Most hospices have services that are similar at least in description. Core staff and services usually include nurses, physicians, home health aides, chaplains, nutritionists, social workers, psychologists, volunteers, physical and occupational therapists, and bereavement services. It is unfortunate that hospice referrals are usually made in the last month or weeks of life when the patient is very ill, symptoms are severe, and the family exhausted. Late referrals to hospice are a mistake. It is very helpful to involve hospice in care before the patient is extremely ill, before symptoms are a major problem, and before the family is exhausted.
Early involvement results in at least some problems being prevented.
To get the maximum benefit from hospice, insist on an early referral from the physician or call hospice programs yourself. The central issue in hospice care is the skill and commitment of the staff in managing symptoms. Staff should also be committed to supporting patient and family and acting as an advocate for them. The amount and variety of services is secondary to these qualities. Some hospice programs are nonprofit and some are for-profit.