When do you call in hospice?

9 answers | Last updated: Dec 07, 2016
A fellow caregiver asked...

When is it time to call in hospice? Is hospice only for end of life care, or could I use it sooner?



Expert Answers

Barbara Repa, a Caring.com senior editor, is an attorney, a journalist specializing in aging issues, and the author of Your Rights in the Workplace (Nolo), now in its 10th edition.

Hospice care is by definition reserved for terminally ill patients, who can no longer benefit from traditional medical care and are most in want of care that keeps them as comfortable and free of pain in their final days as possible. In fact, most hospice services require a doctor's certification that death is likely to occur within six months before they will make their services available.

To find the specific requirements of the nearest hospice providers, check out the "Hospice Search" function at the American Hospice Foundation.

But it sounds as if you're feeling the real need for some type of help in caring for your parent. If your mother or father doesn't qualify for hospice care, consider other forms of help, including:

  • Home care, which includes assistance with the activities of daily living such as bathing, dressing, and walking
  • Home health care, which involves skilled nursing or therapy services
  • Adult day health care, for people who need treatment for multiple, chronic health conditions as an alternative to entering some type of skilled nursing facility, or
  • Adult day care centers, which provide personal care and social activities -- along with daytime supervision and a variety of social and support services.

The specific services available and the types of care they can provide vary dramatically. You may best begin a search for local services the old-fashioned way: by looking in the telephone book under "Adult Care."

Community Answers

I have been there answered...


I am currently caring for my husband's grandmother in our home.  I have 2o plus years as a nurse and caregiver in the geriatric and hospice fields. 
Hospice is a Medicare benefit that requires a terminal diagnosis that has a life expectancy of 6 months or less.
This does not mean that if the client is still alive at the end of the 6 months they would be left to fend for them self.   There is a renewal process that validates the terminal diagnosis remains. There is a web site that can address many of the issues connected with this difficult and painful decision it is: http://www.hospicefoundation.org.
My story:
While working in the nursing home I had a patient who had fallen at home and broke her arm. She was admitted to the nursing home for rehab. During her stay it was discovered she had terminal cancer, the reason for the broken bone was the cancer had spread to her bones. As her nurse I was aware that her Doctor was going to share this with her when he did rounds that day. He stopped by the desk before starting his rounds on my floor. I asked for a hospice order for her. He said I don’t think we need that, giving the fact that he would give orders that would keep her comfortable, and being she was in a Religious nursing home she would have spiritual support. I did not disagree. After the doctor left my floor, this patient’s call light was on. I answered it. Entering the room I asked “can I help you”; her reply “could you sit down and talk with me for 10 minutes without looking at your watch, my doctor just told me I am dying.” I turned off the call light I told her “l will be back in one minute.” I paged the doctor to return to the floor I was working. On my way to her room I began trying to grasp what I would be feeling. Just the second before I saw my doctor’s face I was going to go home in a week and now knowing I would never return there but die instead. Entering my patients’ room I took off my watch and cried with her. I never put my watch back on, it is the gift she taught me, the gift of being were you are, and not thinking of where you have to be. 
When the doctor returned to the floor I told him my story. I asked him how many nurses would have taken this time. I reminded him that if his patient was on hospice she would have a nurse that came to see her only. Volunteers would be there just to hold her hand.The nursing assistant would not have to worry about the resident down the hall. I explained that though he was willing to give us orders to keep her comfortable, it would not be so easy to get these orders from an on call doctor who had never seen this patient. I reminded him of how reluctant some of his colleges are when it comes to ordering narcotics. Gratefully he is a doctor who heard, hospice was ordered.

Suzyq5558 answered...

My FIL has end stage renal failure he stopped urinating some time ago has dialyis three days a week, heart failure, COPD with lungs failing takes 3 liter oxygen, has a ulcerating pressure wound on his leg stump(both legs amputated last year.his health has been declining quite rapidly and he has been the hospital once a month since september with various health issues. now hes back in the hospital with staff infection from the wound. we have tried to talk to him about hospice but he wont hear of it. his Dr had a very frank talk with him about hospice also. he says dialysis is keeping alive and wont hear of hospice because they will take him off of it. but hes just getting weaker and more frail as the days go on and im beginning to think dialyis is taking a huge toll on him as he sleeps all day now and even more so after treatment. he's just exhausted and in pain. how do we talk to him about this?

