Many terminally ill patients wish to spend their final months or weeks at home surrounded by loved ones instead of in the hospital. Hospice care helps make that possible with resources and a support team available at many different stages.

Understanding these levels of hospice care helps families know support comes in many shapes and sizes and is flexible during the duration of end-of-life care. Dignity, compassion, and individual care are the goals — and having a consistent, comprehensive team eases the stress during such an emotional time.

Whether in the home or in a residential facility (such as an assisted living center or nursing home), a dedicated hospice care team gives full attention to someone in their final weeks or days while also supporting the family members and/or caregivers. When the hospice benefit was created in 1982, it was intentional to  include support for family members along with the patient.

Levels of Hospice Care

Heart to Heart Hospice provides various levels of care designed to meet the patient’s needs in alignment with the Medicare hospice benefit. The hospice care team and the patient’s physician will determine the best level of care. Read more to see who qualifies for hospice care and who covers the costs. Hospice support goes well beyond medical care. While physical comfort and pain management are one aspect, hospice care provides mental, emotional, spiritual, and practical support. 

Routine Home Hospice Care

  • The most-used level of care is routine homecare with regularly scheduled visits by the hospice care team to meet the medical, emotional, spiritual, and practical needs of patients and their loved ones.
  • This is provided nearly anywhere a patient calls home – a private residence, a nursing home or residential facility.

Continuous Home Hospice Care

  • Continuous care is provided only during a period of crisis, as necessary to maintain a patient at home.
  • A crisis period is when a patient’s physical symptoms cannot be managed effectively with intermittent visits. Hospice nurses and aides provide round-the-clock care, predominantly nursing care, to control pain or manage acute medical symptoms. Once symptoms are managed effectively, the patient can return to routine intermittent care team visits.

Inpatient Hospice Care

  • When a patient needs short-term management of pain or symptoms that cannot be controlled at home, inpatient hospice care is employed.
  • The patient is transferred to a contracted nursing facility, hospital, or inpatient hospice

unit*. When the symptoms are controlled, the patient may return home.

Respite Care

  • When family caregivers need time away from their caregiving responsibilities or have an urgent situation arise, respite care is available to hospice patients.
  • Patients may receive care in a contracted facility or hospice inpatient unit* for up to five days.

Care Team Support

At all levels of hospice care, you’ll find a team ready to support you in ways that you didn’t even know you needed. Examples of the support provided include (but is not limited to):

  • Hospice Physician — Specially trained hospice medical directors oversee the care of hospice patients. They guide and direct the care team to ensure each patient’s needs are met and symptoms are optimally managed. 
  • Nurses — Provide care and pain management, note changes in a patient’s condition, educate the family on medical and physical needs, coordinate doctors, health care providers, and medical equipment and supplies.
  • Social Workers — Identify psychosocial, grief, financial, environmental, and community needs. Offer counseling and support. Facilitate community resources. Provide information and assist with preparation of advance directives.
  • Spiritual Care Coordinators — Listen and assist with spiritual needs. Collaborate with local clergy as needed. Offer counseling and support, prayer, worship, ritual as appropriate. Provide individual patient/family counseling and/or crisis intervention.
  • Home Health Aides — Help with activities of daily living (bathing, grooming, etc.), light homemaker services, assist patients with safe transfers, nutrition, and environment.
  • Bereavement Coordinators — Coordination of a bereavement care plan and support for family up to 13 months after loss.
  • Volunteers — Provide companionship to patients and families.

The levels of hospice care and the dedicated team mean caregivers and patients always have somewhere to turn for support, comfort, and guidance. If you want to learn more about the different levels of hospice care for yourself or a family member, you can find a Heart to Heart location near you or refer a loved one to our services.

*Heart to Heart Hospice currently has two inpatient centers currently open: Fort Worth and Houston, Texas, and two more opening soon: Detroit-area Troy, Michigan and Evansville, Indiana.