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Press Release | Education, Home Health, Hospice, Policy

NAHC Statement on National Public Radio Story on Hospice at Home

January 21, 2020


Media Contact: Thomas Threlkeld
Director of Communications

NAHC Statement on National Public Radio Story on Hospice at Home

The Medicare hospice benefit offers a broad range of services designed to address physical, medical, psychosocial, emotional and spiritual needs of patients and their families during the final six months of life. In increasing numbers terminally ill beneficiaries and their families are availing themselves of hospice services, and — due in large part to hospice’s comprehensive and compassionate approach to care – indications are that use of hospice care increases satisfaction at end of life.

“Patients Want to Die at Home, But Home Hospice Care can be Tough on Families” (NPR, 1/21/2020) presents some compelling concerns raised by family members that illustrate the caregiver burden that can be associated with care of patients at the end of life. An unfortunate reality is that the Medicare hospice benefit, consistent with the rest of the Medicare program, does not cover extended in-home care. While these burdens are real, they must be acknowledged as part of a larger crisis that is confronting our health care system and relates to Medicare’s failure, in statute and policy, to allow for comprehensive care that sufficiently responds to patient needs outside of facility-based care. Under hospice, there are limitations to what services the interdisciplinary team can provide. Volunteers are expressly prohibited from providing hands-on care; even hospice aides may not go outside the scope of providing personal care and homemaker duties. However, all hospices, as a matter of course, are required to assess a caregiver’s ability to provide care to a patient, and to teach them the skills that they may need – such as administering medications or suppositories in cases where a patient can no longer take medications by mouth. Social workers and other members of the team are involved on a regular basis in helping to identify resources in the community a patient or family can use to secure care that is not covered by Medicare.

Addressing care needs in the final days of life is a particularly important part of hospice care, and hospices make a concerted effort to have staff available to the patient and family during this time. In fact, the provision of visits at the end of life is one of several measures that can be viewed on the Hospice Compare website and can help patients and their family members make better informed choices about hospice care.

The National Association for Home Care & Hospice (NAHC) strongly supports expanding patient and family supports, and as part of its plan for reform of the process under which hospices are surveyed for compliance with health and safety requirements, NAHC urges Congress to establish a hospice-focused ombudsman program to address and respond to patient and family concerns.


About National Association for Home Care & Hospice (NAHC)

The National Association for Home Care & Hospice (NAHC) is the voice of home care and hospice. NAHC represents the nation’s 33,000 home care and hospice providers, along with the more than two million nurses, therapists, and aides they employ. These caregivers provide vital services to Americans who are aged, disabled, and ill. Some 12 million patients depend on home care and hospice providers, who depend on NAHC for the best in advocacy, education, and information. NAHC is a nonprofit organization that helps its members maintain the highest standards of care. To learn more, visit