Physicians, patients and families should consider hospice services when medical treatments can no longer cure their disease and/or the symptom burden outweighs the benefits of treatment. Hospice services can begin when a doctor decides the patient’s life expectancy is six months or less. Hospice services are more efficacious if provided for months rather than days or hours. There is general dissatisfaction among families who believe their loved ones were referred to hospice too late. They reported more unmet needs, greater concerns, and lower satisfaction with the overall quality of care.