Hospice care under Medicare is organized around a written plan of care. The federal hospice rules require the hospice team to put one together and to review it on a set schedule. Most families sign a great deal of paper in the first week and never see that document. You can ask for it, and it helps to know what you are looking for before the next visit.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
This is not a clinical review. You are not being asked to judge medical choices. You are checking whether the document answers the questions that will shape your household's week.
Ask for the document and the review schedule
Ask the hospice for a copy of the current plan of care. Ask how often the interdisciplinary team reviews it, and what would trigger an earlier review. Ask who you call if the plan no longer matches what is happening in the house. Write the answers down with the name of the person who gave them.
Check who is listed to visit and how often
Read which disciplines the plan names, the visit frequency for each, and the difference between scheduled visits and visits made when the family calls. Many families assume the calendar is the whole support. Compare what the plan says with what the first weeks have actually looked like, and ask the agency to explain any gap.
Check how medicines are described
The plan lists medicines and the people responsible for them. Read that section for who the nurse coordinates with, who the pharmacy contacts, and what the family is expected to handle. A non-medical caregiver's role with medicine is limited to reminders and picking up prescriptions as an errand. If the document and what you were told do not agree on that point, ask the nurse to correct it in writing.
Check the goals and the changes you were told to expect
Look for a plain statement of the goals of care and any description of what changes the team expects you to watch for. Ask the nurse to say, in plain words, which changes should prompt a call and at what hour. Ask whether the call route differs at night and on weekends. Then ask how you will know the plan has been revised, whether you will receive the new copy, and how to request a meeting.
Keep the copy where the household can find it
Put the current copy with the other hospice papers, and note when each revision arrived. When the plan changes, read the new version against the old one. The sources page lists the federal and state references this site relies on for these documents.