One goal of hospice is keeping the patient comfortable at home — but it also serves as one of the major hesitations to go on hospice even if the patient qualifies. Patients with a terminal illness and families are afraid they’ll miss out on needed medical support or hospital-level care if the need arises, so they delay hospice benefits.

However, these misconceptions about the levels of hospice care mean families could miss out on valuable expertise, support and quality of life during a patient’s final months. Patients whose treatments are no longer working or desired, and are determined by their doctor to have a life expectancy of six months or less, often qualify for hospice. The levels of hospice care include:

  • Routine in-home — Regularly scheduled visits for medical, emotional, spiritual, and practical needs wherever the patient calls home (private residence, nursing facility, or assisted living facility).
  • Continuous home — Short-term care during a period of crisis in which a patient requires continuous care at home (predominantly nursing care) to control pain or manage acute medical symptoms.
  • Inpatient — Short-term management of pain or symptoms that cannot be controlled at home. The patient is transferred to a hospital or inpatient hospice unit. When the symptoms are controlled, the patient may return home.
  • Respite — When family caregivers need time away from their caregiving responsibilities or have an urgent situation requiring a respite stay. Patients may receive care in a contracted facility or hospice inpatient unit for up to five days.

“Many times, families don’t want to bother an on-call nurse, but that’s what they’re there for,” says Shari Christian, Vice President of Clinical Services with Heart to Heart Hospice. “If a new symptom emerges or medications don’t seem to be managing pain, on-call hospice can provide guidance and peace of mind. Plus, keeping the patient at home and comfortable is often what they desire most.”

Eighty-five to 90 percent of patients want to spend their final days at home. Hospice helps terminally ill patients do so by educating and equipping family caregivers, providing emotional and practical support, nursing care (at the different levels listed above), and compassionate guidance.

Don’t Be Afraid to Call: 24/7 Support

With Heart to Heart Hospice, each level of hospice (including routine in-home care) provides 24/7 on-call support from nurses and medical providers who are trained in unique hospice-level care. They can access your loved one’s file, history, and notes from their in-home hospice nurses who see them regularly. Plus, as the primary caregiver, you provide valuable insight of physical changes or needs you observe. 

Patients and families can reach out via the on-call number after hours and on weekends for a variety of reasons. Sometimes questions are satisfied over the phone, and other times nurses triage (assess the urgency of the situation) to determine if an immediate visit is required. Nighttime can bring unique anxieties and problems, like Sundowners Syndrome, so having 24/7 access helps address questions and anxieties that may pop up. 

Medical Help & More On Call

Beyond medical support, hospice provides on-call options for emotional needs via aides, chaplains, or social workers. Stressful times don’t just happen during the day, and families often desire compassionate personnel who will listen, pray, and provide comfort. Families express great appreciation for family-like hospice workers who lend their expertise and calm presence during stressful times.

While not an emergency, the final stages of the dying process are natural. Hospice presence often increases in the final days of the active dying process to offer medicine for comfort and support for the family. What to expect during the dying process, plus other helpful caregiver resources, are available in Heart to Heart Hospice’s Patient & Family Handbook. Additionally, practical guidance includes helping families navigate advanced directives or other health care documents.

Each hospice patient is unique. Caregivers, who are often thrust into the role by necessity and a desire to provide the best possible life for their loved one’s final days, are equipped for their loved one’s specific goals and needs. Caregiving can be ever-changing and overwhelming, so having somewhere to turn at any hour of the day (or night) means invaluable guidance and peace of mind.