July 19, he enjoyed a 93rd birthday celebration with his family. They had a backyard cookout party and he sat on the deck in the shade while he watched the kids play in the pool.
Within a few weeks, Mr. Jones started having breathing issues and was using oxygen at night. He started using a walker and needed help getting in and out of his golf cart. He exhibited signs of memory loss. A chest x-ray was needed, which he was able to get at home because he was on hospice.
As of Aug. 1, Mr. Jones was no longer able to live on his own. During the week, he became anxious and incontinent. His symptoms were treated, and he was made comfortable.
On Thursday, Aug. 4, he quit eating. On Friday, he became less responsive and showed symptoms of restlessness for the first time.
Saturday morning, he was unable to walk and was put into a hospital bed around lunchtime. By the end of the day, he was unresponsive. Family and friends joined him Sunday, Aug. 7, for a prayer vigil.
Mr. Jones died peacefully in the comfort of his own home, surrounded by family, at 1:19 a.m. on Aug. 8, almost two years after being admitted to Lower Cape Fear LifeCare for hospice care.
Mr. Jones’s family was grateful for his time in hospice care and that it had provided an improved quality of life for the whole family. They were glad they had gotten help early.
Don’t wait. Find out if hospice care is right for you or a loved one by taking our quiz.
If hospice care is not appropriate and you or a loved one are living with a serious or chronic illness and are currently receiving treatment for your illness, palliative care may be appropriate. Again, the time to start treatment is early, immediately following diagnosis.
Many patients respond exceptionally well to hospice care and gain improved quality of life – for themselves and their loved ones. This includes Lower Cape Fear LifeCare patient Mr. Jones Not his real name. We have withheld his real name to protect patient privacy).
We’ve discussed the benefits of hospice care and when to determine if you or a loved one is ready for hospice care.
But how long can you receive hospice care? We’ll examine this question next.
How Long Can You Receive Hospice Care?
We hear it all the time: “We wish we’d called hospice sooner.” Dr. Kelly Erola, chief medical officer, explains that hospice provides for months of care, and why the sooner care begins the better quality of life patients and families can experience.
How Long Can A Patient Receive Hospice Care? Hospice Can Provide Months of Care
Many people think that hospice only serves patients in the last few weeks of life. When considering how long a patient can receive hospice care, remember that in actuality, the truth about hospice is that it is available to the patient and family for months of care.
When a patient has a terminal illness, we find that patients are often referred to hospice too late. By too late we mean that they are referred to hospice in the very last days of life. This perpetuates a myth that hospice is just for the last days of life, which is not true.
In fact, we are frequently asked, ‘How long can a patient receive hospice care?’
How Can You Get the Most Benefit From Hospice?
Hospice is available for the last months of life. To truly benefit from hospice, having months of care is much better than days when you have a serious illness.
So, when should you make the decision to contact us? And how long can a patient receive hospice care? The time to start is when the prognosis is looking like more supportive care is needed and there’s months left, then it’s time to look at hospice.
While hospice does provide support for cancer patients, there are several other diagnoses that can qualify for hospice care.
How Do I Get Hospice Care?
You can talk to your doctor about hospice care, but you don’t have to wait for your doctor. You can call Lower Cape Fear LifeCare yourself and we can help you determine if hospice is the right program for you. You can also “Refer a Loved One” using this form.
What Happens As the Serious Illness Progresses?
One of the biggest questions that we get is what is going to happen as the illness progresses. People start to wonder. Hospice care is very experienced in addressing these concerns and can help explain what’s going on, and answer patients’ questions, concerns, and their worries to help them cope as the illness progresses.
The hospice care team is there to help support the patient and the family, providing pain and symptom management. They also provide spiritual support, volunteer services, chaplain services, if needed, social worker help, and respite services. This team comes to the patient’s home or wherever they call home. This extra layer of support actually helps patients live longer.
What Is the Goal of Hospice Care?
The goal of hospice care is to help the patient live the best quality of life that they can. There are different strategies that the care team can provide to help support the family to manage pain and symptoms. It’s very important to have support for the whole family, not just the patient.
How Long Can a Patient Receive Hospice Care? Lower Cape Fear Life Care Is Ready to Assist You
If you have any questions about hospice care, please call Lower Cape Fear Life Care at 800-733-1476. We are available to discuss the hospice program and how it can truly benefit you and your family for months.
One of the things hospice and palliative care can help with is fall prevention. Next, we’d like to take a moment to provide some useful tips to help you avoid falls.
Be Safe: Fall Prevention Tips
Millions of those 65 and older fall each year, and statistics for falls and fall-related injuries are eye-opening.
According to the Center for Disease Control (CDC):
- Falling once doubles your chances of falling again.
- Falls are the seventh leading cause of death among older adults.
- One out of five falls causes a serious injury such as broken bones or a head injury.
- Each year, three million older adults are treated in emergency departments for fall injuries.
- More than 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture.
