How to Access Hospice Care

Many individuals and families could benefit from hospice care but are unaware of how to access hospice services. Some are afraid to discuss it, some wait for a physician to suggest it, and some don’t know that they can initiate hospice care on their own, as long as eligibility standards are met. At Hospice Foundation of America, we hear from many individuals and families who tell us they wish they had known about hospice earlier.

It’s important to remember that hospice does not extend or shorten life expectancy, but seeks to improve the quality of time that is left. If you can, it’s important to let healthcare providers know early on in a life-limiting illness if you or your loved one would want hospice care when and if it makes sense.
If you think hospice may be the right choice at this time, here’s how to proceed:
Step 1 - Start the Conversation

Discuss hospice with your loved one if possible. Next, discuss the option of hospice with a healthcare provider and ask whether you or your loved one is hospice-eligible. Generally speaking, it’s time to consider hospice when you or your loved one has a serious, incurable illness or condition that no longer responds to treatment aimed at cure. It may also be time if you, your friend or your family member with a life-limiting illness refuses or discontinues treatment because treatment is physically incapacitating, intolerably debilitating, or ineffective. In cases of Alzheimer’s disease or dementia, hospice care is appropriate at the end stage of the disease process.
Step 2 - Get Recommendations

If your physician agrees that hospice medical eligibility requirements have been met for the illness or condition and hospice care would be beneficial, ask the physician to recommend a hospice provider or several hospices with whom you can meet to discuss care. You may also want to ask family, friends or anyone whose opinion you respect about their experience with a local hospice provider. If your physician does not agree that hospice is the right choice at this time (or ever), you can contact a local hospice directly for help with a referral.

Click here for a listing of state hospice organizations that can answer questions about services and options available in your state.
Step 3 - Visit and Assess Providers

Request a no-cost, no-obligation visit by the hospice provider(s) you are considering. The hospice(s) will send a clinician to the home, hospital, assisted living facility or nursing home to make a clinical assessment and to answer questions. Usually, staff at a hospital, physician's office, assisted living facility or nursing home can help set up the appointment with a hospice representative.

Click here for suggestions of what to ask or how to choose a provider.
Step 4 - Proceed with Admission

During the assessment visit with the hospice representative, the individual needing care or someone legally authorized to act on their behalf can choose to proceed with admission into the hospice program.
Step 5 - Receive Services

Hospice care and services can begin as soon as the patient’s consent form and other required documents are signed. At that point, any necessary medical equipment will be discussed and arrangements will be made to have items such as a hospital bed, oxygen, and other supplies delivered. The hospice may also make arrangements to transport the individual from the hospital to home or another residential setting. An initial meeting at the place of residence will be arranged where a comprehensive care plan is developed by the hospice team. Such a meeting may include discussion of caregiving responsibilities by family and friends, pain control approaches if necessary, and any dietary concerns.