Navigating senior care and making decisions for your loved one is challenging, but what’s often even more challenging is deciding on and choosing hospice care. It’s understandable to be riddled with all sorts of emotions when having to make this decision, and you can feel stuck and unsure of where to turn and how to ensure your loved one is comfortable, even in the last stages of their life. We hope that this blog post will help make hospice care less intimidating and more reassuring for both you and your loved one.

Making the decision to begin hospice care for a senior loved one is never easy; it may often come later than needed or wanted. It’s also often bound to come with a range of emotions, including anger, confusion, sadness, and helplessness. Having these sorts of conversations can often feel uncomfortable, but they’re vital as they help you know what your loved one prefers so you can ensure their wishes are met. These conversations often come during a time filled with uncertainty, emotion, and difficult choices. But understanding what hospice truly is, and how to navigate it, can bring clarity, comfort, and reassurance to both you and your loved one.

This blog post will help offer an overview and practical steps to help walk you through what hospice care involves, when to consider it, and how to support your loved one throughout the journey.

What Is Hospice Care?

Hospice is specialized care designed for individuals (not just seniors) facing a terminal illness or condition. Anyone is eligible for hospice, not only seniors or elderly individuals. Hospice is used after and replaces any curative treatments. Rather than focusing on curing a disease, hospice prioritizes comfort and dignity. In fact, hospice can begin months before death and improve the quality of life for your loved one.

According to the Hospice Foundation of America, Hospice care is not just for people who are bedridden or in their last days of life. Patients and their families can benefit from hospice for months, so long as the patient is medically eligible.

The Hospice Foundation also specifies that hospice care is for people who are expected to live six months or less. It is provided primarily where a person lives so the patient can be near family, friends, pets, and valued possessions. 

Hospice care is provided by a team of professionals trained to address the patient’s medical, physical, spiritual, and social needs. The team focuses on the person, not the illness, as they coordinate patient care, clarify the goals of care, and foster communication. 

Members of the hospice team visit the patient periodically. Hospice providers are available around the clock to respond to patient or caregiver concerns. 

The team also supports family members and other close caregivers. Hospice provides bereavement care for the patient’s family and caregivers during the illness and for more than a year after their loved one’s death.

“Hospice care offers numerous benefits, including greater patient and family control over medical care, familiar surroundings for patients, reduced isolation, and better access to loved ones. Hospice care does not require patients to accept their terminal prognosis or have a do-not-resuscitate (DNR) order. Instead, hospice works with each patient and family member to provide support and education to help them come to terms with approaching death.” (Bhatnagar, et al., 2023)

Hospice care is delivered by an interdisciplinary team that may include:

• Physicians and nurses
• Social workers
• Chaplains or spiritual counselors
• Hospice aides and trained volunteers

This team works together to create a personalized care plan that supports your loved one physically, emotionally, and spiritually. 

Hospice is not one-size-fits-all. Depending on your loved one’s needs, care may include:

• Routine home visits
• Continuous care during symptom crises
• Short-term inpatient care for symptom management
• Respite care to give family caregivers a break

Hospice care is there for patients at the end of their lives to have comfort and companionship when they need it the most. This care is also beneficial for families as it helps give them peace of mind, knowing their loved one is in good and caring hands. Hospice care doesn’t end when your loved one dies — the hospice team can provide ongoing support, guidance, and a sense of closure for families and loved ones.

When Is It Time to Consider Hospice?

Many families struggle with timing and deciding when hospice care is needed and when to start. It’s understandable why many families may put off this care and wait until the last minute, but starting hospice earlier can help provide more meaningful support to both you and your loved one.

The Hospice Foundation of America recommends considering starting care when:

• The patient’s physical and/or cognitive status declines significantly despite medical treatment. Signs may include increased pain or other symptoms, substantial weight loss, extreme fatigue, weakness, or shortness of breath.
• Doctors estimate that life expectancy is six months or less.
• The patient is in the end stage of Alzheimer’s disease or dementia.
• The goal is to live more comfortably rather than continuing treatments that take a physical toll and have been unsuccessful in halting or curing a life-threatening illness. 

