What Families Can Expect in the First 48 Hours of Hospice Care

Deciding to enroll in hospice care is one of the most significant choices a family can face. Once that decision is made, a common question follows almost immediately:

“What happens now?”

The uncertainty of not knowing what comes next can feel overwhelming, especially when your family is already carrying so much. This guide is designed to walk you through the first 48 hours of hospice care, clearly, calmly, and without jargon, so you know exactly what to expect and can focus on being present with the people you love.

Before the First Visit: What Happens After Enrollment

Once your loved one’s physician certifies eligibility and the hospice election form is signed, the care team is activated. You do not need to prepare anything elaborate. The hospice team comes to you.

If you are still weighing whether this is the right step, our page on Considering Hospice Care and our Eligibility Guidelines can help you feel more confident in the decision before moving forward.

Once enrollment is complete, here is what the first 48 hours typically look like.

Hours 1 to 4: The Initial Nursing Visit

Within a few hours of enrollment, and often the same day, a registered nurse from the care team will come to your home or care facility to complete the initial assessment.

This visit has several purposes.

The nurse will:

• Review your loved one’s current symptoms, pain levels, and comfort needs
• Go over current medications and make any immediate adjustments needed for comfort
• Assess the home or care environment for safety and support needs
• Begin the formal intake paperwork and care planning process
• Answer your questions – about the process, about what to expect, about anything on your mind

This first visit is not a quick check-in. It is thorough because the nurse needs a full picture of your loved one’s condition before building a care plan. Most families find it takes one to two hours.

Hours 4 to 12: Medications and Equipment Arrive

One of the most immediate and meaningful changes that happens in early hospice care is access to comfort-focused medications and medical equipment – often the same day as enrollment or within the first 24 hours.

Medications related to the hospice diagnosis are covered under the Medicare Hospice Benefit and delivered directly to the home. 

Durable medical equipment – which may include a hospital bed, wheelchair, bedside commode, oxygen concentrator, or other items based on your loved one’s needs – is arranged and delivered by the hospice team. 

For many families, this part of the first day brings a visible sense of relief. Having the right tools and medications in place, and having a team coordinating all of it, removes a significant burden that caregivers had often been managing alone.

Within the First 24 Hours: Meeting Your Care Team

Hospice care is not delivered by one person. It is provided by an interdisciplinary team, and the first 48 hours begin the process of introducing your family to each member.

Your core care team at Foundations Hospice includes:

• Registered Nurses who make regular visits, monitor comfort and symptoms, and are available by phone 24 hours a day, 7 days a week
• Certified Nursing Aides (CNAs) who assist with personal care – bathing, grooming, positioning – based on the care plan
• A Medical Director who oversees the clinical care plan and coordinates with your loved one’s physician
• A Social Worker who helps with practical needs, family communication, and emotional support
• A Spiritual Care Coordinator who offers compassionate presence and support for patients and families of all beliefs

Not every team member will visit on day one, but introductions begin quickly. Your nurse will explain who is part of your team and when you can expect each person to visit.

Within the First 48 Hours: The Care Plan Review

The hospice team develops a personalized plan of care based on the information gathered during the initial assessment. This plan reflects your loved one’s diagnosis, current symptoms, comfort goals, personal values, and your family’s preferences.

Within the first 48 hours, a nurse or care coordinator will walk you through this plan – not just to inform you, but to make sure it accurately reflects what your loved one wants. You have every right to ask questions, request adjustments, and make sure the plan feels right.

The care plan covers:

• Symptom management and comfort medications
• Frequency of nursing and aide visits
• Equipment and supply needs
• Goals of care and personal wishes
• Family contact preferences and emergency protocols

What Your Family May Be Feeling in the First 48 Hours

You may feel relieved that your loved one is finally getting focused comfort care. You may also feel a deep sadness at what this transition represents. Both of those things are true, and both of them are completely understandable.

The hospice team is prepared to hold space for that complexity. Our Social Workers and Spiritual Care coordinators are specifically trained to support families through the emotional dimensions of this season – not just the practical ones. You do not need to hold it together for the team. They are here for all of it.

Bereavement support also begins during this period and continues after your loved one passes. Learn more about how we support families through grief on our Bereavement Care page.

Common Questions Families Have in the First 48 Hours

• Can we still have our regular doctor involved? Yes. Your loved one’s primary physician can remain involved in their care. The hospice Medical Director coordinates with them to ensure continuity.
• Will someone be at the house all the time? Hospice care under the routine home care level involves scheduled visits, not continuous bedside presence. However, a nurse is 24/7 available by phone, and visit frequency increases as the patient’s condition changes. See more details: 4 Levels of Care.
• What if something changes in the middle of the night? Call your hospice care line. A nurse is always available, day or night, to talk you through what is happening and determine whether a visit is needed.
• Can we change something about the care plan? Absolutely. The care plan is a living document. If something is not working or your loved one’s needs change, the team adjusts.
• What does the first visit cost? For Medicare-eligible patients, hospice care is covered under the Medicare Hospice Benefit with no out-of-pocket cost for covered services. For a full overview, visit our Hospice Care page.

What Comes After the First 48 Hours

Once the initial setup is complete, hospice care settles into a rhythm. Nurses visit on a regular schedule, aides assist with personal care, and the broader team checks in based on your loved one’s needs and your family’s preferences.

As the illness progresses, the level and frequency of care adjust accordingly. You do not have to figure out when to ask for more support – the team is monitoring the situation alongside you.

For a broader look at what the hospice journey involves over time, read our guide on What to Expect and our page on Caring for a Hospice Patient.

We Are Here When You Are Ready

If your family is navigating this season across Southeast Louisiana – including Livingston, St. Tammany, Baton Rouge, or any of the surrounding parishes – our team is available around the clock.

Call us at (225) 209-5629 or schedule a care consult whenever you are ready. There is no pressure, no obligation – just a caring team ready to answer your questions and walk alongside your family.