Choosing a Hospice Provider: Five Questions Every Family Should Ask

Choosing hospice care for yourself or a loved one is an important decision, and it may come at a time when your family is navigating many questions and emotions. Understanding what to ask can help you explore your options, learn what support is available and choose a team you trust to care for your loved one and family.

When considering a hospice provider, ask about the medical professionals overseeing care, the consistency and availability of the hospice team, how patients and families participate in decisions and how the provider will support the goals that matter most to your loved one. Kristin Laboda, executive director of Good Samaritan Hospice, a mission of Concordia Lutheran Ministries, has worked with many patients and families as they navigate hospice care. She recommends looking beyond the basic services a provider offers and asking questions that can help you understand what the experience of care will actually be like.

Here are five questions to consider:

1. Who will be overseeing my loved one’s medical care?

Hospice care is provided through an interdisciplinary team that works together to address a patient’s physical, emotional, social and spiritual needs. When considering a hospice provider, it can be helpful to understand who oversees the medical component of that care and how available that physician is when needs arise.

Kristin recommends asking how the hospice’s medical director works with the care team and how available the physician is when patient needs arise. Medical directors may be dedicated solely to hospice care or may have responsibilities with another practice, making it important for families to understand how physician oversight and availability are structured.

Across Concordia’s hospice agencies, medical directors work closely with the hospice team and are readily available when a patient’s needs change.

“Having a physician who is readily available for questions and patient care is important,” Kristin said. “When your loved one is in pain or experiencing a change in symptoms, the hospice nurse needs to be able to reach the physician for orders and guidance.”

As you talk with prospective hospice providers, ask how physician oversight works, how the medical director collaborates with the hospice care team and what happens when a physician’s guidance is needed quickly.

2. Will we have a consistent hospice care team?

Hospice is deeply personal care. Over time, the professionals caring for a patient learn more than a diagnosis or a medication list. They get to know the individual, the family and what is normal, or “baseline,” for that person.

That familiarity can matter when needs begin to change.

“When the hospice team members get to know the patient and what is baseline for them, it helps our team identify changes sooner, so that we can manage those changes quickly,” Kristin explained.

When considering a provider, ask about staffing in the area where your loved one lives. Does the hospice agency regularly serve other patients in that community? How consistent can you expect the nursing and other members of the care team to be? Consistency also helps foster trust. Kristin notes that nursing, social work and spiritual care work together to support patients and families and work together to support patients and families and help honor the patient’s individual goals for care.

3. What support will be available when our family needs help?

One common misconception about hospice is that receiving hospice care means a caregiver will remain at the bedside 24 hours a day. Routine hospice care does not typically work that way.

Instead, hospice team members make visits based on the patient’s individualized plan of care, while hospice support is available when needs or questions arise. Families considering a provider should understand exactly what that support looks like.

Ask questions such as:

• Who should we call if symptoms change?
• What support is available at night, on weekends or holidays?
• How quickly can the team respond to a change in condition?
• What should we expect during routine nursing and hospice aide visits?
• What education will caregivers receive so we know what to expect between visits?

These conversations can help families understand what to expect from the hospice team, what support is available and how the team will help prepare and guide them as they care for their loved one.

Support also extends beyond medical care. Depending on a patient’s individualized needs, hospice care may include nursing, hospice aides, social work, spiritual care, medical equipment and supplies, medications related to the hospice diagnosis and other services designed to support comfort and quality of life.

4. How will our loved one and family be involved in decisions about care?

Patients and families remain at the center of decisions about hospice care. Their needs, wishes and priorities help guide an individualized plan of care, and ongoing communication allows that plan to change as the patient’s condition or goals change.

Open communication can also help build trust between families and the hospice team, particularly as a loved one’s needs begin to change.

Kristin says getting to know a family helps create a bond of trust between them and their hospice team. It also gives team members a better understanding of what the patient and family want from care.

When speaking with a prospective provider, ask how the team develops the care plan, how frequently it is reviewed and how patients and families remain involved as care needs change.

You should feel comfortable asking questions, expressing concerns and talking openly about what matters to your family.