Hospice experts also believe it may be time to consider hospice when curative treatments are no longer effective or desired, thus shifting focus to comfort and quality of life rather than duration of life. Declining health factors also contribute to this, as well as unfavorable diagnoses. 

Starting the Conversation

Talking about hospice can feel overwhelming, but open communication is essential.

Hospice organizations emphasize that these conversations should focus on:

• Your loved one’s wishes and values
• Their goals for care and comfort
• What does quality of life mean to them

Approaching the topic with empathy and honesty can help your loved one feel heard and respected during this stage of life.

The Hospice Foundation of America notes the importance of talking with your loved one before significant physical or cognitive impairment keeps them from making their own decisions. Starting the conversation early can prevent your loved one from experiencing unwanted or unsuccessful care and hospitalizations. The Hospice Foundation also lists some great questions to think about when having these conversations with your loved one, such as:

• What do you value most about your life?
• If you were diagnosed with an illness that could not be cured, would you want to pursue every possible treatment, even those that diminished your quality of life? Would you want to stop curative efforts if they were unsuccessful?
• If you were unable to eat or drink because of a terminal illness, would you want artificial nutrition (often called tube feeding) and hydration (intravenous fluids) even if they might not help you live longer?
• Understanding that cardiopulmonary resuscitation (CPR) could result in broken bones and other medical problems, would you want CPR if you were dying from an illness and were extremely frail?
• How do you feel about a lengthy hospitalization or extended time in a nursing home?
• Do you want to die at home? Who do you want near you when you are dying?
• How much pain is acceptable to you? Would you want to be pain-free even if it meant trading comfort for wakefulness or alertness?
• What decisions about your care do you want to entrust to others, and who would you designate to make those decisions? Have you shared your care preferences with that person and taken steps to ensure they are recognized as a healthcare proxy (also known as a medical power of attorney), substitute decision maker, or spokesperson?
• Do you want a funeral or a memorial service? If so, what music would you want? Who would you want to speak? Are there religious passages, poems, or other readings that would be meaningful to you? 
• Do you want an obituary? Does someone have the information needed to compose it?
• Do you want your body to be buried, cremated, or donated to science?
• If you have organs or tissue that could be donated to help others or to advance science, do you want to donate them? Have you made those wishes known?

You know your loved one better than anyone and know their personal beliefs and personality, all of which play a part in end-of-life and hospice care decisions. The conversation and questions don’t have to happen all at once; they can be many conversations over time, so as not to overwhelm you or your loved one. A tip we might add is making note of your loved one's responses and wishes to refer back to when needed. Documenting those conversations is an important step called advance care planning. Each state has its own laws about how care goals and preferences must be recorded; for Texas, those laws are stated in Chapter 166 of the Texas Health and Safety Code. You can check out the Health and Human Services page of Texas on Advance Care planning for further and more in-depth information and Advance Directive forms that you and your loved one can fill out — https://www.hhs.texas.gov/providers/long-term-care-providers/nursing-facilities-nf/advance-care-planning

Supporting Your Loved One During Hospice

In our last guest expert blog post, we discussed the pressure and stress of caregiving when it comes to balancing work, life, and senior care. This can get even more challenging and complicated when hospice comes into the picture. That’s because it involves a new element of emotions and sadness that might not have been there previously.

“For both the hospice patient and informal caregiver, there is the intrapersonal concern of coping with the suffering of self, and the interpersonal concern of coping with the suffering of the other during hospice care.” (Wittenberg-Lyles, et al., 2011)

An article exploring the themes of Reciprocal Suffering: Caregiver Concerns During Hospice Care, the difficulty some caregivers found in accepting hospice care, stating: Caregivers also described the emotional difficulty of moving from curative treatment to hospice care. A limited understanding of the concept was expressed by several caregivers who struggled to recognize the difference between the two approaches. They also highlighted the loved ones' feeling emotionally overwhelmed by the impending bereavement period. Having to witness your loved one on their deathbed is a challenging emotional rollercoaster, making it hard to effectively support yourself, let alone your loved one.

