# Hospice and end-of-life care

Source: https://onco.cc/technologies/hospice-end-of-life/  
OnCo record `hospice-end-of-life` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Care in the last months of life focused entirely on comfort, at home or in a hospice, when cancer treatment no longer helps. Enrolling earlier than the typical two to three weeks gives patients and families more benefit.

## Summary

Modern hospice began with Cicely Saunders at St Christopher's (1967); the US Medicare hospice benefit (1982) requires a six-month prognosis and forgoing curative treatment, which creates late referral (median length of stay ~18 days). Elements: symptom control, home nursing, bereavement support, and avoidance of chemotherapy in the last 14 days and ICU death (ASCO/NQF quality measures). Evidence links hospice to better family-rated care, lower costs, and no shortening of life. Concurrent-care models (VA, Medicare Care Choices pilot) allow hospice alongside treatment. Medical assistance in dying is legal in a growing number of jurisdictions and interacts with palliative care policy.

## Fields

- Kind: Technology
- Status: standard-of-care
- Last checked: 2026-09-08
- Tags: gap-fill; supportive
- Principle: Prognosis-triggered transition to comfort-focused interdisciplinary care with 24/7 access, delivered predominantly at home; quality is measured by late-enrolment, aggressive end-of-life care and family-reported outcomes.
- Since: 1967
- Strengths: Better family-reported quality of dying; Lower end-of-life costs and hospital use; Bereavement support for caregivers
- Limitations: Late enrolment; 'terrible choice' between treatment and hospice in the US; Underuse by Black and Hispanic patients and in rural areas; Non-existent in many countries

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Hospice
- NHPCO Facts and Figures: https://www.nhpco.org/hospice-care-overview/hospice-facts-figures/
- ASCO end-of-life quality measures: https://www.asco.org/practice-patients/quality-care

## Connected records

- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Cancer pain management](https://onco.cc/technologies/pain-management/), [Early integrated palliative care](https://onco.cc/technologies/palliative-care/)
- people: [Dame Cicely Saunders](https://onco.cc/people/cicely-saunders/), [Dame Deborah James](https://onco.cc/people/deborah-james/), [Elisabeth Kübler-Ross](https://onco.cc/people/elisabeth-kubler-ross/)
- key papers: [Temel: early palliative care alongside chemotherapy improved quality of life, mood and survival in lung cancer](https://onco.cc/key-papers/paper-temel-early-palliative-care-nejm-2010/)
- terms: [Curative intent vs palliative intent](https://onco.cc/terms/curative-intent/)
- roadmaps: [Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards](https://onco.cc/roadmaps/survivorship-roadmap/)

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JSON: https://onco.cc/api/v1/entities/hospice-end-of-life.json