5. What will you do to understand what matters most to my loved one?

Perhaps one of the most important questions families can ask has less to do with a provider’s list of services and more to do with how the hospice team sees the person receiving them.

Kristin encourages families to think about a question that a hospice provider should also be asking them: What are your loved one’s goals for hospice care?

Those goals will look different for every individual.

It might mean remaining comfortable at home surrounded by family. For someone else, it might mean hoping to take one more family vacation, attend a sporting event or be present for a grandchild’s wedding.

A hospice team cannot promise that every goal will be possible, but Kristin believes the team should listen and do what it can to honor what matters to the patient.

“We will work with the patient and family to do everything we can to respect that goal and help them meet it,” she said. That philosophy reflects an important truth about hospice: the focus isn’t simply on the end of life. The focus is on helping a person live as comfortably and meaningfully as possible while supporting the people who love them.

Hospice Care Can Begin Earlier Than Many Families Realize

Families sometimes wait until the final days of a loved one’s life to consider hospice. Hospice care, however, may be available – and very valuable – much earlier.

Hospice can provide support for months and, in some circumstances, longer if the patient continues to meet hospice eligibility requirements. For eligible Medicare beneficiaries, Medicare hospice benefits cover a wide range of services related to terminal illness and related conditions, including nursing care, medications for pain and symptom management, medical equipment and supplies, spiritual care and grief counseling.

“Hospice care is not just for the final days of life,” Kristin said.

Learning about hospice earlier can give patients and families more time to understand their options, build relationships with the care team and benefit from the physical, emotional, social and spiritual support hospice can provide.

Frequently Asked Questions About Choosing Hospice Care

Can I choose my hospice provider?

Yes. Patients and families can ask questions and learn about their hospice options before selecting a provider. Consider the team’s availability, staffing, approach to communication, services and how the provider will support the patient’s individual goals.

Does choosing hospice mean giving up treatment or control?

No. Hospice focuses on comfort and quality of life, and patients and families remain involved in decisions about their care. A patient’s medications and plan of care are individualized according to their needs. Patients may also choose to revoke hospice services if they decide to pursue other treatment and may seek hospice again later if eligible.

Is hospice only for the last few days of life?

No. Hospice is not limited to the final days of life. Eligibility is based on specific clinical criteria, and patients may receive hospice services for an extended period of time as long as they continue to qualify. Talking about hospice earlier can allow patients and families to benefit from more of the support available to them.

Where can hospice be provided?

Hospice care can be provided wherever a person calls home, including a private residence or a senior living or long-term care setting. The appropriate setting and services depend on the individual’s needs and plan of care.

Can I change hospice providers?

Yes. Medicare beneficiaries have the right to change hospice providers once during each benefit period. Patients may also choose to stop hospice care and, if eligible, elect hospice again later.

Hospice Care Across Western Pennsylvania

Across western Pennsylvania, Concordia provides hospice care through Good Samaritan Hospice, Concordia-IRMC VNA, Concordia Home Health and Hospice of Bethlen and Concordia Hospice of Washington.

Our approach begins with listening to the needs of the patient, the concerns of the family and what matters most to the person receiving care. Our hospice teams provide compassionate care centered on comfort, dignity and quality of life while walking alongside patients and families throughout the hospice journey.

If you or someone you love is considering hospice, you don’t have to have all the answers before starting the conversation. Learning about your options and asking questions can be an important first step toward finding the care and support that’s right for your family.

Learn more about Concordia’s hospice services and find a hospice provider serving your community here.

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Founded in 1881, Concordia Lutheran Ministries is a faith-based, CARF-accredited Aging Services Network and recipient of the inaugural Pennsylvania Department of Aging Excellence in Quality Care Award. As one of the largest nonprofit senior care providers in the country, the organization serves 50,000 people annually through in-home care and inpatient locations. Concordia offers a lifetime continuum of care that includes adult day services, home health care, hospice, physician and rehabilitation services, memory care, personal care, assisted living, respite care, retirement living, skilled nursing/short-term rehab, spiritual care and medical equipment.