In a study on Improving Care Experiences for Patients and Caregivers at the End of Life, a strategy shown to improve caregiver knowledge was an effort of inviting family members/caregivers to participate in daily rounds, which improved caregiver knowledge of the patient’s physician and care plan (2020). 

Supporting your loved one during hospice care looks like caring for yourself first and foremost, as self-care is a vital part of caring for someone else. Your role as a caregiver and/or family member/loved one is deeply meaningful and thus sometimes challenging. Here are some key ways to provide support for your loved one:

1. Be Present

Sometimes the most powerful support is simply being there. Sitting quietly, holding a hand, or listening can bring immense comfort. You don’t need to bring a solution or make things right; just being there is enough!

2. Focus on Comfort

Work with the hospice team to ensure your loved one's pain and symptoms are well managed to ensure they are comfortable.

3. Communicate Openly

Encourage your loved one to express fears, wishes, or unresolved feelings. Honest conversations can help foster peace and closure.

4. Accept Help

Hospice teams are there for you, too. Accept assistance from nurses, social workers, and volunteers and realize that they are part of your support system. Staying in regular communication with them and sharing concerns or asking questions will help both you and your loved one.

5. Take Care of Yourself

Caregiving can be physically and emotionally draining, and it’s understandable! Respite care and support groups can help you recharge. “Supporting someone receiving hospice care can be emotionally and physically exhausting. While it’s common to feel guilty for taking time for yourself, understand that self-care isn’t selfish — it’s essential. Taking appropriate time for yourself allows you to provide optimal support for your loved one.” (Worroll, 2026)

You’re Not Alone

Choosing hospice care is one of the most compassionate decisions you can make for a loved one facing a serious illness. While the journey may feel overwhelming, hospice exists to guide you through it with expertise, empathy, and support!

At its core, hospice is about helping your loved one live their final chapter with comfort, dignity, and connection, all while helping you navigate that journey with confidence and care.

If you’re considering hospice for your senior loved one and have questions or would like some guidance on the process of exploring options, we are here for you! You can lean on professionals who can help you every step of the way here at Senior Industry Services, powered by Oasis Senior Advisors of Austin and Central Texas. Senior Industry Services is here to support families like yours with trusted guidance, resources, and compassionate care solutions.

Written for Senior Industry Services by Lauren Hope Bartling

References:

Bhatnagar M, Kempfer LA, Lagnese KR. Hospice Care. [Updated 2023 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537296/

De Swardt, M., Krause, R., & Jenkins, L. S. (2024, April 24). How to approach patients and families at the end of life. South African family practice : official journal of the South African Academy of Family Practice/Primary Care. https://pmc.ncbi.nlm.nih.gov/articles/PMC11079358/#:~:text=The%20person%20may%20gradually%20become,Treat%20these%20first. 

Godfrey, A. (2024, December 6). Starting the conversation. Hospice Foundation of America. https://hospicefoundation.org/starting-the-conversation/ 

Providing care and comfort at the end of life | National Institute on Aging. National Institute on Aging. (n.d.). https://www.nia.nih.gov/health/end-life/providing-care-and-comfort-end-life 

Quigley, D. D., & McCleskey, S. G. (2021, January). Improving care experiences for patients and caregivers at end of life: A systematic review. The American journal of hospice & palliative care. https://pmc.ncbi.nlm.nih.gov/articles/PMC8526304/#:~:text=Additionally%2C%20a%20strategy%20that%20improved,patient’s%20physician%20and%20care%20plan.&text=Another%20study%20identified%20a%20strategy,involvement%20with%20the%20patient’s%20family. 

Wittenberg-Lyles, E., Demiris, G., Oliver, D. P., & Burt, S. (2011, February). Reciprocal suffering: Caregiver concerns during Hospice Care. Journal of pain and symptom management. https://pmc.ncbi.nlm.nih.gov/articles/PMC3053049/#:~:text=The%20larger%20project%20aims%20to,of%20Washington%20Institutional%20Review%20Board. 

Worroll, S. (2026, January 14). 10 ways to support a loved one receiving hospice care. AccentCare. https://accentcare.com/10-ways-to-support-a-loved-one-receiving-hospice-care/