Physicians may be unaware of hospice benefits. Physicians may not wish to transfer control of patient care to hospice providers. Current hospice benefits mandate that the patient have less than six months to live. It is difficult to establish an accurate prognosis with certain patients. As a result, many who would have benefited from services earlier in the course of terminal care are admitted within days of death.
Many cancer patients overestimate their prognoses.
Few inpatient hospices exist. Some terminally ill patients do not have family members available to support them in this way. Others, with severe physical dysfunction, may not be served best in the home setting, given the resources that are generally available in that setting. Hospice care in the U.S. is less accessible in rural and inner-city areas than in other urban and suburban areas. Hospice principles of communication may be alien and threatening to people of certain cultures.