The first 48 hours of hospice care are usually the busiest, but they are also the most reassuring. According to the Centers for Medicare & Medicaid Services (CMS), hospice begins with an admission visit, the development of a personalized plan of care, and the start of regular nursing and support visits.
During this window, your hospice team will manage symptoms, deliver medical equipment, coordinate medications, and help your family feel supported in your own home. Here is what to expect, hour by hour.
Hour 0: The Admission Visit
The first 48 hours begin with the admission visit, usually performed by a registered nurse from the hospice team. This visit can take place in your home, a hospital, an assisted living community, or a skilled nursing facility.
During the admission visit, you can expect:
- A review of the patient’s diagnosis, current medications, and medical history
- A physical assessment to understand current symptoms and comfort needs
- A discussion of goals of care, preferences, and what matters most to your family
- A walkthrough of the Medicare Hospice Benefit and what it covers
- Signed consent forms to officially begin care
This is also when your family meets the nurse who will help guide you through the days ahead. You will receive a 24/7 phone number, and someone is always available, day or night.
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Talk With Our Care TeamFor a deeper look at how care begins, see our page on Starting Hospice Care.
The First Few Hours After Admission
Once the admission paperwork is complete, your hospice team begins coordinating the practical pieces of care. This is often when families feel the weight start to lift.
In the hours that follow, you can expect:
- Medical equipment delivery, such as a hospital bed, wheelchair, oxygen, or shower chair, depending on need
- Medication coordination, including a comfort kit with commonly used medications for pain, nausea, anxiety, and shortness of breath
- A care plan, built around the patient’s symptoms, preferences, and home environment
- An introduction to the broader team, including the medical director, registered nurses, aides, social workers, and spiritual care providers
If your loved one has open wounds, complex symptoms, or specialized needs, services like wound care are also coordinated in this window.
The First 24 Hours
By the end of the first day, most families have settled into a rhythm that feels more manageable. The bed is in place, the medications are organized, and someone from the hospice team has likely checked in again.
Here is what typically happens in the first 24 hours:
- Symptom management begins with the nurse adjusting medications as needed for pain, breathing, or restlessness
- The plan of care is finalized and shared with the family
- The hospice aide schedule is set, often beginning within a day or two, for bathing, grooming, and personal care
- A social work visit is scheduled, usually within the first few days, to help with paperwork, advance directives, or community resources
- A spiritual care visit is offered, regardless of faith background, for families who want that kind of support
You may also receive a folder or digital binder with phone numbers, instructions, medication logs, and what to do if a symptom changes overnight. Keep it in a place that is easy to find.
Hours 24 to 48: Building the Care Routine
The second day is usually about adjustments. Your nurse may revisit medication doses, your aide may begin regular visits, and your family may start to find a daily routine that works.
During this window, expect:
- A follow-up nursing visit to reassess comfort and adjust the plan of care as needed
- The first scheduled visit from the hospice aide, if not already started
- A check-in from the social worker to walk through any paperwork, financial questions, or planning concerns
- A conversation about which of the four levels of hospice care is right for the current situation, since needs can shift quickly
- Information about respite care if the primary caregiver needs a short break
- Resources for emotional care and ongoing family support
If your loved one is a veteran, your team may also coordinate benefits and recognition through veterans services.
What the Family Can Do in the First 48 Hours
You do not have to do everything at once. Most families do best when they focus on a few small things during the first two days.
Here is a simple checklist:
- Designate one primary contact for the hospice team, usually the person closest to the patient
- Keep the hospice phone number visible, on the fridge, on a phone, or near the bed
- Track symptoms simply, noting changes in pain, breathing, appetite, or alertness
- Move medications to one central spot, ideally a locked box if there are children or vulnerable adults in the home
- Take care of yourself, eat regular meals, sleep when you can, and accept help when it is offered
If you have questions about the role of the family during care, the Family Support section of the site walks through every service available, including bereavement care for the months ahead.
When to Call the Hospice Team
You can call your hospice team at any time, day or night. The number is staffed 24/7, and someone will answer. Most calls are about questions, comfort, or reassurance, not emergencies.
You should always call right away if you notice:
- New or worsening pain
- Difficulty breathing or significant changes in breathing patterns
- Confusion, agitation, or restlessness that is new
- Falls or skin injuries
- A sudden change in alertness or responsiveness
- Anything that simply does not feel right
If you are unsure, call. Trust your instincts. Our team would rather hear from you ten times in a day than have you wait through a worry alone.
You can reach Grace and Glory Hospice at (650) 898-5784 any time.
What If Hospice Is Not the Right Fit Yet?
Sometimes families realize within the first 48 hours that their loved one’s situation is different than expected. That is okay.
If the patient stabilizes or improves, they can be discharged from hospice and resume traditional care, with the option to return later. If hospice is not the right fit yet, palliative care may be a better starting point, since it can be received alongside curative treatment.
For a deeper comparison, read Hospice vs. Palliative Care: How to Know Which One Your Loved One Needs.
Talk to a Nurse Who Can Walk You Through It
If you are preparing for hospice or trying to decide whether it is time, the team at Grace and Glory Hospice is here to listen. Call us anytime at (650) 898-5784 any time, or you can request a free evaluation. We are a family-owned, nurse-led hospice serving Alameda, Contra Costa, San Mateo, San Joaquin, and Sacramento counties, and families always have direct access to the owner.





