Saying yes to hospice at home often comes with a quiet fear: what happens now, and can we really do this? Knowing who will come through the door, and when, takes away much of that fear. Here is what the first days and weeks usually look like.
The first visits
The admission visit
A hospice nurse or admissions staff member comes to the home to explain the benefit and answer questions. Your loved one, or their representative, signs a hospice election statement, which is required before any hospice services begin. The nurse reviews medications, asks about symptoms and wishes, and looks at what equipment will help, such as a hospital bed, wheelchair, commode or oxygen.
The first two days and the first five
Federal rules set the pace. A hospice registered nurse must complete an initial assessment within 48 hours after hospice is elected, sooner if the doctor or family asks. The full hospice team must complete a comprehensive assessment within five days. From those assessments comes a written plan of care: which visits, how often, and what to do when symptoms flare.
Who is on the team
- Hospice doctor, working with your loved one’s regular doctor if they have one.
- Nurse or nurse practitioner, usually the case manager and the person you will see most.
- Hospice aide, who helps with bathing, grooming and personal care.
- Social worker, for paperwork, planning, family worries and community resources.
- Counselors and chaplains, for spiritual and emotional support, whatever your beliefs.
- Volunteers, who can sit with your loved one so you can rest or run errands.
- Therapists, pharmacists and dietary counselors as needed.
The four levels of hospice care
| Level | What it means | When it is used |
|---|---|---|
| Routine home care | Regular scheduled visits wherever your loved one lives | Most days, for most patients |
| Continuous home care | Mostly nursing care provided at home for extended hours, at least 8 hours in a day | Brief periods of crisis, to keep someone home instead of in a hospital |
| General inpatient care | Short stay in an inpatient hospice unit, hospital or nursing facility | Pain or symptoms that cannot be managed at home |
| Inpatient respite care | Short stay in an approved facility, up to 5 days at a time | When the family caregiver needs rest |
Your loved one can move between levels as needs change. The hospice decides with you which level fits.
Help day and night
A hospice nurse and doctor are on call 24 hours a day, 7 days a week. Put that number on the refrigerator and in every family member’s phone. If something changes, such as new pain, trouble breathing, a fall or confusion, call hospice before 911. They can talk you through it, send a nurse, or arrange care that keeps your loved one covered. Going to the emergency room without the hospice arranging it can lead to bills Medicare will not pay.
What the family does
Hospice visits; it does not move in. Between visits, family and friends usually:
- Provide everyday care: meals, help to the bathroom, turning and repositioning, companionship.
- Give medications the way the nurse teaches, and keep a simple log of doses and symptoms.
- Call the hospice line when something changes.
- Let the team know what is getting hard. That is how they adjust visits, add volunteer hours, or plan respite.
If no one can be home most of the time, say so early. The social worker can help you think about paid help or a move to a setting where hospice can continue, such as assisted living or a nursing home.
Your rights along the way
- You can change hospice providers once in each benefit period.
- Your loved one can stop hospice at any time and return to treatment, and come back to hospice later if eligible.
- Original Medicare still covers care for health problems unrelated to the terminal illness.
- If the hospice says your loved one no longer qualifies, you should receive written notice and can ask for a fast appeal.
After a death
When death comes at home, call the hospice first, not 911. The nurse will come, confirm the death, help with the next calls, and give you time. Hospice support does not end with the death; grief support for the family is part of the benefit.
What to do next
- Ask the hospice how often each team member will visit in the first two weeks.
- Make a list of who in the family can cover which hours.
- Ask what to do, step by step, in the first hour of a crisis.
- Not sure hospice is the right fit? Compare hospice and home health, or browse hospice providers.
Common questions
How often does a hospice nurse visit at home?
It depends on the care plan. Visits are set by the team based on your loved one’s needs and increase as needs grow. Ask for the planned schedule in writing.
Does hospice provide 24-hour care at home?
Not routinely. A nurse and doctor are on call around the clock, and during a crisis the hospice may provide continuous care at home for at least 8 hours a day for a short time. Day-to-day care between visits comes from family or paid caregivers.
What equipment does hospice provide?
Medicare-covered hospice includes medical equipment and supplies related to the terminal illness, such as a hospital bed, wheelchair or oxygen, as the care plan calls for.
Can my loved one go to the hospital while on hospice?
Yes, when the hospice arranges it, such as general inpatient care for symptoms that cannot be managed at home. Call hospice first so the care stays covered.
Bringing a loved one home on hospice? If you want someone to talk it through with, we are here, free. Tell us about your loved one or call 801-859-7000.
Sources
- Medicare Hospice Benefits booklet (March 2026)
- Medicare.gov: Hospice care
- 42 CFR 418.54: Initial and comprehensive assessment
- 42 CFR 418.302: Hospice levels of care
- American Cancer Society: Levels of hospice care
This guide is general information, not medical, legal or financial advice. Coverage rules change; confirm details with the program or your plan.
