How to Choose Hospice Care

Lisa Fields
Added: 06.24.2022
5 minutes read
If your parent’s doctor recommends hospice care, how will you decide which local programs to approach to see if they’ll be a good fit for your parent and your family?

Each hospice program offers slightly different services. It may seem intimidating to comparison-shop if you don’t know much about hospice, but many of the same criteria that you’ve used to pick a new doctor may serve you well during this decision.

“Hospice is like everything else,” says Craig Borchardt, PhD, assistant professor of humanities in medicine at the Texas A&M University College of Medicine and CEO of Hospice Brazos Valley in Bryan, Texas. “If you have time to shop, I would call different hospices and talk to them.”

These questions may help you find the best hospice for your parent with dementia:

How do I find out what hospice programs are available?
When a doctor refers your parent for hospice care, they should provide you with a list of hospice programs in the area.

“That is required by Medicare,” Borchardt says. “They should not just tell you, ‘This is the hospice you need to go to.’”

Most communities have access to several hospice programs, even in rural areas. Be wary if the referring doctor points you toward one hospice program without offering you a choice.

“There are some medical directors that will refer only to their own hospice, which is not legal, but that kind of stuff goes on,” Borchardt says.

Is there an online resource that rates hospice providers?
Medicare runs Hospice Compare, where you can search for hospice programs by zip code. The results will include details about the medical conditions treated at each hospice, the level of care that’s provided, the family caregiver experience and more.

“We have to report certain quality measures [to Medicare] as part of our claims process,” Borchardt says. “Medicare also has a third-party vendor that does a family survey after the death of the patient, and those surveys are scored.”

Hospice Compare includes numerical ratings, which some people may find confusing.

“I think in next year, they’re going to change that website to more of a five-star kind of thing, so it’s more like... when you Google your doctor and you can see that your ENT has five stars or four stars,” Borchardt says.

Are there advantages to choosing a nonprofit hospice?
Some hospice programs follow a for-profit model, while others are nonprofit. There are benefits to choosing a nonprofit hospice.

“The nonprofit model of care is much more patient-focused care – it really is about the patient for us,” Borchardt says. “Your for-profit hospices really are driven by the bottom line, [but] we’re willing to sacrifice our margins to make sure that we get more nursing visits, more care.”

Nonprofit hospices are more likely to have fully developed programs that benefit family members, such as bereavement services.

“We are required by Medicare to provide bereavement care for patients’ families for 13 months after the death of the patient,” Borchardt says. “Every nonprofit that I know of has an extensive bereavement program. [But] any for-profit hospice in our community, they either don’t have one or it’s pretty minor.”

Once I’ve narrowed down my search, what questions should I ask each hospice?
The best way to get a good sense about a hospice is to speak with someone who can answer your questions. Borchardt recommends asking questions like:
  • How many visits will my parent get each week?
  • How long should it take for someone to get back to me when I have a question?
  • How long should it take me to get a response if there’s a crisis?
  • How do you respond to a middle-of-the-night crisis?
  • What is your nurse-to-patient ratio?
  • How many hospice- and palliative-certified staff do you have?