By Mike Schonberg, CEO and Co-Owner of vCare Hospice
“Dad, Mom is getting weaker, she had a fall recently and she’s not eating like she used to. I think it may be time to get her assessed by a hospice nurse, just to see if they can help.”
“Not hospice! I’m not ready for hospice yet.”
“I hear you Dad, but I think Mom might be ready for hospice. I know you love her and only want what’s best for her, that’s why we have to think about the extra care, attention and comfort she is missing out on each day. Getting that nurse assessment really is what’s best for her right now. Then we can go from there.”
For many caregivers, the word hospice can feel overwhelming or even frightening. It is often misunderstood as “giving up,” when in truth, hospice is about shifting the focus to comfort, dignity, and quality of life. Knowing when it may be the right time to request a hospice assessment can help families make informed, compassionate decisions—earlier rather than later.
Research done by The Cleveland Clinic confirms that patient outcomes are overwhelmingly better when hospice is considered sooner rather than later. Hospital admissions and ER visits are reduced, symptom management is better, and long-term comfort and quality of life are improved. Yes, long-term – hospice is not intended to be an eleventh-hour emergency call. The best outcomes result from hospice care lasting many months. Former President Jimmy Carter received hospice care for over nineteen months and his family praised the difference it made for him and his family.
It may be time to consider an assessment when repeat emergency room visits or hospitalizations start. If your loved one has been hospitalized multiple times in recent months for the same condition—such as heart failure, COPD, dementia-related complications, or cancer—this may suggest that the illness is becoming harder to manage with curative treatment alone.
Another sign is declining physical function. This may include increased weakness, oxygen dependence, spending most of the day in bed or a chair, difficulty walking, frequent falls, or needing help with basic activities like bathing, dressing, or eating.
Weight loss and decreased appetite are also important signals. When a person is eating much less, losing weight unintentionally, or expressing little interest in food, it can indicate that the body is slowing down and redirecting its energy.
Caregivers should also pay attention to changes in cognition or alertness. Increased confusion, agitation, withdrawal, or long periods of sleeping may be signs that they are progressing.
Finally, consider the emotional and practical toll on the caregiver. If caregiving feels increasingly overwhelming, exhausting, or isolating, hospice can provide much-needed support—not only for the patient, but for the entire family.
Caregivers might ask themselves, “Would I be surprised if my loved one’s health significantly declined in the next six months?” If the answer is “no,” it may be time to request a hospice assessment.
You do not need to wait for a doctor to suggest hospice. Caregivers can request an assessment directly, and there is no obligation to enroll. You can even decide to quit hospice at any time.
Hospice care is designed to support patients with a life-limiting illness—like advanced Alzheimer’s, COPD, heart disease, and cancer—whose focus is comfort rather than cure. Services include nursing care, pain and symptom management, social work, chaplain support, medications related to the hospice diagnosis, medical equipment, and access to care 24 hours a day.
Importantly, hospice care usually takes place where the patient lives—at home, in an assisted living facility, or in a nursing facility. The goal is to keep patients comfortable and supported in familiar surroundings whenever possible.
Choosing to explore hospice is not about giving up hope—it is about redefining hope. Hospice can be an amazingly supportive guide on the journey. An early hospice assessment can empower caregivers with information, resources, and reassurance—helping families make thoughtful decisions grounded in care, dignity, and love.
“Ok, son, if it’s in your Mom’s best interest, let’s give them a call. After the assessment, we can decide together what is best for Mom.”
