08 May Everything You Need to Know About the Different Levels of Hospice Care
Learn about the four levels of hospice care—routine Home Care, Continuous Home Care, General Inpatient Care, and Respite Care—and how they provide flexible support based on patient needs.
Hospice care is a comprehensive approach to end-of-life support, but the intensity and location of care can vary depending on the patient’s needs. Understanding the different levels of hospice care can help patients and families know what to expect and when a change in the level of care might be necessary. These levels are defined by Medicare and are designed to meet the patient’s needs wherever they call home.
Levels of hospice care
- Routine Home Care
This is the most common level of hospice care. It is provided in the patient’s home, which can be a private residence, an assisted living facility, or a nursing home.
What to Expect: Intermittent visits from members of the hospice team (nurses, home health aides, social workers, chaplains, volunteers) based on the patient’s needs. The primary caregiver provides most of the day-to-day care.
Focus: Managing symptoms, providing education and support to the caregiver, and ensuring the patient’s comfort.
Setting: Patient’s place of residence.
- Continuous Home Care
This level of care is provided during periods of crisis when a patient is experiencing acute medical symptoms that require close monitoring and hands-on care to achieve palliation (symptom control).
What to Expect: More intensive nursing care in the home for a temporary period (usually 8 to 24 hours per day). The focus is on managing acute symptoms to prevent hospitalisation.
Focus: Crisis management, intensive symptom relief, and support to stabilise the patient’s condition in their home.
Setting: Patient’s place of residence.
Goal: To manage the crisis so the patient can return to routine home care.
- General Inpatient Care
This level of care is provided for short-term stays in an inpatient facility when symptoms cannot be managed in any other setting.
What to Expect: 24-hour skilled nursing care in a hospital, inpatient hospice unit, or skilled nursing facility that has an agreement with the hospice agency. This is for acute symptom management that requires a higher level of medical intensity than can be provided in the home.
Focus: Aggressive symptom management in a controlled environment until symptoms are under control.
Setting: Approved inpatient facility.
Goal: To manage acute symptoms so the patient can return to their home or a less intensive level of care.
- Respite Care
Respite care is short-term inpatient care provided to give the primary caregiver a break.
What to Expect: The patient stays in an approved facility for a temporary period (typically up to five consecutive days). The hospice team provides care during this time.
Focus: Providing relief for the family caregiver.
Setting: Approved inpatient facility (hospital, skilled nursing facility, or inpatient hospice unit).
Goal: To support the caregiver and allow them to rest and recharge.
The hospice team continuously assesses the patient’s needs to determine the most appropriate level of care. The goal is always to provide the right level of support to ensure the patient’s comfort and quality of life, wherever they are. Understanding these levels helps families know that hospice care can adapt to changing circumstances and provide continuous support throughout the end-of-life journey. Reach out to us at https://angelwingshospice.org/contact-us/
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