How to Choose a Hospice Care Provider

The word "hospice" is often received by family members with a mixture of emotions when it is recommended for a loved one. Initial reactions can range from grief to anger, fear, hopelessness and regret. What family members and caregivers should understand is that the doctor makes this recommendation out of compassion.

When continuing treatment is no longer the best option, that's when hospice care steps in. Hospice focuses on care, not cure. The goal of hospice is to make the patient's remaining days as comfortable as possible. That almost always means that as soon as a patient goes on hospice care, his or her quality of life improves.

In most cases, hospice care is provided in the patient's home, so that he or she can be in a familiar environment, surrounded by loved ones. Hospice care also can be provided at a hospital, nursing home or other long-term care facility. If you’re unsure where to begin, learning how to find a hospice provider that suits your needs can help you start this important journey.

Where and how to start your search when choosing a hospice. 

So how do you go about finding a hospice provider? The healthcare professionals who oversee care are a good place to start. They likely have referred many patients and have received a lot of feedback from families — both positive and negative — and can share that with you.

As with anything health related, ask friends and family if they can give you any hospice recommendations. It's important that you trust the source of your information, and your friends and family are unlikely to steer you in the wrong direction.

An obvious place to look when figuring out how to choose a hospice provider is online sources. When you search online, you'll want to put in your desired location. That can help narrow down your options. A search engine such as Google is the most obvious starting point, as well as social media (though when reading reviews consider that particularly when it comes to hospice, everyone's situation is different, and one family's experience may in no way reflect what you and your loved one might come to expect). If you want to see side-by-side comparisons, Medicare’s Hospice Compare is a reliable resource. You can search by hospice name or location, add agencies to a "favorites" list, and compare selected agencies.

Understanding the services offered by a hospice provider.

When choosing a hospice care provider, it’s essential to have a clear understanding of the services they offer. Each hospice provider may differ slightly in the level and scope of care provided, so asking detailed questions can help ensure the provider meets your needs and expectations.

Here are some key areas to explore:

• Core Services - Hospices are typically required to provide a range of services, including pain and symptom management, emotional and spiritual support, and bereavement counseling. Confirm that these core services are included and ask how they are delivered.
• Specialized Therapies - Some hospices offer complementary therapies, such as music therapy, massage therapy, or pet therapy, to improve quality of life and comfort for patients. Ask about the availability of these services and whether they are included in the standard care plan or require additional fees.
• Staff Availability - Ensure that the hospice provides 24/7 access to care, including an on-call team for emergencies outside of regular business hours. Confirm how quickly the staff can respond to urgent needs or questions.
• Medication, Equipment, and Supplies - Hospice care often includes medications, medical equipment (e.g., hospital beds, oxygen), and supplies necessary for patient comfort. Ask if these items are covered by the hospice and whether there are any exceptions or additional costs.
• Additional Programs and Services - Many hospices go beyond standard requirements to offer unique programs. For example, some may have programs to fulfill patients’ final wishes, like Crossroads’ Gift of a Day program. Others may offer extended bereavement services for family members. Discuss these options to understand what sets one provider apart from another.
• Family and Caregiver Support - A hospice should provide education, training and respite care for family caregivers. Ask what support is available to help you and your loved ones navigate the caregiving journey. 

Questions to ask when choosing a hospice provider.

Knowing what to ask in terms of hospice care is as important as knowing whom to ask. According to the American Hospice Foundation, which was originally formed to improve access to quality hospice care, here are some key questions to ask that will help in your search for the hospice that's right for your situation:

1. How long has the hospice been in operation?  
2. Is the hospice Medicare certified, accredited and, if applicable, state licensed? 
3. How does the hospice measure/track quality service? 
4. Are any services offered beyond required services? What type of bereavement services are offered? 
5. What are the expectations about the family's role in caregiving? Is respite care available for burned-out family members?  
6. What is the average amount of hours spent with a patient? Does that increase in the last few days or hours of the patient’s life? 
7. What types of therapies, such as music or art therapy, are offered to support patient well-being?
8. Will the patient or family ned to cover any out-of-pocket expenses for hospice care?
9. How are medications handled once prescribed by the hospice—are they delivered, or must they be picked up? 

Additional questions you may want to ask include:

1. Can the hospice staff meet with you the same day a doctor recommendation is made? How long is the admissions process? 
2. Can a patient be admitted at night, weekends or on a holiday, or are admissions limited to certain hours during the day? 
3. Is the agency staffed 100 percent with its own employees or does it contract agency staff?  
4. Does the service include a dedicated on-call team around the clock?  
5. Will the hospice strive to have someone with the patient in his/her final moments (nurse, aid, chaplain, social worker, etc.)? 
6. What is the average number of weekly visits the hospice will provide? 

Additional tips for choosing a hospice provider.

Choosing a hospice provider for a loved one is not a decision to be taken lightly. A great deal of research and thought should go into your decision-making process. Following are additional considerations to take into account as you conduct your research.

As an article by Consumer Reports indicates, obtaining hospice care for a loved one doesn't mean you're giving up on them. In fact, if the patient's condition improves based on the better quality of life, hospice care can be discontinued and treatment resumed. The point is that you shouldn't postpone hospice care because you are in denial or avoiding the inevitable. By choosing hospice care, you'll know you're doing right by your loved one.