Hospice for Kidney Failure and Stopping Dialysis

Updated September 2026. Written and reviewed by the Lily Hospice clinical team.

Yes, hospice can care for someone with kidney failure, whether they never started dialysis, have decided to stop, or have kidney failure alongside another serious illness. Hospice manages itching, nausea, fluid and restlessness at home, supports the decision itself, and can begin before the last dialysis session.

Lily Hospice is a family-owned, Medicare-certified, ACHC-accredited hospice based in Troy, caring for families across Oakland, Macomb and Wayne counties. In Medicare’s most recent Care Compare data, a Lily nurse or social worker visited 71.3% of our patients in their last three days of life, against 48.3% nationally and 63.3% across Michigan, and our early live discharge rate was 3.2% against 7.3% nationally. You can read how those measures work on our hospice quality scores page.

Dialysis keeps many people alive for years. It also asks a lot: three sessions a week in the chair, the drive to and from the center, the washed-out hours afterward, and a diet and fluid limit that shape every meal. At some point, for some people, the treatment starts to cost more than it gives. When that happens, the conversation turns to comfort, and that is where hospice comes in.

Three ways families come to hospice for kidney failure

Choosing not to start dialysis. Some people, often older adults with several other health problems, decide with their nephrologist that dialysis is not right for them. This path is sometimes called conservative kidney management. The National Kidney Foundation explains that people who make this choice are eligible for hospice services, and that the symptoms of kidney failure can be controlled with medication and other supportive measures.

Stopping dialysis after months or years. This is the most common door. The sessions have become the hardest part of the week, the hospital stays keep coming, and the person says, sometimes quietly and sometimes clearly, that they are done. The National Kidney Foundation states plainly that dialysis patients are allowed to make decisions about stopping treatment, and that someone who stops is generally eligible for hospice care.

Kidney failure alongside another terminal illness. Sometimes the kidneys are one part of a bigger picture: advanced heart failure, dementia, cancer, COPD or the aftermath of a stroke. Dialysis may no longer fit the person’s goals, and hospice looks after the whole person, not one organ.

Signs families notice

The nephrologist watches lab results, and the physician makes the hospice eligibility decision. What families see at home is usually simpler:

• Missed or shortened dialysis sessions because he is too exhausted, or because his blood pressure drops too low in the chair
• Repeated hospital stays, often right after treatment
• Weight loss, little interest in food, and meals that feel like a chore
• Confusion or foggy thinking after sessions that takes longer to clear each time
• Saying, in one way or another, that he is tired of the chair
• The nephrologist or dialysis social worker raising “goals of care” or “comfort-focused care”

If several of these sound familiar, it is reasonable to ask about hospice now. Our guide to signs it may be time for hospice covers the broader picture.

What hospice does for someone with kidney failure

Comfort for the symptoms that come with kidney failure. As waste and fluid build up, people tend to feel more tired, nauseated and itchy, according to the National Kidney Foundation. MedlinePlus also lists drowsiness, confusion, muscle twitching and swelling among the symptoms of end-stage kidney disease. Your hospice nurse works with the hospice physician on medications and simple measures for itching, nausea, restlessness and sleep, and adjusts them as things change.

Fluid and breathlessness. Without dialysis, fluid can collect and make breathing harder. The National Kidney Foundation notes that doctors can prescribe medication to help remove fluid and ease breathing. Positioning, oxygen where appropriate and a clear plan for what to do first all help at home.

A loosened diet. After years of counting potassium, phosphorus and every cup of water, many families are surprised to hear that the rules can relax. The goal becomes enjoyment and comfort. The nurse will talk through what makes sense, and a favorite meal is often on the table again.

Support for the decision itself. Nobody is rushed. Our social worker helps families talk it through, and a chaplain is available for any faith or none. Many families carry a quiet fear that stopping dialysis means they are “killing” him. We answer that gently: the kidney disease is what is causing harm, not the choice. Declining a treatment that has become a burden is a recognized right, and the National Kidney Foundation notes that many religions teach that people may stop a treatment that is not helping and is burdensome.