- Each year, at least 300,000 older people are hospitalized for hip fractures.
- More than 95 percent of hip fractures are caused by falling, usually by falling sideways.
There are many factors that contribute to falls in older adults including medications, balance issues, vision problems, and unsafe environments. Addressing these issues can help keep you safe from fall-related injuries.
While falls can occur anywhere, they most often occur in your own home (70 percent of home falls occur in the bathroom). It’s important to remove clutter and keep walkways clear.
Download our free Fall Prevention Tip Sheet to prevent injury and help keep you or your loved ones safe in the comfort of their own home.
Balance exercises, such as those from Go4Life, can help you improve balance and walk safely. Practicing Tai Chi is another great way to improve your balance.
Check your risk for falling using this self-assessment from the CDC and talk to your doctor about the results. Review your medications with your doctor or pharmacist to see which ones may be contributing to balance issues. Also, have your vision checked.
Lower Cape Fear LifeCare Is Here for Help Enhance the Quality of Life
So many people wait too long to enter hospice. Entering hospice care as soon as you or a loved one is eligible means you can enjoy more precious moments with your family and friends. Don’t wait to get the comfort care you need.
Did you know that anyone—doctors, family, neighbors—can make a referral to hospice? Patients can even refer themselves! Just contact us to make a referral and learn more.
Key Takeaways:
Time for Hospice or Palliative Care:
- Palliative care can begin at any stage of serious illness and is provided alongside curative treatment.
- Hospice care is for patients with a life expectancy of six months or less and focuses on comfort and quality of life.
- Anyone—not just doctors—can refer a person for hospice or palliative care.
- Early access to hospice care can improve quality of life and may even extend it.
- Common signs that care may be needed include unexplained weight loss, fatigue, frequent falls, and uncontrolled pain.
- Additional indicators include difficulty with daily tasks, shortness of breath, and frequent hospital visits.
- Hospice and palliative care can be safely delivered at home and reduce the need for ER visits.
- Delaying care often leads to missed benefits, and many families say they wish they had called sooner.
When to Consider Hospice Care:
- Hospice care should be considered as soon as a patient receives a prognosis of six months or less to live.
- Starting hospice care early can greatly improve a patient’s quality of life and reduce stress for both patients and families.
- Hospice care is a holistic approach that includes physical, emotional, and spiritual support through an interdisciplinary team.
- Many people mistakenly associate hospice care only with the final days of life, but it can be beneficial for much longer periods.
- Patients can choose which hospice agency provides their care, and doctors can assist with the referral process.
- Hospice services can include in-home support, symptom management, medication adjustments, and emotional and spiritual care.
- Families often express gratitude for the early start of hospice care, recognizing its value in improving everyone’s experience.
- If hospice is not appropriate, palliative care may be a better fit for patients still receiving curative treatment but dealing with serious illness.
- The best time to explore hospice or palliative care options is immediately after diagnosis of a life-limiting or chronic condition.
How Long Can a Patient Be In Hospice Care:
- Hospice care can provide support for months, not just the final days of life.
- Many patients are referred to hospice too late, missing out on the full benefits of extended care.
- Early enrollment in hospice leads to better quality of life for both patients and their families.
- Hospice care is available for various terminal illnesses, not just cancer.
- You don’t have to wait for your doctor to initiate hospice care—you or your loved one can reach out directly.
- The hospice team provides comprehensive care, including pain management, spiritual and emotional support, and family services.
- Hospice professionals help patients and families understand and cope with the progression of serious illness.
- Receiving hospice care at home or in another familiar setting helps patients remain comfortable and supported.
- Hospice aims to maximize quality of life, not hasten death, through compassionate and personalized care.
- Contacting hospice early allows families to fully benefit from the wide range of services offered over several months.
Fall Prevention:
- Falls are extremely common among adults aged 65 and older, and one fall significantly increases the risk of falling again.
- Falls are a leading cause of serious injury and death in older adults, including hip fractures and head trauma.
- The majority of falls happen at home, especially in the bathroom, making home safety a critical focus for prevention.
- Common fall risk factors include medications, poor balance, vision problems, and cluttered or unsafe environments.
- Practicing balance exercises like Tai Chi and Go4Life routines can help reduce fall risk and improve stability.
- Reviewing your medications and getting regular vision checkups can also help prevent falls.
- The CDC offers a self-assessment tool to help identify your personal fall risk.
Lower Cape Fear LifeCare encourages early referrals to hospice to maximize quality of life and comfort.
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Sources:
Centers for Disease Control, “About Older Adult Falls,” https://www.cdc.gov/falls/index.html
Medicare, “Hospice Medicare Coverage,” https://www.medicare.gov/coverage/hospice-care
National Alliance for Care at Home, https://www.nhpco.org/
National Library of Medicine, “Comparing hospice and nonhospice patient survival among patients who die within a three-year window,” https://pubmed.ncbi.nlm.nih.gov/17349493/
