How to Get Hospice Care at Home: A Step-by-Step Guide for Arizona Families

If you’re reading this, someone you love is probably getting sicker, and you’re tired. Maybe there have been more ER trips. Maybe your mom now sleeps most of the day. Maybe a doctor mentioned the word “hospice” and nobody explained what comes next.

Care Plus Hospice is a family-owned hospice agency in Scottsdale, serving families across the Phoenix metro. We’ve guided many families through this exact moment. Here is what we want you to know: getting hospice care at home is simpler and faster than most people expect, and anyone can make the first call.

This guide walks you through the whole process, from the first phone call to the first nurse visit at your door.

The short answer

1. Call a hospice agency. A family member, a doctor, a hospital case manager, or an assisted-living discharge planner can make the call. Anyone can start the process.
2. Get a hospice order. Hospice care can’t begin without an order (referral). It can come from the patient’s primary care doctor (PCP), a specialist, a hospital case manager, a discharge coordinator, or the facility where the patient lives. If you don’t have one yet, we help you get it.
3. A physician certifies the patient. The patient’s doctor (if they have one) and the hospice medical director confirm the patient qualifies.
4. The admission visit happens at home. At Care Plus, this is usually the same day you call.
5. Care begins. Nurses, aides, a social worker, and a chaplain start visiting. Equipment and medications are delivered to the house.

Below is each step in detail, plus the questions families ask us most.

Step 1: Recognize when it may be time

Hospice is for people with a serious illness who are expected to live six months or less if the illness follows its usual course. Families rarely know that date in advance, and they don’t need to. The signs we see most often are:

• Hospital visits keep repeating. Three or four admissions in a few months, each one leaving the patient a little weaker.
• Treatments are no longer helping, or the burden of treatment outweighs the benefit.
• Unplanned weight loss, eating very little, or trouble swallowing.
• More time in bed or a chair, and needing help to bathe, dress, or walk.
• Symptoms getting harder to control at home: shortness of breath, pain, confusion, or restlessness.
• A doctor has said “there isn’t much more we can do,” or “you might want to think about comfort care.”

Common hospice diagnoses include heart failure, COPD, dementia and Alzheimer’s, cancer, kidney disease, liver disease, stroke, ALS, and Parkinson’s. It also includes general “failure to thrive” in older adults.

You don’t have to be sure. If you’re asking the question, it’s worth a phone call. An evaluation is free and doesn’t commit you to anything.

Step 2: Make the call (anyone can)

Many families think they have to wait for someone else to bring up hospice. You don’t. At Care Plus, the first call comes from all of these people:

• Family members: a spouse, an adult child, or a grandchild.
• The patient’s doctor or specialist.
• Hospital case managers and discharge planners.
• Assisted-living and group-home staff.

When a family calls us directly, we contact the doctor for you. You don’t have to manage the paperwork or chase signatures. That’s our job.

You’ll need a hospice order to start

To begin hospice services, we need a hospice order (also called a referral). Any of these can provide it:

• The patient’s primary care physician (PCP) or specialist, such as a cardiologist, oncologist, or neurologist.
• A hospital case manager or discharge coordinator, if the patient is in the hospital.
• A skilled nursing, rehab, or assisted-living discharge planner.
• Other treating providers, such as a nurse practitioner or palliative care team.

Already have the order? Tell us when you call, or have the provider fax it to us at 480-520-4727. We can often admit the same day.

No order yet? Call us anyway. With your permission, we contact the patient’s doctor or the hospital case manager, explain what the patient needs, and request the order for you.

Have these ready if you can (it’s fine if you don’t have them all):

• The patient’s full name, date of birth, and address.
• Their Medicare, AHCCCS, or insurance card.
• The name of their primary doctor or specialist.
• The main diagnosis and a list of current medications.

Step 3: Eligibility and physician certification

A hospice nurse will talk with you and review the patient’s medical history. For Medicare to cover hospice, two physicians must certify that the patient’s life expectancy is six months or less if the illness runs its normal course:

• The patient’s attending physician, if they have one.
• The hospice medical director.

This sounds formal, but it moves quickly. We coordinate it directly with the doctor’s office, usually within hours.

If the patient doesn’t qualify yet, we’ll tell you honestly. We’ll also tell you what to watch for, and point you to palliative or home-health options in the meantime.

Step 4: The admission visit (same day at Care Plus)

This is where Care Plus is different. We admit patients the same day. When a family is in crisis, “we’ll get you on the schedule next week” isn’t good enough.

