{"entity":{"id":"hospice-end-of-life","kind":"technology","name":"Hospice and end-of-life care","aka":[],"tldr":"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.","status":"standard-of-care","asOf":"2026-09-08","wikipedia":"https://en.wikipedia.org/wiki/Hospice","links":[{"label":"NHPCO Facts and Figures","url":"https://www.nhpco.org/hospice-care-overview/hospice-facts-figures/"},{"label":"ASCO end-of-life quality measures","url":"https://www.asco.org/practice-patients/quality-care"}],"tags":["gap-fill","supportive"],"related":[],"cancers":[],"sections":["supportive-care"],"technologies":["palliative-care","pain-management"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["cicely-saunders","elisabeth-kubler-ross"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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.","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"],"since":1967},"route":"/technologies/hospice-end-of-life/","neighbours":{"section":[{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"pain-management","kind":"technology","name":"Cancer pain management","route":"/technologies/pain-management/"},{"id":"palliative-care","kind":"technology","name":"Early integrated palliative care","route":"/technologies/palliative-care/"}],"person":[{"id":"cicely-saunders","kind":"person","name":"Dame Cicely Saunders","route":"/people/cicely-saunders/"},{"id":"deborah-james","kind":"person","name":"Dame Deborah James","route":"/people/deborah-james/"},{"id":"elisabeth-kubler-ross","kind":"person","name":"Elisabeth Kübler-Ross","route":"/people/elisabeth-kubler-ross/"}],"paper":[{"id":"paper-temel-early-palliative-care-nejm-2010","kind":"paper","name":"Temel: early palliative care alongside chemotherapy improved quality of life, mood and survival in lung cancer","route":"/key-papers/paper-temel-early-palliative-care-nejm-2010/"}],"term":[{"id":"curative-intent","kind":"term","name":"Curative intent vs palliative intent","route":"/terms/curative-intent/"}],"roadmap":[{"id":"survivorship-roadmap","kind":"roadmap","name":"Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards","route":"/roadmaps/survivorship-roadmap/"}]}}