<P> Many hospice patients, though not all, have made decisions against receiving CPR should their heart or breathing stop . If a patient does decide to request CPR, that service may not be provided by the hospice; the family may need to contact Emergency Medical Services to provide CPR . The principle of not extending life and withdrawing diagnostic or curative treatments is often the greatest barrier for patients in accepting hospice care . In some cases, medical professionals may feel conflict in attempting to provide it . </P> <P> Some confusion still exists as to what treatments a patient may receive in hospice care . Hospices may provide treatments that have been traditionally regarded as curative, including radiation therapy or antibiotics, if these are administered to improve quality of life . Determination of appropriate treatment is made by medical personnel on an individual basis . </P> <P> Another aspect of the hospice philosophy is that the care is patient - centered, to treat the whole patient . Many healthcare agencies in the US market themselves as patient - centered; for hospice, this patient - directed care is integral and interwoven throughout the care which is provided . Related Medicare regulations reflect this philosophy . </P> <P> In order to qualify for hospice care, a patient must have certification from two physicians that he or she has less than six months to live if his or her disease runs its natural course; usually the patient's primary physician and the Hospice Medical Director will provide this certification . Patients can and do stay on hospice longer than six months, and as long as the hospice team continues to certify with supporting evidence that the patient is terminal, insurance companies will usually continue to pay for hospice care . </P>

The united states has five models of hospice care. the largest number paid for by medicare is the