Choosing a hospice provider can be a difficult decision at an emotional time. But if you know what to look for, you’ll have an easier time finding the right fit for your loved one and family.
Here’s a checklist of what to ask about, based on recommendations from Consumer Reports and the latest research on caregiver experience surveys. It includes everything from not-for-profit status to 24/7 crisis response.
“You’re only going to have one opportunity to do this for your loved one,” says Edward W. Martin, MD, MPH, HopeHealth’s chief medical officer. “You want to make the right choice and get the best care possible.”
> Learn how to get started with hospice care.
1. Not-for-profit status
In recent years, the number of hospice providers in the U.S. has grown rapidly, which means you may have a number of agencies to choose between. One question to start with is whether they’re for-profit or not-for-profit.
In 2023, the Journal of the American Medical Association published a study showing that caregivers whose family members received care in a not-for-profit (nonprofit) hospice reported the best experiences across eight categories — from timely care and help with symptoms to emotional and religious support. As a group, for-profit hospices scored lower across all of these categories.
2. More than 20 years of experience
Hospice providers with a longer history tend to have more stability, usually thanks to a strong track record.
“You can be confident the provider won’t be closing its doors in the coming months and leaving your loved one without service,” says Dr. Martin. Plus, “The longer a provider has been around, the longer you have to develop policies and expertise in delivering care.”
HopeHealth is the second oldest hospice in the country, and one of the largest nonprofit providers of hospice and palliative care in New England.
> Related: Finding the spark: The special calling of a hospice aide
3. Hospice-certified nurses and doctors on staff
Clinicians who become certified in hospice have additional training in the unique and complex needs of patients at the end of life. But not all hospices require this training. Some agencies have physicians with little or no hospice experience filling in as medical director.
So before choosing a hospice, check if their care team is hospice-certified.
At HopeHealth, “Our physicians and nurses have made a commitment to make hospice a major part of their work, and have made the effort to get the education to become certified,” says Dr. Martin.
4. Care in many settings, including nursing homes and assisted living residences
“A hospice provider should be able to offer care wherever your loved one calls home,” says Dr. Martin.
For example, HopeHealth provides care at homes, residential settings, hospitals and skilled nursing facilities throughout Rhode Island and Massachusetts. That includes nursing homes and long-term acute care centers, as well as short-term inpatient care for complex symptoms or caregiver respite.
Even if your loved one is at home now, they may eventually transition to a facility as their needs evolve. Being able to keep the same hospice team can best support them and you through that experience.
5. An inpatient center if symptoms can’t be managed at home
Some end-of-life symptoms become so severe that patients need hospital-grade care. Without an inpatient hospice unit to go to, the only option is usually the emergency room.
But if your hospice provider offers an inpatient center, your loved one can receive the care they need in a peaceful setting that honors their final moments. At the HopeHealth Hulitar Hospice Center, that includes private rooms for every patient, and 24-hour visiting hours for family and friends, including children and pets.
“It’s designed to be a home-like setting. We don’t have bells and whistles going off. It’s a very different environment,” says Dr. Martin. “The support here is not just for the patient, but the family.”
> Related: In the halls of Hulitar: An inpatient hospice nurse opens up
6. Available 24/7 for rapid crisis response
When you’re caring for a loved one at the end of life, knowing you have support at any time of day or night is crucial for everyone’s peace of mind. It can also keep your loved one out of the emergency room if they start to experience new symptoms.
Ask all hospices what their staffing and availability is like for questions and crisis response — both over the phone and in person.
“At HopeHealth, we have staff in our office 24/7 waiting for phone calls. If you have a question at 2 a.m., you have a nurse waiting to answer your question,” says Dr. Martin. “If they can’t manage it over the phone, we have nurses ready to go out and assist you.”
7. Specialized, respectful support
Comfort comes in many forms. When you’re interviewing hospice providers, ask whether they offer alternative support services for patients and families. At HopeHealth, this includes pet therapy, music therapy, massage, meditation and reiki.
You can also ask about any special credentials or sensitivity training that’s important to you. For example, HopeHealth is known for:
• Level 3 We Honor Veterans partner, including special training and services for veterans
• SAGECare Platinum credential for serving LGBTQ+ elders
• Dedicated Pediatric Supportive Services team for children and young adults
• Support for all faiths and beliefs
> Related: Knocking on doors: How a silent monk became a hospice chaplain
8. Grief support
Grief support can be essential for family members and loved ones, both leading up to and after a death. A good hospice should offer a number of programs and services, including one-on-one counseling.
“At HopeHealth, we have an incredibly robust grief support program through the Center for Hope & Healing,” says Dr. Martin. This includes individual counseling, an expansive grief support group program, and community programs like Camp BraveHeart for kids as well as remembrance events.
9. Certified in palliative care, too
If you or a loved one is living with a serious illness, but isn’t ready yet for hospice, palliative care can transform your and their quality of life.
Like hospice, palliative care is another medical specialty that requires unique expertise. So it can easily set a hospice provider apart.
“If you find a provider that’s certified in both palliative care and hospice, you’ll have access to care that can evolve with your needs,” says Dr. Martin. Learn about palliative care at HopeHealth.
10. Final reminders
Before beginning care with any hospice, make sure they’re covered by your insurance. (HopeHealth is certified by Medicare and Medicaid, as well as other insurance providers.)
Finally, remember that hospice care should be grounded in compassion and dignity for the whole family — and that begins with your very first phone call or email.
Never hesitate to reach out for information and support. We’re here to answer all your questions, and to help your family through this profoundly important time.