In the first 24 hours of hospice care at home, a registered nurse conducts an initial assessment, medications are reviewed, and essential medical equipment is delivered. AmeriHospice makes the admission process as smooth as possible for families in Dallas and Fort Worth, with a care team available around the clock. To begin the process, visit the admissions page.

The Moment Hospice Begins: What to Expect

Choosing hospice care for a loved one is an act of profound love. Once the decision is made, families often feel a mix of relief and uncertainty: relief that help is coming, and uncertainty about what that help will actually look like. Understanding what to expect in the first 24 hours can ease that uncertainty and help you focus on being present with your loved one.

AmeriHospice serves families across the Dallas and Fort Worth metro area, and our team is trained to make the admission process as gentle and organized as possible. Here is a detailed look at what typically happens from the moment hospice services begin.

Step 1: The Referral and Admission Coordination

The process begins before the first nurse arrives at the door. Once a referral is received, whether from a physician, hospital discharge planner, or family calling directly, the AmeriHospice admissions coordinator contacts the family to gather information, confirm physician orders, and schedule the initial assessment visit.

This coordination usually happens quickly. In many cases, the first nurse visit can be scheduled the same day the referral is received. Families can also initiate the process directly by reaching out to the 

Step 2: The Initial Nurse Assessment Visit

The most important event in the first 24 hours is the initial assessment visit from a registered nurse. This visit typically lasts one to two hours and covers several key areas:

The nurse will perform a comprehensive physical assessment of the patient, including vital signs, pain level, respiratory status, skin condition, and mobility. This creates the clinical baseline that guides all future care decisions.

Medications are reviewed in full. The nurse will go through every medication the patient is currently taking, identify which are related to the hospice diagnosis and will continue, determine which may be discontinued, and coordinate with the physician and pharmacy to ensure the right medications are in place.

A comfort kit, sometimes called a hospice emergency kit or go bag, is ordered or delivered. This kit contains pre-prescribed medications for common end-of-life symptoms including pain, anxiety, breathlessness, nausea, and secretions. Having these medications on hand means families can respond quickly to sudden changes without waiting for a pharmacy delivery.

Step 3: The Plan of Care Is Established

Based on the assessment, the nurse begins building an individualized plan of care that outlines the patient’s current needs, goals, and the specific services that will be provided. This plan is developed collaboratively with the family and the patient when possible.

The plan of care includes the schedule for nursing visits, 

Step 4: Medical Equipment Delivery

Any medical equipment ordered by the physician is typically delivered on the same day as admission or within 24 hours. Common equipment delivered in the first day includes a hospital bed to keep the patient comfortable and safe, a bedside commode, a wheelchair or transfer equipment, and oxygen supplies if the diagnosis involves respiratory distress.

The equipment supplier coordinates directly with the hospice team to ensure delivery is timely and that everything is set up properly in the home.

Step 5: Paperwork and the Medicare Hospice Election

There is an administrative side to hospice enrollment that happens during or shortly after the first nurse visit. The patient or their authorized representative will sign an election statement, which is the official document that enrolls the patient in the Medicare Hospice Benefit or the applicable insurance benefit. Additional consent forms and an explanation of patient rights and services are also reviewed and signed.

The admissions nurse or coordinator walks through each document clearly, making sure the family understands what they are signing and has the opportunity to ask questions.

Step 6: Family Education and On-Call Support

One of the most valuable things the first nurse visit accomplishes is preparing the family. The nurse will review what to watch for, what changes are expected as the illness progresses, and what to do in urgent situations. Families receive direct contact information for the 24-hour on-call nursing line so they are never left waiting or uncertain in the middle of the night.

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What the Days After Admission Look Like

After the first 24 hours, additional members of the interdisciplinary team will begin their visits. A social worker typically visits within the first few days to assess the family’s emotional, financial, and practical needs. A chaplain may visit if the family desires spiritual support. Aide visits are scheduled based on the patient’s care plan.

Within the first week, the full team will have had a chance to meet the patient and family and will begin the routine rhythm of visits that characterizes ongoing hospice care.

Frequently Asked Questions