Questions to Ask Hospice Interview
Questions for families meeting with a hospice agency, whether you are comparing two providers or sitting through an admission visit. They cover who is on the team and how often they visit, what happens at night and on weekends, how symptoms are managed, what the benefit pays for, and what support continues after a death.
The questions
Open any question for the note
Are you Medicare certified, and are you accredited by an outside body?
Why ask it
Medicare certification is the baseline for coverage and for meeting federal requirements. Accreditation by an independent organization is voluntary and involves outside review, so it is worth asking who last surveyed them and whether findings are available.
How long have you served this area, and are you nonprofit or for profit?
Why ask it
Neither ownership type is automatically better, but it shapes questions worth asking next: whether they turn away complex cases, and whether they have their own inpatient beds. Length of service in the area usually tracks with established relationships at local hospitals and nursing homes.
Who will be on the care team, and what does each person do?
Why ask it
The team normally includes a nurse, an aide, a social worker, a chaplain, a physician and volunteers. Ask which of them you will meet in the first week, since teams look different on paper than in practice.
How often will the nurse visit in a typical week, and how often the aide?
Why ask it
Ask for numbers rather than the phrase as needed. Two nursing visits a week and three aide visits is a specific commitment you can compare between agencies and hold them to when things get harder.
Will the same nurse and aide come each time?
Why ask it
Continuity matters more than most families expect, because a nurse who knows the patient notices changes a stranger will not. High turnover shows up as a new face every visit, so ask directly what their staff turnover has been in the past year.
Who answers the phone at two in the morning, and is it a nurse with access to the chart?
Why ask it
There is a real difference between an on call nurse who can see the medication list and an answering service that takes a message. Ask what happens next: whether a nurse can be dispatched to the house overnight, and how long that usually takes.
If symptoms get out of control, can you provide continuous nursing at the bedside, and how often have you done that recently?
Why ask it
Continuous home care is one of the four levels of hospice care, so every agency can describe it. Asking how many times they provided it in the last month distinguishes agencies that actually staff for it from those that only have it on the brochure.
Do you have an inpatient unit or contracted beds, and where are they?
Why ask it
If symptoms cannot be managed at home, someone has to have a bed available, and the location decides how far the family will be driving. Ask who makes the decision to move a patient and how quickly a bed is usually found.
Who is the physician overseeing care, and will our own doctor stay involved?
Why ask it
The hospice medical director oversees the plan, and the patient's own doctor can often remain the attending physician if the family wants that. Clarify this at admission, because families are frequently surprised to find their long time doctor out of the loop.
Who manages the medications, and how fast can a new prescription reach the house?
Why ask it
Symptom changes need a same day response, and the answer depends on their pharmacy arrangement and whether a comfort kit is placed in the home at admission. Ask what is in that kit and who authorizes using it.
If pain is not controlled, who has authority to change the dose overnight, and how long does that take?
Why ask it
This is the question that matters most at three in the morning. You want to hear that the on call nurse can reach a physician with prescribing authority quickly, not that changes wait for the next scheduled visit.
What does the hospice benefit cover, and what will we still be paying for?
Why ask it
The benefit covers care related to the terminal illness, including medications, equipment and supplies for that condition. Unrelated prescriptions, room and board in a facility, and some treatments remain the family's cost, so ask for those exclusions in writing.
What equipment and supplies do you provide, and how soon do they arrive?
Why ask it
A hospital bed, oxygen, a bedside commode and incontinence supplies are common, and delivery timing is what determines how hard the first few nights are. Ask whether delivery happens the same day as admission, including on a weekend.
How many hours of aide help can we expect for bathing and personal care?
Why ask it
Aide time is the support families feel most immediately, and it is usually measured in a few hours a week rather than daily help. Knowing the real number early lets you arrange private help or family shifts instead of discovering the gap mid week.
What do the social worker and chaplain do, and can we decline either?
Why ask it
The social worker often handles practical work families do not know to ask for: benefits paperwork, facility placement, funeral arrangements, family meetings. Chaplain support can be declined or requested from your own tradition, and it is reasonable to say so.
Is respite care available, and how do we arrange it?
Why ask it
Respite provides a short inpatient stay so a family caregiver can rest, generally up to five days at a time. Ask how much notice they need and where the patient would go, because exhausted caregivers usually ask about this too late.
What happens if we want to go back to the hospital, or pursue treatment again?
Why ask it
A patient can revoke the hospice benefit and return to standard care, and can enroll again later. Hearing this explained without discouragement tells you the agency understands the decision belongs to the patient and family.
In the last days, what support is there overnight for whoever is sitting with the patient?
Why ask it
Ask specifically what changes in the final days: more frequent visits, continuous care if needed, volunteers who can sit for a few hours. This is the period families describe as the hardest, and staffing for it varies considerably between agencies.
At the time of death, who do we call, who comes, and how long will they take?
Why ask it
Knowing the sequence in advance removes one source of panic: call hospice rather than emergency services, a nurse comes to the house, confirms the death, handles medication disposal and contacts the funeral home. Ask their usual response time at night.
What bereavement support continues after the death, for how long, and who is it available to?
Why ask it
Medicare requires bereavement services for about a year, but the substance varies from mailed material to counseling and support groups. Ask whether it extends to grandchildren, close friends and caregivers, not only the next of kin.
Meeting With a Hospice Agency
Practical guidance for the conversation itself
Before the Meeting
Bring two people if you can
One person asks questions, the other writes down answers. Admission visits cover a great deal of information, often on a difficult day, and almost nobody remembers it afterward. If you are alone, ask whether you can record the conversation.
Have the medication list and documents ready
Bring the current medication list, insurance cards, the name and number of the primary physician, and any advance directive, living will, healthcare proxy or out of hospital do not resuscitate order. Having these on hand shortens admission considerably.
Write down what matters most to the patient
Staying at home, avoiding sedation, being alert enough to talk, having a specific person present. Say these things out loud at the interview. They shape the plan of care, and a good team will write them into it.
Comparing Two Agencies
- Ask both for the number of scheduled nurse and aide visits per week, then compare the numbers rather than the descriptions.
- Ask both what happens at two in the morning, and note whether a nurse can come to the house.
- Ask both how many times they provided continuous bedside care in the past month.
- Ask both about inpatient beds and where they are located.
- Ask both about staff turnover in the past year.
- Look up quality and family survey scores on the Medicare hospice comparison tool.
- Ask a local hospital discharge planner, nursing home nurse or your own physician which agencies they see doing good work.
After You Enroll
Keep one notebook in the house
Record each visit, who came, what changed, medication times and doses, and the phone numbers you have been given. Different family members take different shifts, and the notebook is what keeps the nurse from getting three versions of the same week.
Call earlier than feels necessary
Hospice teams would rather hear about restlessness, a change in breathing or a missed dose while it is small. Waiting until a symptom is severe is what turns a phone call into an emergency.
Ask for a care plan meeting if something is not working
If visits are too infrequent, an aide is not a good fit, or symptoms are not controlled, you can ask for the plan of care to be reviewed. If it still does not improve, families are allowed to change hospice agencies, and the social worker can explain how.