What are the 4 levels of hospice care?

Published: Tuesday, January 16, 2024
Kimberly Deleon, BSN
Supervisor, Hospice of NGMC

If medical providers have recommended that your loved one enter hospice, you may have many questions about what that entails. The short answer: It depends on the type of care your friend or family member needs.

Hospice care isn’t one-size-fits-all. It’s a method of providing care for patients nearing the end of life, and it’s personalized to meet the needs of each individual person.

While your loved one’s individual care plan will vary and evolve, there are four levels (or types) of hospice care, as defined by Medicare. Keep reading to learn more about the levels of care and what’s involved in each.

Defining hospice

Before we dive into the different levels of hospice care, let’s first talk through the basics of what hospice is. Up until now, your loved one may have been receiving active treatment for a medical condition or conditions.

When medical treatment can no longer have a curative effect, hospice care may be recommended. Hospice care is for those with a condition that cannot be cured and an anticipated life expectancy of six months or less.

Those in hospice receive a wide range of care offerings, designed to manage symptoms and maintain quality of life. Hospice care providers are trained to meet the full spectrum of patient needs, caring for a person’s physical, mental, emotional, psychosocial, and even spiritual needs.

Levels of care

Within the broad scope of hospice care, there are four levels of care. A patient may receive different levels of care during their time in hospice, depending on their specific needs at a given time.

It’s important to note that the levels aren’t numbered and aren’t tiers you progress through—they’re simply different types of care. The four levels of hospice care include:

Routine home care

This level of hospice care is the most common. While “home” is in the name, routine home care is provided wherever a patient is, whether that’s in a house, an assisted living facility, or a skilled nursing facility.

Those receiving routine home care are generally considered in stable medical condition, with any symptoms well-controlled by medications or other measures. Services may include visits from a medical provider, nursing care, medications to relieve symptoms, nutritional counseling and support, medical supplies or equipment, and physical, occupational, and speech-language pathology services.

Continuous home care

When the patient receiving hospice care is less stable or dealing with a flare-up of symptoms, continuous home care may be provided. Like routine home care, this type of hospice care is provided wherever the patient is.

In contrast with routine home care, though, continuous home care is provided for a longer consecutive period of time. When a hospice patient experiences a medical crisis that isn’t well-controlled by medications or other therapies, continuous home care brings a hospice nurse into the home for at least eight hours in a 24-hour period to manage those symptoms. Other providers may also be in the home and offering care.

If symptoms such as pain or nausea ease or become better managed, continuous home care may be discontinued and a patient will begin receiving routine home care again.

General inpatient care

While many hospice patients can achieve relief of symptoms in the home setting, there may be times that more intensive care is needed. General inpatient care provides hospice care in an inpatient setting, such as a hospital, a freestanding hospice facility, or a skilled nursing facility.

In this level of hospice care, a hospice nurse can provide around-the-clock care to help ease a flare-up of symptoms like pain. Like with continuous home care, general inpatient care can be discontinued if symptoms ease.

Respite care

This level of care is unique because it is provided based on the needs of family members and other caregivers, rather than the hospice patient. Caregiving for someone with a serious health condition, such as those in hospice, can be incredibly stressful and overwhelming at times.

You may have heard the phrase “care for the caregiver.” That’s essentially what respite care provides. This temporary type of care involves a short stay for the hospice patient (up to five days) in a setting outside the home, such as a hospice facility, a nursing home, or a hospital. During that time, hospice nurses and other providers attend to the patient’s needs to allow caregivers a small amount of time to rest and recuperate.

Recapping the basics

If you have a loved one who enters hospice care, the level of care he or she needs will be determined by a team of hospice providers.

Care is provided to ease symptoms and maintain quality of life, and hospice patients may move from one level of care to another as their needs evolve. Our providers are here to offer support to our patients and their families at every step of the way.

Learn more

Hospice of Northeast Georgia Medical Center partners with you and your family to provide excellent care and enhance your quality of life. Call 770-219-8888 or visit our website for more information about how we can help.