Hospice care in the Netherlands: what to expect

This explainer sets out the three forms of hospice care in the Netherlands, who is eligible, how to apply, and who pays for what.

Three forms, one phase

Hospice care in the Netherlands serves people in the terminale fase (terminal phase) — generally defined as a levensverwachting (life expectancy) of less than three months. The Associatie Hospicezorg Nederland recognises three principal forms.

High-care hospice

A standalone hospice with 24-hour medical and nursing staff on site. There is a hospicearts (hospice physician) or a closely involved huisarts (general practitioner), specialist palliative nurses, and trained volunteers. High-care hospices are designed for patients with complex symptoms — severe pain, breathlessness, agitation, delirium — that need active medical management around the clock.

Patients live in their own room, with personal belongings, and family can visit freely and often stay overnight. The atmosphere is closer to a home than a hospital, but the medical capability is at a hospital level for symptom control.

Bijna-thuis-huis

Literally "almost-at-home house". A small house, often a converted residential building, run primarily by trained volunteers (typically VPTZ-affiliated) under the coordination of a small professional team. Medical care continues to be provided by the patient's own huisarts and by the wijkverpleegkundige (district nurse), as it would be at home. The house provides the physical setting, the round-the-clock presence, and the practical support — meals, washing, sitting with the patient — that the family alone often cannot sustain.

A bijna-thuis-huis is suited to patients whose symptoms can be managed within the standard primary-care setting, but whose home environment cannot accommodate the intensity of the last weeks.

Palliatieve unit in a care institution

Some verpleeghuizen (nursing homes) and hospitals run a dedicated palliatieve unit (palliative care unit) within the larger institution. The patient is admitted to the unit specifically for end-of-life care, with palliative-trained staff and a focus on comfort rather than cure. This route is common when the patient is already a resident of the institution, or when the institution has specialist palliative expertise the patient needs.

A separate, related setting is the eenheid eerstelijnsverblijf palliatief, a primary-care short-stay bed used for patients in the last phase whose situation cannot be managed at home but who do not need hospital admission.

Eligibility

Across the three forms, the central eligibility criterion is the same: the patient is in the terminale fase, with a life expectancy of less than three months, and curative treatment is no longer the goal.

Confirmation usually comes from the treating doctor — the huisarts or the medisch specialist — through a verklaring or referral. The receiving hospice or unit may then conduct its own intake conversation to assess the medical needs, the patient's wishes and the family situation.

Patients of any age, with any underlying condition, can in principle be admitted. Cancer is the most common diagnosis, but neurological diseases (such as ALS), advanced organ failure (heart, lung, liver, kidney) and end-stage dementia are all routine.

How to apply

The path into hospice care in the Netherlands almost always runs through the huisarts.

1. Conversation with the huisarts. Once the doctor agrees that the terminal phase has begun (often using the so-called "surprise question" — would I be surprised if this patient died within twelve months — combined with clinical signs), proactive planning starts.
2. Choice of setting. Patient and family discuss whether the wish is to die at home, in a bijna-thuis-huis, in a high-care hospice, or in a palliatieve unit. Many people change their mind as the illness progresses; the wish is recorded but not fixed.
3. Referral. The huisarts refers to the chosen hospice. For a high-care hospice or a palliatieve unit, an indicatie (formal indication) under the Wet langdurige zorg (Wlz) is usually arranged through the Centrum Indicatiestelling Zorg (CIZ), with a "palliatief" note that allows fast-track processing.
4. Intake. The hospice conducts an intake interview, assesses the room availability, and sets a date.

For families in acute situations, the wijkverpleegkundige and the huisarts together can usually arrange admission within days. Hospices keep beds available specifically for terminal admissions.

Who pays

Funding is split between two systems, depending on the form of care.

• High-care hospices and palliatieve units are usually funded under the Wet langdurige zorg (Wlz — Long-Term Care Act), via the CIZ indication. The patient pays an eigen bijdrage (own contribution), set by the CAK on a sliding scale according to income and assets.
• Medical care in a bijna-thuis-huis continues under the Zorgverzekeringswet (Zvw — basic health insurance), because it is provided by the huisarts and the wijkverpleegkundige as it would be at home. The hospice itself often charges a daily contribution for the "hotel" component (room, meals, laundry), commonly between €40 and €50 per day [unverified for 2026; figures from Associatie Hospicezorg / hospice tariff guidance].
• VPTZ volunteer support in any of these settings is free.
• Some funeral or supplementary insurance policies reimburse the daily contribution; it is worth checking the policy before admission.

The financial structure is one of the topics families are most uncertain about. The hospice's own administration team or the wijkverpleegkundige can usually walk through it in detail before admission.

Waiting times

For terminally ill patients, hospices in the Netherlands are designed to admit quickly — usually within days, sometimes within hours. There is no formal national waiting list. Capacity varies by region: hospices in larger cities are sometimes fully occupied, in which case the huisarts and the wijkverpleegkundige look at neighbouring locations. The Associatie Hospicezorg Nederland publishes a directory of hospices by region.

What the family receives

A hospice admission is not only about the patient. The family receives:

• A predictable place to be present, day or night.
• Trained presence — staff or volunteers — that takes over the night watches, freeing the family to rest.
• Conversations about what to expect in the coming days, including the signs of approaching death.
• Bereavement contact in the weeks after the death (nazorg), through the hospice or through the huisarts.

For mantelzorgers (informal caregivers) who have spent months caring at home, the move to a hospice is often the first chance in a long time to be in the room as a relative rather than as a nurse.

In the app

In the Personal Portal you record your preferred place for the last phase — home, bijna-thuis-huis, high-care hospice, palliatieve unit — and the contact details of your huisarts. The wish is visible to the people who will need to act on it, before it is urgent.

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Sources

1. VPTZ Nederland — volunteers in palliative care, hospice information. https://www.vptz.nl
2. Associatie Hospicezorg Nederland — directory and standards for the three hospice forms. https://www.associatiehospicezorg.nl
3. Pallialine / IKNL — Kwaliteitskader Palliatieve Zorg and clinical guidance. https://palliaweb.nl