Hospice Care Basics

Who It’s For:
Hospice care is designed for individuals with a terminal illness, generally with a prognosis of six months or less, who have chosen to forgo curative treatment and focus on comfort.

Services Provided:
Hospice offers pain management, symptom control, emotional and spiritual support, and assistance with daily activities. A care team may include doctors, nurses, social workers, chaplains, and volunteers.

How to Get Care:
Hospice care is typically accessed via a referral from a healthcare provider but an individual or family member can also reach out directly to a hospice care program.

Where Care Is Provided:
It is primarily provided in the patient’s home, but can also take place in nursing homes, assisted living facilities, dedicated hospice centers—generally, wherever home is for the patient.

How It’s Paid For:
Hospice is usually covered by Medicare, Medicaid, and private insurance, covering services related to the terminal diagnosis, including medication, equipment, and support.

Palliative Care Basics

Who It’s For:
Palliative care is for individuals with serious, chronic, or life-limiting illnesses at any stage, whether or not they are receiving curative treatment.

Services Provided:
Palliative care focuses on symptom relief, pain management, emotional support, and care coordination. The care team typically includes doctors, nurses, and other specialists.

How to Get Care:
It can be accessed through a healthcare provider's referral and is often initiated in hospitals, but can extend into outpatient clinics or home settings.

Where Care Is Provided:
Palliative care can be provided in hospitals, outpatient clinics, long-term care facilities, or at home.

How It’s Paid For:
Palliative care is often covered by Medicare, Medicaid, and private insurance, but coverage may vary depending on the services provided.

Additional resources for learning more about hospice and palliative care:

CaringInfo: The National Hospice & Palliative Care Organization's consumer site offers comprehensive information on end of life care, including services, eligibility, and how to find care.

Get Palliative Care: A resource provided by the Center to Advance Palliative Care that explains palliative care, services, and how to access it.

Medicare and Hospice Care: This page provides detailed information on how Medicare covers hospice services, including what’s included, costs, and eligibility criteria.

Please visit our Resources page for more information.

Death With Dignity, VSED, Palliative Sedation

Washington State's Death with Dignity Act

The Washington Death with Dignity Act, Initiative 1000, passed on November 4, 2008, and went into effect on March 5, 2009. This Act allows some terminally ill patients to request and use lethal doses of medication from qualified medical providers as part of their end-of-life care.  A terminally ill patient must be eligible to use the Death with Dignity end-of-life care:

• 18 years of age or older
• Can make and communicate an informed decision to health care providers
• Diagnosed with an incurable and irreversible disease that will produce death within six months
• Washington resident

Voluntary Stopping Eating and Drinking (VSED)

VSED is a legal option in Washington where a terminally ill or suffering individual voluntarily chooses to stop eating and drinking, leading to death by dehydration. It is typically supported by palliative care to manage symptoms and ensure comfort. VSED is an option for those seeking to hasten death without using medication.

Palliative Sedation

Palliative sedation is a legal and ethical option used in end-of-life care to alleviate extreme, refractory symptoms like severe pain or agitation that cannot be managed through other treatments. The process involves sedating the patient to reduce consciousness, thereby easing suffering. Palliative sedation is not intended to hasten death and is closely monitored by healthcare professionals. It is typically considered when a patient is in the final stages of a terminal illness and comfort measures are the primary goal of care.

Additional resources for learning more about these legal end of life options:

Washington State Death With Dignity Act

End of Life Washington

Compassion and Choices

VSED Resources Northwest