Does hospice provide 24-hour care at home?
The short answer
Usually not. Hospice team members visit on a schedule and a nurse is on call by phone 24 hours a day, but family or hired caregivers provide most of the day-to-day care. Extended nursing care at home, called continuous home care, is only for brief periods during a medical crisis.
General information, not medical advice. Your hospice team knows your person and can answer for your situation.
What does hospice care at home look like?
A member of the hospice team visits regularly. Nurses check on symptoms and medicines, and aides help with bathing and personal care. The visit schedule depends on your loved one's plan of care, and it can change as their needs change.
Between visits, family and friends usually give the day-to-day care. The hospice team coaches you on how to do it.
Visit schedules vary between hospices. Before you sign, ask how often the nurse and aide will come, and how the schedule changes if your person declines.
Who helps at night and on weekends?
A hospice nurse and doctor are on call 24 hours a day, 7 days a week. If something changes, call the hospice number first. A nurse can talk you through it and may come out to the house.
Ask how quickly someone can come for an urgent visit at night. The answer tells you a lot about a hospice.
What is continuous home care?
If your person has a medical crisis, like pain or breathing trouble that won't settle, hospice can provide continuous home care. This means nurses, sometimes with aides, give care in the home for eight hours or more in a day, mostly nursing care, to get symptoms under control.
It is only for brief periods of crisis, to help your person stay at home.
What if you need a rest?
That is what respite care is for. Your person can stay in a Medicare-approved facility, like a hospice unit or nursing home, for up to 5 days at a time while you rest. The hospice arranges it. You can use respite more than once, but only now and then. There may be a small copay.
Needing a break is normal. Caring for someone at home is hard work.
What if no one can be there all the time?
Hospice doesn't pay for private caregivers, so you may need to arrange help from relatives, friends, or paid aides. The hospice social worker can help you think through options.
If your person lives in a nursing home or assisted living, the facility staff give daily care and hospice adds its visits on top. Hospice doesn't cover the room and board there.
Sources
- CMS, Medicare Hospice Benefits (booklet 02154): medicare.gov/publications/02154-medicare-hospice-benefits.pdf
- National Institute on Aging, What are palliative care and hospice care?: nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care
- CMS, Medicare Benefit Policy Manual, Chapter 9: cms.gov/regulations-and-guidance/guidance/manuals/downloads/bp102c09.pdf
Educational information only. This article is not medical, legal, or financial advice, and it can't account for your person's health or your state's rules. Always talk with your hospice team, doctor, or Medicare (1-800-MEDICARE) about your situation. If you think it's an emergency, call your hospice's 24-hour number or 911.