Start with Medicare's Care Compare to find nearby Medicare-approved hospices and review their public quality information. Then interview your strongest candidates about dementia experience, 24/7 support, symptom crises, and the care your family must provide. Hospice is comfort-focused care for someone approaching the end of life. Quality scores can narrow your options, but they cannot replace direct questions about staffing, dementia support, and the individual care plan.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Is Your Family Member Eligible for Hospice?
- Build a Local Shortlist
- Which Quality Measures Matter?
- Test the Hospice's Dementia Readiness
- Clarify What Hospice Will—and Will Not—Provide
Is Your Family Member Eligible for Hospice?
For Medicare hospice eligibility, the hospice doctor and attending doctor must certify that the person's prognosis is six months or less. The patient must also choose comfort-focused care instead of treatment intended to cure the terminal illness, according to Medicare's hospice coverage guidance. Ask the person's clinician whether a hospice evaluation is appropriate.
An evaluation lets the hospice review eligibility and explain what it could provide; it does not require your family to select that provider. Before enrolling, clarify which illness the hospice considers terminal and which treatments would remain available. This helps prevent misunderstandings about the shift from curative treatment to comfort-focused care.
Build a Local Shortlist
Enter your location in Medicare's Care Compare directory to identify nearby Medicare-approved hospices. use the public information to create a manageable shortlist before calling providers.
For each hospice, record: Do not choose solely by proximity or a single rating. A slightly farther provider may offer a clearer after-hours plan or more relevant dementia experience.
- Whether it serves the person's home, facility, or current location
- Its publicly reported quality and family-experience results
- Whether it is accepting patients
- How quickly it can arrange an evaluation
- Who answers calls at night and on weekends
Which Quality Measures Matter?
Look at family-experience results alongside clinical measures. CMS reports hospice quality information drawn from caregiver surveys, Medicare claims, and the HOPE patient-assessment tool. CMS measures whether hospices assess treatment preferences, pain, breathlessness, beliefs and values, and bowel regimens for people receiving opioids.
Its end-of-life visit measure also shows the proportion of eligible patients who received in-person registered-nurse or social-worker visits on at least two of their final three days. These details appear on CMS's current hospice measures page. The Hospice Care Index combines ten claims-based indicators, including nursing-visit gaps, weekend nursing minutes, live discharges, hospital transitions, and visits near death. CMS does not report the index for hospices with fewer than 20 discharges across two pooled years, so missing data does not automatically establish poor quality.
Test the Hospice's Dementia Readiness
Ask for concrete evidence of dementia experience. The Alzheimer's Association recommends asking whether staff have cared for other people with Alzheimer's, whether the hospice is Medicare-certified, whether it operates a 24/7 call line, and which specialized comfort services it offers.
Use scenario-based questions rather than accepting broad assurances: Ask who would actually serve your family, not only what the organization offers in general. Staffing and response details are more useful when they describe the assigned team and a specific after-hours process.
- Who guides us when the patient cannot clearly express discomfort?
- Which team member visits when symptoms change suddenly?
- What dementia-specific training or experience does the assigned team have?
- How do you learn the patient's preferences, beliefs, values, and familiar routines?
- What happens if symptoms cannot be controlled in the current setting?
Clarify What Hospice Will—and Will Not—Provide
Home hospice does not normally include round-the-clock hands-on custodial care. Ask how much day-to-day care the family or another caregiver must provide, when staff make routine visits, and how urgent needs are handled after hours. A Medicare-certified hospice must develop an individualized written care plan with the attending clinician, patient or representative, and primary caregiver.
Covered services can include nursing, medical equipment, symptom-control drugs, social work, spiritual counseling, grief support, short-term inpatient symptom care, and respite. Before signing, request a plain-language explanation of: Compare the written answers from at least two suitable providers. If a hospice cannot clearly explain its after-hours response, caregiver responsibilities, or plan for uncontrolled symptoms, continue interviewing other candidates.
- Which services and equipment the hospice will arrange
- Whom to call during a symptom crisis
- When respite may be available
- Where short-term inpatient symptom care would occur
- How the plan will change when the patient's needs change
