What Is the Highest Level of Assisted Living Before Hospice?

The highest level of assisted living before hospice includes help with most activities of daily living. Residents at this level receive staff support for most of the day, although they don’t typically require overnight care. If a person has a terminal diagnosis and enters hospice, they receive these services at their assisted living residence.

Assisted living residents have access to four levels of hospice care, reflecting the progressive nature of terminal illnesses and the dying process. Medicare-certified hospice providers are required to offer these levels of care:

• In the early stages, hospice care often involves periodic nurse visits and assistance with personal care, such as bathing.
• Routine care is provided when an individual’s symptoms, like nausea and pain, are managed and under control.
• Continuous care is available for those requiring intensive monitoring, entailing at least eight hours of skilled nursing care within a 24-hour period. This level is typically necessary in the later stages of hospice.
• Respite care offers temporary relief for family caregivers, allowing the patient to be cared for in an assisted living facility or another setting temporarily.
• General inpatient care is provided in a hospital setting for symptom management that cannot be adequately addressed at home or in an assisted living facility.

Each level of care is designed to meet the evolving needs of hospice patients, ensuring comfort and dignity throughout the dying process. Decisions to transition between levels of care are made collaboratively by the hospice team, the patient and their family, based on the patient’s condition and care needs.

Hospice care lasts an average of 97 days. This estimate comes from data drawn from Medicare hospice recipients by the National Hospice and Palliative Care Organization. Health care providers recommend hospice when someone has a terminal diagnosis with a life expectancy of six months or less.