Choose the Best Hospice in Your Area
And here’s how to do it.
If you’ve decided to stop curative care, and your prognosis is six months or less, please call hospice sooner rather than later. Hospice organizations, often overworked and understaffed, can best provide comfort when they’re on board before the pain or discomfort becomes unmanageable.
They get to know you and your medical history, try different ways to manage symptoms, and adjust as needed. This early approach also allows you more time to switch to another hospice if the one you’ve picked isn’t a good fit.
Beginning The Search
I encourage my clients to use online resources and local directories to research what’s available in their area. We also ask for recommendations from healthcare professionals, friends, or family members.
Sometimes we ask the different hospice groups directly for references.
Two important questions to consider: Do we want a for-profit or a non-profit? Religiously based or secular? This is the time to decide.
We also ensure that the hospices we’re looking at are certified by the relevant health authorities. In the United States, for example, Medicare-certified hospices meet specific quality standards.
I usually inquire about the qualifications and training of the hospice staff. The teams should include medical professionals, social workers, spiritual counselors or chaplains, and trained volunteers.
If you’re working with a death doula, ask about how they include doulas or family/friends in a unified care team.
Visit the Hospice
If the organization has a hospice house or a floor/care center at a local hospital, we schedule a time to visit in person. This gives us a firsthand look at the facilities, staff, and overall atmosphere.
It's an opportunity to ask questions and address any concerns we may have.
Then, my clients and I assess the communication style of the hospice staff. They should be transparent, empathetic, and responsive to questions and concerns. Good communication is crucial during this challenging time.
Choose the best method of communication for your needs. This might be texting, emails, or phone calls.
Availability of Services
Understand the range of services offered by the hospice. A good organization should provide comprehensive care, including medical, emotional, spiritual, and bereavement support.
They should also provide medical equipment, such as hospital beds, at no extra cost.
We ensure that the hospice provides the necessary services when needed. Rarely does a hospice offer 24/7 care. Most have specific hours of operation. Therefore, be prepared to hire home care aides or death doulas if round-the-clock care is needed.
Policies and Procedures
We review the hospice's policies and procedures before making a decision. This includes understanding how they handle emergencies, what support is available to family members, and how they manage the transition to hospice care.
Many clients want to die consciously. Some prefer palliative sedation. Most are somewhere in between.
If palliative sedation is something my clients want, we choose a hospice that offers it. I ask the medical team if they have rules around medication. For example, do they have policies that would deny someone the right to increase the dosage if needed?
Cost and Insurance
We clarify the costs associated with hospice care and whether insurance covers these expenses. Discussing financial arrangements upfront helps to avoid any surprises later.
Community Involvement
Sometimes, we consider hospices that are actively involved in the community. For some of my clients, the hospice group must have positive relationships with local healthcare providers, end-of-life doulas, hospitals, and other support services.
Does Medicare Cover Hospice?
Yes, as of right now, Medicare Part A covers hospice if eligible individuals meet certain conditions. Most of the time, those conditions include the diagnosis of a terminal illness and/or a life expectancy of six months or less.
A hospice medical director and the individual's attending physician will certify the condition and prognosis. Don’t wait until the last minute! Look into hospice immediately after stopping curative care.
Studies show you’ll live longer.
Medicare's hospice benefit covers a range of services, including medical care, nursing care, counseling, prescription drugs for symptom control and pain relief, durable medical equipment, and support services for the individual receiving hospice care and their family.
Death doulas and other service providers are private pay and not covered by Medicare. (This is why I offer a sliding scale for those with limited funds.)
Depending on where you live, hospice care is provided in various settings. This includes the individual's home, a hospice facility, a nursing home, or an assisted living facility.
Contact the Medicare helpline or visit the official Medicare website for the most up-to-date and accurate information regarding coverage.
Specific Questions to Ask
Choosing a hospice provider is an important decision, and asking the right questions helps you make an informed choice. Here are the exact questions my clients and I ask potential hospice providers:
Are you accredited by a recognized accrediting body, and are you certified by Medicare?
What are the qualifications and training of the hospice staff, including doctors, nurses, social workers, and volunteers?
What services does the hospice provide?
Do you offer palliative sedation?
If I'm uncomfortable, do you allow an increase in medication?
Is the hospice available 24/7 for emergencies, and how do they handle after-hours support?
How does the hospice communicate with families, and what support is available to both the patient and their loved ones?
Will you provide information about your policies and procedures?
How is the care plan developed, and how often is it reviewed and updated?
What bereavement support services are offered to families after the patient's passing?
May I visit your facility and meet the staff?
What are the costs associated with hospice care, and how does billing work?
How is the hospice involved in the local community, and do you have relationships with other healthcare providers?
Can you provide references or share testimonials from other families who have used your services?
How does the hospice handle crises or unexpected changes in the patient's condition?
How does the hospice ensure care is tailored to the individual's needs and preferences?
Asking these questions and discussing your specific concerns with potential hospice providers helps you make an informed decision that aligns with your needs.
Choosing Hospice Now
The research is clear: choosing hospice early offers real, tangible benefits.
Comprehensive support to manage symptoms, control pain, and maintain comfort.
A more holistic approach to care.
Time to develop an individualized care plan.
Time to build a relationship with the hospice care team that provides a sense of trust.
Education about the terminal illness, treatment options, and what to expect, allowing for informed decision-making.
Helps to avoid unnecessary hospital stays.
You remain in a more comfortable environment.
More time for important end-of-life discussions, including expressing preferences for care, discussing advance care planning, and addressing spiritual and emotional concerns.
Allows for families to actively participate in the caregiving process and receive guidance on how to support their loved ones.
Time to switch organizations if the one you’re in isn’t working.
While I’ve never had a client say they called hospice too soon, I’ve had several who said they should have called sooner.
Choosing hospice is deeply personal and depends on individual circumstances. But considering hospice care earlier in the trajectory of a terminal illness helps create a more supportive and comfortable life and death.