Hospice vs Nursing Home

Hospice vs Nursing HomeHospice vs. Nursing Home

Making the right care decisions as a loved one moves toward their final days isn’t cut and dry. You want to make their remaining time as comfortable as possible, and will likely need to enlist the aid of some professional help in order to do so.

Medicare will help cover some of the costs you incur in hiring the help you need, but it puts many families in the position of making a difficult decision: should you choose hospice care or a nursing home?

Medicare’s reimbursement guidelines will only cover one or the other, so how can you decide which is the best choice for your loved one?

What is Hospice Care?

Hospice care is professional care provided to people believed to be within a few months of death. Where most health care is focused on helping people to recover, hospice shifts the focus to making life as comfortable as possible for the time remaining.

Hospice care can take place within an institution, or you can hire someone to come into the home to provide it. Since most seniors prefer to die in their own homes, if given the chance to choose, hospice care provided in the home is often the preferred end-of-life option for seniors themselves.

What is a Nursing Home?

Nursing homes provide a place to live and 24/7 care from licensed health care professionals. Unlike hospice, nursing homes aren’t designed to ease the suffering of a person about to die, they aim to help the person recover, and if at all possible, even move back out once they’re well enough.

Nursing homes take care of everything a senior needs for the time they’re in there (other than familial love and attention, of course, that’s still the job of the family). Meals, cleaning, and medical care are all part of the deal.

For seniors that no longer have the skills or capacity to take care of themselves when it comes to basic day-to-day tasks like getting dressed or remembering to take their meds, nursing homes step in to fill the gap, while also providing medical staff that can immediately respond to any serious emergencies or health problems that may arise.

In most cases, family members simply aren’t trained in what’s involved in taking care of loved ones with particular illnesses or general failing health. The staff at nursing homes are. While staying at home often seems the most comfortable option for seniors, nursing homes often end up being the most practical one.

What Are the Differences?

The main difference between the two options is the main goal behind them:

  • Hospice aims to make the process of dying more comfortable for those who have already accepted (and whose families have accepted) that it’s coming.
  • A nursing home provides full-time trained healthcare staff to seniors who need a greater level of care than families can provide, and works toward the possibility of helping them get well enough to return home eventually.

The options aren’t mutually exclusive. It is possible to hire hospice to provide their services to a senior living in a nursing home. But while both are covered by Medicare, they’re rarely covered at the same time. You can usually only make use of both services if you can cover the cost of nursing home care yourself.

Which One is Right For Your Loved One?

The biggest challenge that comes with deciding when to choose hospice or nursing home care is knowing when the time has come for hospice care. The generally accepted standard is that hospice care is for people that have six months or less to live. Yet while doctors can offer their best prognosis, no one really knows when someone’s going to die. It’s not an exact science.

That often makes the question a difficult one for families. It’s important to be aware that choosing to accept hospice care doesn’t mean giving up or rushing the process of death. The choice can come with unnecessary guilt if you approach it that way. It’s simply a different type of care that supplies what your loved one needs when they’ve reached the point when they’re ready.

Talk to your loved one about what they want. If they have dementia, you may have to make some of these decisions for them, but still take the time to discuss it with them and hear what they have to say. Then talk to their doctor together. See what the doctor feels the prognosis is and hear what they recommend for your loved one.

The simple answer is that if your loved one has accepted that death is near and they’re prepared for it – and their doctor agrees – then hospice is the better choice. If it looks like there’s a good chance they can kick this and live for years to come, then a nursing home makes the most sense.

But these things aren’t simple. So you also need to consider:

  • How the cost of the options compare and what you can afford beyond what Medicare will cover
  • How well prepared your family is to take care of your loved one if they choose to live out their remaining months at home with the help of hospice, and if you can afford in-home healthcare to help lighten the load.
  • The quality of the nursing homes in your area and whether any of them feel like a good fit for your loved one and their needs.
  • And finally, what your loved one would most want if the decision was entirely up to them. Unfortunately it’s not, because you have practical concerns to take into consideration as well as their wishes, but their wishes should absolutely be part of the conversation.

Ultimately, only you and your family can decide what the right choice is for you. Both options have their benefits and they’re both the right choice in different situations. Weigh all the factors and try to do what’s best for your loved one.

We all know intellectually that dying is something we’ll all experience at some point. That knowledge doesn’t make facing it any easier, but the right help at the time you need it most does.

Kristen Hicks is an Austin-based copywriter and lifelong student with an ongoing curiousity to learn and explore new things. She turns that interest to researching and exploring subjects helpful to seniors and their families for SeniorAdvisor.com.


  1. Jennifer Bembry October 26, 2017 Reply

    This is a really helpful article and so good for families to read. I wanted to add that home hospice care is an option for those who do have the resources available for that option. Home hospice provides the comfort of home and the care of a private duty nurse.

  2. Erica J July 6, 2019 Reply

    Will insightful, this article is full of inaccuracies. As a long time employee of a hospice company, please note- one CAN be in a nursing home and receive hospice services. The hospice benefit is a federal benefit through Medicare. One can not be in rehab and receive hospice benefits- as that is seeking aggressive therapy. At both home and a facility- hospice is “supplemental ” not “custodial”. We assist in ensuring the patient dies on their terms with symptoms managed. Hospice ABSOLUTELY visits patients in nursing homes and homes to assist that our patients and their families receive the care that they desire. It is not a one or the other option. Author needs to be fact checked.

  3. Dennis Sanchez August 19, 2019 Reply

    I never knew that the difference between standard healthcare and hospice is that the latter is focused on making life as comfortable as possible for someone that will be passing away soon. This is something that is very emotional and very difficult for anyone to experience. Using hospice shouldn’t be seen as giving up on people.

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