If you or a loved one is living with advanced, life-limiting illness and want to know if or when hospice is an option, you should discuss the idea with the attending physician or another clinician providing care. A physician must determine whether someone meets the medical eligibility requirements for hospice services, but there is no rule against the patient or a loved one bringing up the subject. Some people have even mentioned hospice right after receiving a diagnosis so that their physician knows they would be interested in learning more about hospice care at the appropriate time.

It is important to know that anyone - patient, loved ones or others involved in providing care - can make the first contact with a hospice to help determine if the patient meets medical eligibility requirements.
 

Starting the process

When it is time to consider hospice as an option, the next step is to request that the hospice send a representative to meet with the patient and family/caregiver. This request may be made by the individual's physician, the staff at an assisted living community, nursing home or hospital, or you can initiate a call to a hospice provider yourself. There should be no charge for this visit, no obligation to choose that provider, and no pressure to make a choice immediately.
 

What to expect during the introductory visit

When the hospice’s representative meets with you, he/she can:
 

1. Discuss the hospice’s services, including Medicare and insurance options, and answer your questions.
2. Complete a comprehensive assessment of the patient’s condition.
3. Complete the admission into the hospice’s program.

Some hospices divide these tasks into separate visits.

The admission is complete when required paperwork is signed by the patient or someone legally authorized to make such decisions on their behalf.
 

What to expect after admission

Individual members of the hospice care team will meet with the patient and loved ones to discuss goals, symptoms, services and expectations. With that, a plan of care is developed to meet the patient’s unique needs. The care plan is the hospice team’s “playbook” and specifies such things as:
 

• how often the doctor, nurse, medical social worker, home health aide, chaplain and adult volunteer visit the patient;
• other services needed;
• medications;
• and medical supplies and equipment.

The hospice team reviews each patient’s care plan regularly and updates it as necessary to address changes in the patient’s needs.

Read how hospice is a family affair here. 
 

What not to expect

Hospices offer access to a physician or nurse on any day at any time in an emergency, but it is important to understand that hospice is not 24-hour care at the bedside (except in very specific circumstances, and even then, only for a very brief period).

Also, hospice care that is provided in hospitals, nursing homes and other residential facilities does not include room and board and is not a substitute for long-term care or adult day care.