First 48 Hours of Hospice: What to Expect | Engrace Hospice

The hours after starting hospice are filled with questions. Here is what actually happens, who comes to your door, and what you need to have ready.

The call has been made. The papers are signed. And now you are waiting, wondering what happens next.

The first 48 hours of hospice care are busy, but they are also predictable. Knowing what to expect can ease the anxiety that comes with any new experience, especially one as significant as this. Here is exactly what happens after you call Engrace Hospice in Pendleton, Oregon.

The First Call: What We Need From You

When you call Engrace to start hospice care, an intake coordinator will gather some basic information. This usually takes 15 to 20 minutes.

We will ask about:

• The patient's diagnosis and recent medical history
• Current medications and symptoms
• Where the patient lives (home address, nursing facility name)
• Insurance information (Medicare, Medicaid, or private insurance)
• Who the primary contact person will be
• The name of the physician who is certifying hospice eligibility

If the patient does not yet have a physician willing to certify, we can help with that too. We work with doctors throughout Umatilla County and can coordinate the necessary paperwork.

Once we have what we need, we schedule the first nursing visit. This typically happens within 24 hours, often the same day if the situation is urgent.

The First Nursing Visit: Assessment and Planning

A registered nurse arrives at the patient's location with a simple goal: understand what is happening and build a plan to keep the patient comfortable.

This first visit usually lasts one to two hours. The nurse will:

• Review the patient's medical history and current condition
• Assess pain levels and other symptoms
• Check vital signs and overall physical status
• Review all current medications
• Look at the home environment for safety and comfort
• Talk with the patient and family about goals and concerns
• Answer questions about what comes next

This is not a rushed appointment. The nurse is there to listen as much as to assess. Families often have questions they have been holding in for weeks. This is the time to ask them.

Who Else Visits in the First 48 Hours

Hospice care involves a team, not just one nurse. Depending on the patient's needs and your location in Eastern Oregon, you may also see:

Certified Nursing Assistant (CNA): If the patient needs help with bathing, dressing, or personal care, a CNA may visit within the first day or two to establish a schedule. Most patients receive CNA visits two to five times per week.

Social Worker: A medical social worker typically visits within the first 48 hours to talk through practical concerns. Do you need help with advance directives? Are there family conflicts about care decisions? Is there financial stress the family is carrying quietly? The social worker is there for all of it.

Chaplain or Spiritual Care Coordinator: If the patient or family requests spiritual support, a chaplain will visit. This is not about pushing religion. It is about listening to what gives a person meaning and helping them find peace, whatever that looks like for them.

Medications, Equipment, and Supplies

One of the most common questions families ask: how do we get the medications?

During or shortly after the first nursing visit, the hospice team arranges delivery of:

• Comfort medications for pain, anxiety, nausea, and breathing difficulty
• Medical equipment such as a hospital bed, wheelchair, oxygen concentrator, or commode
• Medical supplies including wound dressings, incontinence products, and disposable gloves

All of this is covered under the Medicare Hospice Benefit. Most families pay nothing out of pocket.

The nurse will explain what each medication is for and how to administer it. If you are uncomfortable giving medications, the nurse or CNA can handle it during their visits.

The 24/7 Contact Number

Before the first 48 hours are over, you will have a direct phone number that reaches a hospice nurse at any hour of the day or night.

This is not an answering service that takes messages. It is a real nurse who knows your loved one's situation and can guide you through symptoms, medication questions, or emergencies.

Many families tell us this phone number alone changes everything. For the first time in months, they are not alone with hard decisions at 2 a.m.

What You Should Have Ready

To make the first 48 hours go smoothly, gather these items if you can:

• A list of current medications, including over-the-counter drugs and supplements
• Insurance cards (Medicare, Medicaid, or private insurance)
• Emergency contact information for family members
• Any advance directives or living wills the patient has completed
• A comfortable chair for the nurse to sit in during the assessment
• Questions written down so you do not forget them in the moment

Do not worry if you cannot find everything. The hospice team will work with whatever you have.

Frequently Asked Questions

Can we still go to the ER if something happens? In most cases, the hospice team can manage symptoms at home without a trip to the emergency room. That is the whole point of having 24/7 support. However, if you feel an ER visit is necessary, you always have that choice. We will help you think through whether it is truly needed.

What if the patient gets better? People do sometimes improve on hospice care. Better pain management, reduced stress, and personalized attention can lead to unexpected stabilization. If this happens, the patient can be discharged from hospice and return to curative treatment. They can also come back to hospice later if needed.

Do we have to sign more papers? The main consent forms are signed at the beginning. After that, the focus is on care, not paperwork. The nurse may ask you to sign a few forms related to specific medications or equipment deliveries, but nothing as involved as the initial enrollment.

Engrace Hospice serves patients and families in Pendleton, Oregon and throughout Umatilla County. Our team is available 24 hours a day. Call us at +1 541-263-7494 or contact us online. If you are wondering whether it is the right time for hospice, you may also find our guide on when to choose hospice helpful.