A hospice nurse comes to wherever the patient lives: a house, an apartment, an assisted-living community, or a group home. During the visit, the nurse will:

• Examine the patient and review symptoms and medications.
• Explain the hospice benefit in plain language and answer every question.
• Go over consent forms with the patient or their legal decision-maker.
• Ask what matters most to the patient and family: staying home, managing pain, being alert for a grandchild’s visit, or a spiritual wish.
• Order what’s needed. A hospital bed, oxygen, wheelchair, commode, and comfort medications are typically delivered to the home, often that same day or the next.

Step 5: What hospice care at home actually looks like

Once admitted, the patient has a whole team built around them:

And the most important piece: a hospice nurse is on call 24 hours a day, 7 days a week. If something changes at 2 a.m., you call us, not 911. We walk you through it by phone or come to the house.

The four levels of hospice care

Medicare defines four levels of care, and Care Plus provides all four:

1. Routine home care: scheduled visits at home. This is where most patients are most of the time.
2. Continuous home care: extended nursing at home during a short-term crisis, such as uncontrolled pain or severe breathing distress.
3. General inpatient care: short-term care in a facility when symptoms can’t be managed at home.
4. Respite care: up to 5 days of care in a facility so the family caregiver can rest.

“Does choosing hospice mean we’re giving up?”

This is the fear we hear more than any other. It’s the reason so many families wait too long.

Hospice is not giving up. It changes what you’re fighting for.

Instead of fighting the disease with treatments that no longer work, you fight for:

• Comfort: pain and breathlessness under control.
• Time at home, not in an ER waiting room.
• Good days: meals together, visits with grandchildren, conversations that matter.
• Dignity: care that follows the patient’s wishes.

A few facts that surprise families:

• You can leave hospice at any time. If the patient wants to try a new treatment, they can stop hospice and return later if needed.
• Some patients improve on hospice. Better symptom control, fewer hospital stays, and regular nursing attention can bring stability. If a patient no longer qualifies, they are discharged — and that’s good news.
• Other health conditions are still treated. Hospice covers the terminal diagnosis. Medicare still covers care for unrelated problems.
• Hospice isn’t only for the last few days. The benefit is designed for the last six months, and families consistently tell us they wish they had started sooner.

A story we see again and again

We hear that sentence more than any other.

Who pays for hospice at home?

For most families, hospice care costs little or nothing out of pocket.

• Medicare Part A covers hospice in full for eligible patients. That includes nursing visits, aide visits, the social worker, chaplain, medical equipment, supplies, and medications related to the terminal diagnosis. There may be a small copay (up to $5) per prescription and a small coinsurance for inpatient respite care.
• Medicare Advantage members are still covered. Hospice is paid through Original Medicare, so you can choose any Medicare-certified hospice, including Care Plus.
• AHCCCS (Arizona Medicaid) covers hospice for eligible members.
• VA benefits cover hospice for eligible veterans.
• Most private insurance plans include a hospice benefit.

Not sure what the patient has? Call us with their card in hand, and we’ll verify coverage for you at no charge.

Why families choose Care Plus Hospice

We’re a family-owned hospice, and that isn’t just a line on our website. It’s how we practice. We care for every patient as if they were our own family. That means:

• Same-day admissions, because families in crisis shouldn’t wait.
• A 24/7 nurse line answered by people who know your loved one’s plan.
• Anyone can call: family, doctors, hospitals, or assisted-living communities. We help you get the hospice order from the PCP, hospital case manager, or discharge coordinator.
• Care wherever home is: private homes, assisted living, and group homes across the Phoenix metro.
• Honest guidance, including telling you if hospice isn’t the right fit yet.

Frequently asked questions

Can I call about hospice for my parent myself?

Yes. Any family member can call. Services start once there is a hospice order from a doctor, hospital case manager, or discharge coordinator. If you don’t have one, we contact the provider and request it for you.

How fast can hospice start at home?

At Care Plus Hospice, admission is typically the same day we receive the hospice order.

Can hospice be provided in assisted living?

Yes. “Home” means wherever the patient lives, including assisted living, group homes, and memory-care communities.

What if my loved one lives longer than six months?

Hospice can continue as long as a physician recertifies that the patient still qualifies. Medicare’s hospice benefit has no fixed limit.

Can we stop hospice if we change our minds?

Yes, at any time. You can return to hospice later if needed.

Do we still call 911 on hospice?

In most situations, no. Call the hospice 24/7 line first. A nurse can often manage the problem at home and avoid a stressful ER trip.