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 (AHzN) 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. Planning often starts before the terminal phase: doctors use the so-called "surprise question" — would I be surprised if this patient died within twelve months? — to recognise the palliative phase. Once the doctor agrees that the terminal phase has begun (a life expectancy of less than three months), the choice of setting becomes concrete.
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 or medisch specialist refers to the chosen hospice, usually with a statement that the patient is in the terminal phase. For most people no separate indicatie (formal indication) under the Wet langdurige zorg (Wlz) is needed, because hospice care is paid from basic health insurance.
4. Intake. The hospice conducts an intake interview, assesses the room availability, and sets a date.

Admission can be quick, but beds are limited (about 855 in 153 hospices), and in some regions there is no room when you need it. Ask early and consider nearby alternatives.

Who pays

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

• Care in a hospice or palliatieve unit is usually paid from the Zorgverzekeringswet (Zvw — basic health insurance); your eigen risico (annual deductible) applies. Only if you already have an indication under the Wet langdurige zorg (Wlz — Long-Term Care Act), for example because you live in a nursing home, is the care paid through the zorgkantoor, with a monthly eigen bijdrage (own contribution) set by the CAK.
• Medical care in a bijna-thuis-huis continues under the Zvw, because it is provided by the huisarts and the wijkverpleegkundige as it would be at home.
• Many hospices charge a daily contribution for the "hotel" component (room, meals, laundry), commonly between €30 and €50 per day. Rates differ per hospice, so ask for the current amount.
• VPTZ volunteer support in any of these settings is free.
• Some supplementary health insurance policies (aanvullende zorgverzekering) 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

Hospices try to admit terminally ill patients quickly, but capacity is limited: in 2024 there were about 855 beds in 153 hospices (AHzN), and demand is higher. In some regions there is no room when you need it, in which case the huisarts and the wijkverpleegkundige look at neighbouring locations. Ask early, and consider nearby alternatives. AHzN lists its member 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, in My Farewell Wishes, you can note where you would want to be at the end — at home, in a hospice, in a hospital or somewhere else — and who you would want beside you. In the Guide for Your Family you can add your huisarts to the people to contact. You fill it in at your own pace, and what you record becomes part of your Zorgmap, a PDF you print or hand to the people who will need to act on it, before it is urgent.

Request access →

Closed beta — access by invitation.

Sources

1. VPTZ Nederland — volunteers in palliative care, hospice information. https://www.vptz.nl
2. AHzN (Associatie Hospicezorg Nederland) — member hospices, standards and the Registratierapportage 2024 (beds and hospices). https://www.ahzn.nl
3. Palliaweb (PZNL, Palliatieve Zorg Nederland) — Kwaliteitskader Palliatieve Zorg and clinical guidance. https://palliaweb.nl
4. kanker.nl — hospice care and costs. https://www.kanker.nl
5. Zorgwijzer — reimbursement of hospice care. https://www.zorgwijzer.nl/vergoeding/hospice