Three Myths About Hospice That Keep Families in the Dark

The American Association of Retired Persons (AARP) just released their 2025 report on Caregiving in the United States. It is an impactful study, full of statistics and trends on the state of caregiving that are sometimes encouraging, and oftentimes deeply discouraging. And yet reading through the report, I noticed one significant omission: those who specifically are caring for family members in the twilight of their lives. Every year, nearly 2 million older adults receive hospice services, and that number is even higher when we consider palliative care services more broadly. In other words, every year, millions of caregivers and care receivers are beset with questions about what it means to live well with advanced illness—and what it means to consider what a “good death” might look like.

Questions of death and dying are universally challenging. While such challenges are inescapably part of our humanity, we excel at keeping them at arms-length, and for good reason. We all hope to flourish in our lives for as long as such flourishing can be sustained. This hope keeps us going, and provides us with perseverance through adversity. Yet it has a downside: when facing life-limiting illnesses, we often lack the resources we need to navigate very difficult terrain.

Some fault lies at the feet of our healthcare system. Research has shown that while most care receivers and their care partners want to know more about hospice and palliative care, a full two-thirds nonetheless report ongoing neglect of these topics from medical providers. Less than half of those eligible for hospice services receive them. And only about 10% of all people using Medicare have even had an advance care planning discussion with their providers. In short, healthcare tends to compound the problem. Medicine, too, excels at keeping death and dying at a distance.

Where there is a void of clear communication and resources, misinformation proliferates. In my work, few patients and their caregivers feel they understand hospice. Fewer still understand what a “palliative care approach” to care and caregiving might mean. In what follows, I list three common myths about the twilight of life, and offer three responses to set the record straight.

Myth #1: Hospice means “giving up” to death.

Response: There is significant research, especially among those with advanced cancer diagnoses, that those on hospice actually live longer than those who do not elect for hospice. Why is this? The key to understanding hospice is that it entails not “giving up,” but rather an embrace of a different way of approaching care. In the context of advanced illness, our bodies can only take so much curative medicine. Sometimes, our default to continue high intensity interventions and hospitalizations runs counter to our goals for quality of life, and even longevity. Hospice is just about shifting that perspective. Hospice clinicians do a lot for their patients, they just focus on comfort and what matters in the big picture.

Myth #2: “Palliative Care” is just a doorway to hospice.

Response: An entire specialty of medicine and nursing has blossomed in the last few decades focused on palliative care. “Palliative” comes from the Latin root “to cover,” associated with alleviating suffering. Importantly, palliative care and curative care are not mutually exclusive. A person fighting advanced cancer and receiving chemotherapy can elect for palliative care simultaneously as a way of accessing clinicians’ expertise on relieving symptoms that curative medicine might overlook. One can receive palliative care for years, even decades, without hospice. While it has in common with hospice a focus on quality of life, it is not synonymous with it.

Myth #3: Treating disease is always better than managing symptoms.

Response: One of modern medicine’s greatest strengths is also its greatest weakness: its focus on individual treatments for individual diseases. But the whole is not the sum of its parts. For those living with multiple medical conditions and symptoms, sometimes this weakness can lead to avoidable suffering, and even early death. Focusing care globally on symptoms—how someone feels every day—can have profoundly positive effects. This attention to “symptom management” is one of palliative care’s and hospice medicine’s well-honed skills.