This checklist assumes care will happen at home. Most hospice in the United States is delivered where the person lives.
The short version
- Gather identification, insurance cards, a medication list, physician contacts, and any advance directive in one folder before the first call.
- Set up one comfortable room near a bathroom. Hospice arranges a bed and related equipment; it does not pay for home modifications.
- Choose one primary family contact and one backup, so the nurse’s report reaches someone who can act on it.
In this guide
01
Gather the paperwork first
The intake process moves faster when these are in one folder, whether paper or on a phone you can hand to a nurse:
- Photo identification for the patient.
- Medicare card, Medi-Cal card, or private insurance card, plus any secondary coverage.
- A current medication list, including doses, prescriber, and pharmacy.
- Names and phone numbers of the primary physician and any specialists.
- Advance directive, living will, and healthcare power of attorney, if they exist.
- A copy of the most recent hospital discharge summary, if there was a recent stay.
If some of these are missing, say so at the first call. Missing documents delay admissions; they do not prevent them.
02
Set up one room, not the whole house
The goal is a single comfortable space where the patient can be cared for, near a bathroom, with room for a visitor chair and a walker or wheelchair. For many families, that means converting a dining room, den, or living room rather than moving furniture upstairs.
Hospice provides a hospital bed, an overbed table, a bedside commode, oxygen if ordered, and other equipment related to the terminal diagnosis. It does not provide home modifications. If stairs, narrow doorways, or a bathroom on another floor are a problem, raise it at intake, because the answer may be a different room, not a renovation.
03
Decide who is in charge
Hospice teams communicate with a primary contact. When six family members each call with a different question, information gets scrambled and the patient’s actual condition gets lost in the noise.
Choose one primary contact and one backup. Tell the rest of the family who they are. This is not about excluding anyone; it is about making sure the nurse’s report reaches someone who can act on it.
04
Questions worth asking before you sign
- Who answers the phone at 2 a.m., and is that person a nurse?
- How quickly can a nurse reach the home in an urgent situation?
- How often will the nurse, aide, social worker, and chaplain visit, and does that change over time?
- What equipment and medications are covered, and what will we be billed for?
- What happens if symptoms escalate and the family cannot manage at home?
- Can our own physician stay involved?
- What bereavement support is available after the death, and for how long?
A provider should answer these without irritation. If the answers are vague, that is information too.
05
What the first week actually feels like
Expect a lot of people, a lot of paper, and a period of adjustment while medications are reviewed and symptoms are brought under control. Expect the family to be tired. Expect at least one moment when someone says, “I did not realize it would be like this.”
That moment is normal. Say it out loud to the nurse or social worker. Adjusting the plan is part of the plan.
Common questions
Do we need to buy a hospital bed before hospice starts?
No. A hospital bed and other equipment related to the terminal diagnosis are typically provided through the hospice benefit once care begins. Ask specifically what is provided and what is rented, because arrangements vary.
Can we prepare for hospice before the patient is ready?
Yes. Many families gather documents and have the initial conversation weeks before admission. Nothing is signed until the patient (or their authorized decision-maker) agrees.
What if family members disagree about starting hospice?
Disagreement is common and it is not a reason to delay a conversation. A hospice social worker or chaplain can meet with the family. The patient’s own stated wishes carry the most weight, and legal decision-making authority should be clarified.
Related reading
Communication
Talking With a Loved One About Hospice
How to raise the subject without triggering fear, what to say when they refuse to discuss it, and how to handle disagreement in the family.
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Choosing care
How to Choose a Hospice Provider: Questions Worth Asking
What to compare between hospices, which answers signal a well-run program, and the promises nobody can honestly make.
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End of life
What to Expect in the Final Days of Life
The physical changes that usually happen, what helps, what does not help, and who to call when you are unsure.
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