Lung cancer is tricky to diagnose early. In fact, about 8 out of 10 lung cancers are diagnosed after they’ve spread outside of the lungs. Your doctor may call this stage III or IV lung cancer. It means cancer, which originally took root in your lungs, has spread to different parts of your body like your lymph nodes, liver, or brain.
Late-stage lung cancers are hard to treat. For example, on average only about 1 in 10 people whose lung cancer has traveled to other organs live for more than 5 years after being diagnosed.
If your treatments no longer help, your doctor might suggest hospice care.
What Is Hospice Care?
It’s a medical specialty that focuses on comfort care as you near the end of your life. Typically, your doctor may recommend hospice when treatments stop working and if they think you may have less than 6 months to live. More than half of those who have lung cancer on average live less than 1 year after their diagnosis.
Hospice philosophy views death as a natural part of the life cycle. It includes a team of health professionals who focus on compassionate care for your physical, emotional, psychosocial, and spiritual needs.
Hospice care involves your family members, especially caregivers, to make decisions to help you spend your last days in dignity and comfort.
What Does Hospice Care Look Like?
You usually get it at home, in a nursing home, or in a community living center. Hospice care also can start at a hospital until you’re ready to go home.
Your care team will set up a plan of care to manage your daily needs. They’ll also help your loved ones set up physical spaces, such as your bedroom. For example, your hospice team will arrange for a hospital bed if needed. They also can bring other medical equipment and supplies like bedpans, wheelchairs, walkers, and bandages. Someone from your hospice care team, usually a nurse, will visit regularly to check on you and show you how to use the equipment.
Your hospice team is available to support you and your family 24 hours a day, 7 days a week. They’re always a phone call away.
Home Care vs. Inpatient Hospice Care
Home care. Most people get hospice care at home – whether you live in your own house or apartment, a nursing home, an assisted living facility, or a long-term care facility. But during home hospice care, most of your hands-on care is given by a family member or a loved one, also called a primary caregiver. Someone may need to be with you 24/7.
The staff at an assisted living or a nursing home may help with some of the physical care if it’s part of the contract or if your insurance covers it.
Inpatient hospice care. This is usually given by a fully staffed facility run by a hospice agency or at a hospital. Some nursing homes may also have a small hospice care unit. You may opt for this service if you don’t have caregivers or need professional care around the clock.
Who’s on Your Hospice Care Team?
Your hospice care team will include a variety of health professionals, like:
- Doctors of different specialties like cancer (oncologist), primary care, and those who focus on serious illness (palliative).
- Social worker
- Home health aide
- Trained volunteers
- Spiritual or religious leaders like priests
What Kind of Services Are Provided During Hospice?
Your hospice team will provide different services, such as:
Palliative care and symptom management. This is also called supportive care. Palliative doctors usually manage symptoms or side effects during active cancer treatment. They don’t treat cancer. But they’ll work with you and your caregivers to help you stay comfortable and make the most of your final days. This means they tend to your pain, nausea, and other side effects to help you feel as good as possible and stay as alert as possible.
Care coordination. Your hospice team will oversee your care and is available to you or your caregivers 24/7 if you need help. They’ll also communicate updates so everybody on the team is on the same page.
Your team will coordinate care throughout the end-of-life process – they’ll contact pharmacists if you need medications, put you in touch with spiritual leaders, or walk your caregivers through funeral services after you pass.
Family meetings. People from your care team, usually hospice nurses or social workers, will schedule regular meetings to update your loved ones on your condition and what to expect. You or your caregivers can use this time to voice concerns or ask questions you may have about the process of dying.
Respite care. Cancer can have a big effect on your caregivers, too. Your hospice team can give them a break to take some much-needed time away. Usually, it’s given for up to 5 days at a stretch. During this time, you or your loved one can continue hospice care at a hospice facility, nursing home, or a hospital.
Spiritual care. Your religious or spiritual needs may vary. If you’d like, your hospice team can connect you to a priest or spiritual guide. They can talk to you about facing death, walk your caregivers through how to say goodbye, or help set up religious ceremonies or rituals.
Bereavement care. Bereavement is the period when your loved ones mourn your loss. Your hospice team will help family members and loved ones through the grieving process. This can include services like counseling, spiritual guidance, phone calls to update people about the loss, and referrals to support groups. Your loved ones are eligible for bereavement care for up to a year after you pass.
Paying for Hospice Care
Medicare, the government health insurance program for those who are 65 and older, and benefits from the U.S. Department of Veterans Affairs (VA) cover all hospice care-related costs. Most military families also have hospice coverage through Tricare, the health care program for service members and their families.
If you have Medicaid, a state-federal insurance program for people with low income, hospice care is covered in most states. But each state sets its own coverage limits and the length of life expectancy for eligibility. If you’re unsure, talk to your insurance coordinator about it.
If you have private insurance and you’re under 65, your plan may cover some hospice care. Check with your insurance company about costs, coverage, and out-of-pocket expenses.
If you are uninsured, most hospices will accept “self-pay.” But if you can’t afford it, most hospice programs offer some form of financial help. You might pay little or nothing, based on your income. Many hospice providers tap into donations and government or private grants.
If you have a medical emergency while under hospice care, you must alert the hospice team before you call 911 or go to the hospital. They’ll tell you what to do and make the necessary arrangements. Going directly to the hospital might jeopardize your hospice benefits, and your insurance might not pay for your hospital stay.