Suzyq5558 answered...

My FIL was in the hospital last week with ulcerating wound on his amputated leg this is ongoing problem for him. he has been in the hospital more the past three months than home,he also suffers with COPD, renal failure and CHF. the past year the family has been talking to him about hospice as the decline in his health has accelerated but he didn't want to hear about it at all. when he came home Sunday we all felt that a tipping point had been reached for him,he is so weak and tired. when the home care nurse came in the afternoon my FIL asked her to explain hospice again to him which she did and he finally agreed to go on hospice telling the nurse that he is just to tired to go to dialysis any longer and just wants to rest:( so sad this dying business. but as a family we were relived that he had made this decision. hospice is always up to the patient and waiting for them to decide when the time is right can be very hard.My FIL feels is like giving up but when he agreed to it his relief was all over his face and he seems quite at peace now with it as though he knows its ok to let go now.the hospice nurses are wonderful and caring i love them all! i don't what we have done without their help and understanding.

A fellow caregiver answered...

As a volunteer for Hospice yes, you can use hospice long before the begining of the end. Some patients just need company and special time. One lady I cared for loved hand and arms massage along with reading to her. She was in her 90's. She was a sweetheart. I miss her.

Alanh answered...

If you are caring for someone at home and you know that he/she qualifies for hospice care but are wondering when is the right time to call in hospice, then you should consider how able you are to continue caring for the person. For example, when my Mom was no longer able to help me move her in and out of her wheelchair, then we knew that we had a situation that we needed help with. In a typical house, you can't carry a person without real risk of injuring them or your yourself. No one wants that to happen. Then you need outside help and the kind of facilities that hospice can provide.

A fellow caregiver answered...

hi, i am a hospice nurse, my job is a clinical liason, which means i educate medical staff, families and potential patients about hospice care. Hospice is appropriate for patients with a life limiting illness and usually with a life expectancy of 6 months or less. Of course, no one can predict the exact course of a terminal illness and there are patients who are in hospice longer than 6 months, unfortunately because of fear, lack of understanding and lack of communication, most people have hospice services only a very short period of time, sometimes days. This denies the patient and loved ones the full services that hospice can offer. I suggest you contact a local hospice and have someone come in and have an honest discussion with your loved one and you so you can make an infomred decision, I have been a hospice nurse for several years and I have never heard anyone say the wished they had of waited longer before coming to hospice.

*susan answered...

The above answers are so on target. Such an important subject when we're trying to help parents age well until the very end.

Like many, we called Hospice for Dad later than we should have. He would have been more comfortable the last 2 weeks of his life. A far-away-living child, I asked my brother--who lived with Dad-- to call Hospice as soon as I heard Dad was having problems (kidney failure), just after my regular monthly trip to the West Coast. It didn't happen--until I came back 2 weeks later. Dad died 2 days later, but the 2 days Hospice was involved, they were wonderfully supportive through medications, their knowing how to make him comfortable, and ultimately--because he died minutes before the Hospice nurse came the 2nd day--Hospice made the initial necessary phone calls. I think Hospice wasn't involved earlier (turns out Dad's doctor had suggested it) because family neither understood Hospice nor knew how to tell Dad they called Hospice for him.

I addressed the Hospice subject in my blog,"Help! Aging Parents," using my counselor training to suggest how best to explain to parents that a Hospice nurse is coming. The link to that 3/24/12 post: "Aging Parents and Hospice: To Call, Not to Call, When to Call" is http://wp.me/pGfkw-22X if you're interested.

A fellow caregiver answered...

I don't have a answer ...my mom is 71 and lung cancer can't walk I am so scared hospice is coming Sunday ....