The whole household. Aide visits for bathing and personal care, volunteers for company, respite care when the caregiver needs a break, a nurse by phone at any hour (see who answers at night) and grief support afterward.

What to expect after stopping dialysis

This is the question every family asks. The National Kidney Foundation puts it this way: “People who stop dialysis may live from a few days to several weeks, depending on their remaining kidney function and overall health.” Nobody can promise a timeline.

The usual arc is gradual. The first days often feel fairly ordinary, and some people enjoy a few good visits without the dialysis schedule. As waste builds up, sleep grows longer and appetite fades. Toward the end, most of the day is spent asleep. The National Kidney Foundation notes that death from kidney failure is usually not painful, and that any discomfort can be treated with medication.

Hospice can start before the last session. If the decision to stop has been made, calling us beforehand means the nurse has already met the family, medications are in the house and the plan is written down before anything changes. If he is in the hospital when the decision is made, read about going home on hospice from the hospital.

Dialysis while on hospice

When kidney failure is the terminal diagnosis, hospice care takes the place of dialysis for that illness. The focus shifts to comfort, and the hospice team manages the symptoms dialysis used to control.

The less common case is when the terminal illness is something else, such as cancer, and the person is also on dialysis. Whether dialysis continues in that situation is decided with the hospice physician and the nephrologist before admission, so the family knows the plan from day one. Our page on Medicare hospice coverage in Michigan explains how the benefit works in general.

Kidney care resources in metro Detroit

Many of the families we meet come to us from dialysis centers across the region, including Henry Ford Health’s Greenfield Health Systems, which runs dialysis centers in communities such as Troy, Berkley, Southfield, Novi, Pontiac, Livonia, Dearborn, Taylor, Detroit, Eastpointe, St. Clair Shores and Clinton Township. Your dialysis social worker can be a good partner in planning the move to hospice.

The National Kidney Foundation of Michigan offers education and support for patients and families. Its Detroit branch is at 7800 West Outer Drive, Suite LL02, Detroit, MI 48235, (313) 259-1574, and its statewide number is 800-482-1455.

Common questions

Can Dad have hospice if he never started dialysis?

Yes. The National Kidney Foundation states that people who choose not to start dialysis are eligible for hospice services. The hospice physician confirms eligibility, and the team focuses on keeping him comfortable at home.

How long do people live after stopping dialysis?

The National Kidney Foundation says people who stop dialysis may live from a few days to several weeks, depending on their remaining kidney function and overall health. No one can promise an exact timeline.

Is stopping dialysis the same as suicide?

No. Declining a treatment that has become a burden is a recognized right, and the kidney disease is what causes death. The National Kidney Foundation notes that many religions support this choice. Our chaplain can talk it through with your family.

Can he change his mind?

Yes. The National Kidney Foundation says a person may go back on dialysis if they change their mind, and that this should be discussed with the doctor. Leaving hospice to restart treatment is always allowed.

Can he keep his nephrologist?

Yes. His nephrologist or primary doctor can stay involved and work with our hospice physician and nurses. Read more about keeping your own doctor on hospice.

Will he be in pain, or will it be peaceful?

The National Kidney Foundation notes that death from kidney failure is usually not painful. Hospice treats the discomforts that do come, such as itching, fluid, nausea and restlessness, so that the final days can be as calm as possible.

How fast can hospice start in Oakland, Macomb or Wayne County?

Usually within a day, and often the same day, including weekends. See same-day hospice admission and starting hospice this weekend.

Where we come to you

Lily Hospice cares for families at home and in assisted living and nursing homes across Oakland County, Macomb County and Wayne County, from our office at 2125 Butterfield Dr, Suite 299, in Troy. Weighing where care should happen? Read hospice at home vs. a facility, or see the full list of hospice services. Related guide: hospice for frailty and advanced age, hospice for ALS. Lily is a We Honor Veterans Bronze Level partner.

General education, not medical advice. Whether hospice is appropriate is a decision made with your loved one’s physician, and the physician decides hospice eligibility.

Hospice isn’t giving up. It’s showing up. Call (248) 955-5100. A real person answers, 24 hours a day.