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What to Expect: The First Week

A guide to the initial days of hospice care and what happens during the transition.

Written and reviewed by a board-certified hospice & palliative medicine physician

Last reviewed:

The First Few Days are About Setup

The first week of hospice is a transition period. Your hospice team will visit frequently to assess needs, deliver equipment, teach you about medications, and create a care plan. Don't worry—they'll guide you through everything step by step.

Timeline: What Happens When

Day 1

Initial Assessment & Admission

  • RN visit (1-3 hours): Complete health assessment, vital signs, medication review
  • Paperwork: Sign consent forms, advance directives, DNR orders (if desired)
  • Care plan discussion: Goals, preferences, symptom management strategies
  • Emergency contact card: 24/7 phone number for your hospice team
  • Equipment ordered: Hospital bed, commode, oxygen (if needed)
Days
2-3

Team Introductions & Equipment Delivery

  • Medical equipment arrives: Delivery and setup by hospice staff
  • Medications delivered: Pain meds, comfort medications, emergency kit
  • Social worker visit: Emotional support, advance care planning, resource connections
  • Chaplain introduction: Spiritual support offered (optional)
  • Aide schedule set: Times for bathing, personal care assistance
Days
4-7

Routine Begins & Fine-Tuning

  • Regular nursing visits: RN assesses comfort, adjusts medications
  • Aide visits start: Help with bathing, grooming, comfort care
  • Symptom management: Pain control optimized, other symptoms addressed
  • Volunteer offered: Companionship, respite for caregiver
  • Family education: What to expect, how to provide care, when to call

Who You'll Meet

🩺 Registered Nurse (RN)

Your main contact. Visits regularly to assess and manage symptoms.

Typical visits: 2-3x/week initially, adjusted as needed

Hospice Medical Director

Provides medical oversight, guides the care plan, and manages complex symptoms.

Typically does not see patients in person unless required for certification or specific medical needs.

Certified Nursing Assistant (CNA)

Helps with bathing, dressing, grooming, and personal care.

Typical visits: 2-3x/week or more if needed

Social Worker (MSW/LCSW)

Provides emotional support, counseling, and resource connections.

Typical visits: Initially, then as needed

Chaplain/Spiritual Counselor

Offers spiritual support (all faiths or none welcome).

Optional—visits only if desired

🫂 Trained Volunteer

Provides companionship and gives caregivers a break.

Optional—usually starts after first week

Common First-Week Concerns

"It feels overwhelming with so many people coming"

Normal! The first week has more visits as the team assesses and sets up care. After that, visits become more routine and predictable.

"I don't know what I'm supposed to do"

The team will teach you! Nurses will show you how to give medications, recognize signs of discomfort, and provide basic care. You'll learn as you go, with support every step.

"It makes death feel more real"

This is a huge emotional shift. It's okay to feel sad, scared, or overwhelmed. The social worker and chaplain are there specifically to support you through these feelings.

"Did we make the right choice?"

Completely normal doubt. Many families experience this. Talk to your nurse or social worker about your concerns. Remember: you can always change your mind and leave hospice if you want.

"When should I call for help?"

Call anytime you're concerned! The team is available 24/7. New symptoms, increased pain, anxiety, confusion, or just needing reassurance—all are valid reasons to call.

What to Have Ready

Helpful to gather before the first visit:

Medical Information:

  • • List of current medications
  • • Medical history summary
  • • Recent hospital/doctor records
  • • Insurance cards (Medicare, Medicaid, private)
  • • Advance directives (if you have them)

Practical Items:

  • • Emergency contact list
  • • Notebook for tracking symptoms/visits
  • • Questions you want to ask
  • • Space cleared for medical equipment
  • • List of patient's preferences/goals

Don't worry if you don't have everything—the team will help you gather what's needed.

After the First Week

Once the initial setup is complete, visits become more routine:

  • Nurse visits: 1-3x per week (more if needed)
  • Aide visits: 2-5x per week for personal care
  • Social worker: As needed for support
  • Other team members: Available when needed
  • 24/7 on-call: Always available by phone

Visit frequency increases if symptoms worsen or as end of life approaches.

Pro Tips for the First Week

Write things down: Keep a notebook for questions, instructions, and observations
Ask for clarification: If you don't understand something, ask again. No question is silly.
Save the 24/7 number: Put it in your phone and post it visibly
Accept all help offered: Volunteers, respite care, equipment—say yes to support
Be patient with yourself: It takes time to adjust. The team knows this and will support you.

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