Understanding Hospice Care
What is hospice care?
Hospice care is specialized medical care for people with life-limiting illnesses when curative treatment is no longer effective or desired. Instead of trying to cure the disease, hospice focuses on managing pain and symptoms, ensuring comfort, and supporting both patients and families through the end-of-life journey.
When is the right time to start hospice?
The right time to start hospice is when curative treatment is no longer working or the side effects outweigh the benefits, and a physician certifies that life expectancy is six months or less if the illness follows its natural course.
Isn’t hospice just for the last few days of life?
No. While some families wait until the final days to enroll, hospice is designed to provide support for weeks or months, not just days.
Research shows patients who receive hospice care live an average of 29 days longer than similar patients who don’t choose hospice, while also experiencing better comfort and quality of life.
What’s the difference between hospice and palliative care?
Palliative care focuses on symptom management and comfort for people with serious illnesses while they continue curative treatment. You can receive palliative care at any stage of illness.
Hospice care is a holistic care specifically for people who are no longer pursuing curative treatment and have a terminal prognosis of six months or less.
Think of it this way: palliative care is comfort care alongside treatment. Hospice is comfort care instead of treatment.
Getting Started with Hospice
How do I know if my loved one qualifies for hospice?
Your loved one may qualify for hospice if:
- A physician certifies that life expectancy is six months or less if the illness follows its natural course
- The focus of care shifts from curative treatment to comfort
- They have a terminal diagnosis such as cancer, heart failure, COPD, dementia, kidney disease, ALS, or another serious illness
Do we need a doctor’s referral to start hospice?
No formal referral is required, though many families come to us through their physician, hospital discharge planner, or a friend’s recommendation.
How quickly can hospice services start?
In many cases, hospice services can begin within 24 hours of enrollment.
Learn about the enrollment process
What if we start hospice and my loved one improves?
That’s completely okay. If your loved one’s condition stabilizes or improves and they no longer meet hospice eligibility criteria, they can be discharged from hospice and return to regular medical care.
Can we stop hospice if we change our minds?
Yes. Hospice is completely voluntary, and you can revoke it at any time for any reason.
Care Delivery: Who, What, When, Where
Who will be visiting my loved one and how often?
Your loved one will receive visits from a multidisciplinary team tailored to their specific needs:
- Registered Nurses (RN)
- Certified Nursing Assistants (CNA)
- Social Workers
- Chaplains
- Hospice Physician or Medical Director
- Volunteers
Visit frequency depends on your loved one’s needs and adjusts as their condition changes.
Meet your care team – Hospice Care Team
Where do hospice services take place?
Hospice care happens wherever your loved one lives:
- Your home (house, apartment, or family member’s residence)
- Assisted living facilities
- Skilled nursing facilities
- Hospitals
Most hospice care is provided at home, but our team serves patients in all residential settings across Virginia.
Are you available 24/7 if we need help?
Yes. James River Hospice provides 24/7 access to registered nurses every day of the year, including nights, weekends, and holidays.
Will my loved one still see their regular doctor?
Your loved one’s primary physician can remain involved in their care if they choose, though the hospice physician or Medical Director will oversee the hospice care plan.
Can we go to the emergency room or hospital if needed?
Hospice focuses on managing symptoms at home to avoid unnecessary hospitalizations. However, if hospitalization is necessary for acute symptom management, we coordinate that care.
Payment and Insurance
Who pays for hospice care?
Hospice care is covered by Medicare, Medicaid, and most private insurance plans with little to no out-of-pocket cost for families.
Learn more about hospice costs and coverage
What if my loved one doesn’t have Medicare?
If your loved one has Medicaid, hospice care is fully covered with typically no out-of-pocket costs.
If they have private insurance through an employer or Medicare Advantage plan, we verify coverage during enrollment and explain any potential copays or costs before care begins.
Does hospice cover room and board in assisted living or nursing homes?
Hospice covers all medical care, medications, and services related to the terminal illness.
Hospice does NOT cover room and board (rent, meals, housekeeping) at assisted living facilities or skilled nursing homes. Those costs continue to be paid separately by the family, Medicaid, or long-term care insurance.
Are there any hidden costs?
No. We verify your insurance coverage during enrollment and explain exactly what’s covered and any potential out-of-pocket costs (which are typically minimal) before care begins.
Family Support and Caregiving
What support do family caregivers receive?
Family caregivers receive extensive support, including:
- Education and Training
- Emotional Counseling
- Respite Care
- 24/7 Clinical Support
- Bereavement Services
Learn more about family support services →
What if I can’t provide care at home anymore?
If home care becomes unsustainable due to caregiver burnout, safety concerns, or medical complexity, we help explore options.
Can my children or grandchildren visit?
Yes. One of the benefits of home-based hospice is that there are no visiting hour restrictions. Children, grandchildren, and close friends can visit freely.
End of Life and After Death
What happens when my loved one is actively dying?
When death is imminent (hours to days away), our team:
- Increases visit frequency to ensure comfort
- Provides clear guidance on what physical changes to expect
- Stays in close contact by phone
- Can provide continuous nursing care (up to 24 hours) if needed
- Supports family members emotionally and spiritually
What do we do when death occurs?
When your loved one passes:
- Call our 24/7 nurse line (not 911)
- A hospice nurse comes to your home to pronounce death and provide support
- The nurse guides you through next steps, including contacting the funeral home
- We coordinate with the funeral home to arrange transport
- We provide immediate grief support and connect you with bereavement services
About James River Hospice
How is James River different from other hospice providers?
James River Home Health & Hospice stands out for:
- 24/7 Availability with Direct Nurse Access
- Rapid Response and Fast Enrollment
- High Visit Frequency
- Comprehensive Multidisciplinary Team
- ACHC Accreditation
- Local Expertise Since 2013
What areas do you serve?
James River Hospice serves families throughout Virginia with seven office locations:
Not sure if we serve your area? Call (855) 415-5744 and we’ll let you know immediately.
View all locations and contact information
Are you accepting new patients?
Yes. We are always accepting new hospice patients across all our service areas. Call us anytime at (804) 273-3300 to discuss your situation and begin the enrollment process.
Still Have Questions?
We’re here to help. If your question isn’t answered here, call us at (855) 415-5744 to speak with a member of our team. No question is too small. No concern is too minor. If it matters to you, it matters to us.
We’re available 24 hours a day, 7 days a week to answer questions, provide guidance, and help you determine if hospice is the right choice for your family.