Market note: This article draws on sources from both Korea and the United States. Each piece of information is marked in the text with 🇰🇷 Korea or 🇺🇸 U.S. to indicate which country it applies to.
Palliative care and hospice care are often thought of as something you turn to "when there is nothing more that can be done." But the essence of this care is not giving up — it is a transition. It is a shift in goals, from curing disease to placing the quality of life and comfort of the patient at the very center. Reducing pain, easing breathing, and supporting psychological and spiritual well-being: this process is care that is just as necessary for the family members keeping vigil as it is for the patient themselves.
🇰🇷 Korea 완화의료 (palliative medicine) in Korea is provided by a team of physicians, nurses, and social workers who deliver holistic services encompassing physical, psychosocial, and spiritual care. Four types of service are currently in operation: inpatient hospice, home-based hospice, consultative hospice, and a pediatric and adolescent palliative care pilot program. As of August 2024, 104 inpatient hospice hospitals, 40 home-based hospice institutions, and 42 consultative hospice institutions are in operation. The hospice utilization rate stands at 24.2% as of 2022 — still relatively low — but has been growing at an average annual rate of 4.6% from 2016 through 2024. Through the 제2차 호스피스·연명의료 종합계획 (Second Comprehensive Plan for Hospice and Life-Sustaining Treatment, 2024–2028), the government has announced plans to expand the number of specialized hospice institutions to 360 by 2028 and to raise the utilization rate among eligible patients to 50%.
🇺🇸 U.S. In the United States, 53.1% of Medicare decedents received hospice care at the end of life as of 2024. This marks the first time in history that the figure has exceeded a majority, with a total of 1,910,000 Medicare beneficiaries enrolled in hospice for one or more days. The Medicare Part A hospice benefit applies when both the attending physician and the hospice medical team determine that the patient has a life expectancy of 6 months or less, and when the patient chooses comfort-focused rather than curative care. The benefit includes nursing, medications, medical equipment, and emotional support, and also provides bereavement support services for the family for a minimum of 13 months after the patient's death.
Another preparation that family caregivers must be aware of is advance directive documents. 🇰🇷 Korea The 사전연명의료의향서 (advance statement on life-sustaining treatment) can be completed in advance by any adult aged 19 or older, even if they are not a terminal patient, and can be changed or revoked at any time. As of August 2025, the cumulative number of registered documents has exceeded 3,000,000, and the number of registered institutions had expanded to 819 as of the end of 2025. Starting in 2026, steps are being taken to allow the document to be completed and registered online without visiting an institution in person. 🇺🇸 U.S. In the United States, patients record their treatment wishes in advance through an Advance Directive or a POLST (Physician Orders for Life-Sustaining Treatment). While these documents are not a required condition for receiving the Medicare hospice benefit, they are the most reliable basis for family members to convey the patient's wishes in a confusing situation.
In the reality of hospice care, the greatest difficulty families feel is the guilt of asking themselves, "Is it okay for me to make this decision?" This is because stopping treatment can feel like giving up on someone you love. The experiences of families who have chosen palliative care, however, tell a different story. There are times when a parent whose pain has lessened and whose breathing has eased is finally able to make eye contact with their family and open up about things they had wanted to say. This decision may not be giving up — it may be the choice that allows the time that remains to be spent in the most humane way possible.
Caring for the caregiver is also especially important during this period. 🇺🇸 U.S. The Medicare hospice benefit includes respite care, which allows family caregivers to take a temporary break; the patient can be placed in an inpatient facility for up to 5 consecutive days per benefit period. 🇰🇷 Korea With home-based 호스피스 (hospice), a physician, nurse, and social worker visit the home to support both the patient and the family together. When it becomes difficult to continue care at home, the first step is to be honest with the care team about the situation. A caregiver who collapses from exhaustion is of no help to the patient either.
The final chapter is something every family is experiencing for the first time. What choice is right, how much longer to hold on, whether these feelings are normal — these are questions too heavy for anyone to carry alone. Sierra Care Advisor stands alongside families who are approaching or in the middle of this period, helping to identify available systems and resources and thinking through the next step together.
Sources: 질병관리청 국가건강정보포털 (Korea Disease Control and Prevention Agency National Health Information Portal) (Hospice Palliative Care, 2024); 보건복지부 정책뉴스 (Ministry of Health and Welfare Policy News) (제2차 호스피스·연명의료 종합계획 2024–2028 / Second Comprehensive Plan for Hospice and Life-Sustaining Treatment 2024–2028); 암모니터링포털·국립암센터 중앙호스피스센터 (Cancer Monitoring Portal and National Cancer Center Central Hospice Center) (Hospice utilization rate trends 2016–2024); 네이트뉴스/국가생명윤리정책원 (Nate News / Korea National Institute for Bioethics Policy) (연명의료결정제도 연보 2024 / Annual Report on the Life-Sustaining Treatment Decision System 2024; report on 사전연명의료의향서 cumulative 3,000,000 registrations, 2025.9); 의약일보 (Pharmacy News Daily) (Online registration initiative for 사전연명의료의향서, 2026.6); National Alliance for Care at Home — 2025 Facts and Figures: Hospice Care Delivery in the United States (2024 data); Medicare.gov — Medicare & Hospice Benefits guidance; Connecticut Hospice (Medicare Hospice Benefit family guide, 2025).
Note: This article was compiled by AI from the sources cited above. We strive for accuracy, but for decisions about your specific situation, please confirm the latest guidance from a professional or the relevant agency.