The four levels of hospice defined by Medicare are routine home care, continuous home care, general inpatient care, and respite care. A hospice patient may experience all four or only one, depending on their needs and wishes.

• Cancer (29.6% – 336,307) Just as expected, cancer is still the number one diagnosis for hospice patients.
• Heart Disease (17.4% – 196,971)
• Dementia (15.6% – 177,490)
• Respiratory Illnesses (11% – 124,407)
• Stroke (9.5% – 107,439)

In the event that death is very near the skin of their knees, feet, and hands may become purplish, pale, grey, and blotchy. These changes usually herald death within hours to days. When death does occur, the skin turns to a waxen pallor as the blood settles.

1. Frequent hospitalizations or trips to the ER.
2. Frequent or reoccurring infections.
3. Reduced desire to eat, leading to significant weight loss and changes in body composition.
4. Rapid decline in health over past six months, even with aggressive medical treatments.
5. Uncontrolled pain, shortness of breath, nausea or vomiting
6. Decreasing alertness, withdrawal, increased sleeping or mental confusion
7. Inability to perform tasks of daily living, such as eating, walking, using the bathroom, personal cleaning or getting dressed
8. Decision to focus on quality of life, instead of aggressive treatments.