Hospice care is not only for the last days. When you start earlier, your team has time to fine-tune medications, deliver equipment, teach practical skills, and be there after hours when things change. The result is more control and less scrambling. 

Hospice begins when a serious illness is no longer responding to curative treatment or when the focus shifts to comfort and quality of life. Life expectancy’s timeline can be extended if your loved one continues to meet criteria, so starting hospice earlier does not shorten care.

General Signs It Is Time To Consider Hospice

You do not need every sign on this list. Patterns of decline are what matter most.

• More frequent ER trips or hospitalizations in the past few months.
  
• Unintentional weight loss, appetite changes, or increasing fatigue.
  
• Shortness of breath at rest or with minimal activity.
  
• Uncontrolled or escalating pain or symptoms despite treatment.
  
• Spending more than half the day in a chair or bed, needing help with most daily tasks.
  
• Caregiver burnout and safety concerns at home.

If several of these sound familiar, it is reasonable to ask the doctor for a hospice evaluation. There is no commitment simply for asking.

Dementia: Clear Signs It Is Time For Hospice

For Alzheimer’s disease and related dementias, clinicians often use the Functional Assessment Staging Tool (FAST) to understand progression. FAST Stage 7 usually signals end-stage dementia and often aligns with hospice eligibility. Common signs at this stage include very limited or no meaningful speech, inability to walk independently, and problems staying awake for long periods. Secondary complications like infections and weight loss also matter. 

What You Might Notice At Home:

• Needs help with dressing, bathing, toileting, transfers, and eating.
  
• Sleeps much of the day and has limited interaction.
  
• Difficulty swallowing, frequent choking or coughing with meals, recurrent infections.
  
• Nonverbal expressions of discomfort such as grimacing, agitation, or shouting.

How Hospice Helps In Dementia:

• Symptom relief for anxiety, agitation, pain, and breathing changes.
  
• Swallowing and nutrition guidance that prioritizes comfort.
  
• Caregiver teaching on safe transfers, skin care, and preventing infections.
  
• Consistent support at home and 24/7 phone access.

Read our guide to learn more about the Benefits of Hospice Care for Dementia Sufferers.

Congestive Heart Failure (CHF): Clear Signs It Is Time For Hospice

CHF can advance in bursts, so noticing trends is important. Hospice is usually appropriate when CHF is advanced, recovery periods are shorter, and symptoms limit daily life despite optimal medical therapy. Doctors must certify that life expectancy is about six months if the disease runs its normal course. 

What You Might Notice At Home:

• Shortness of breath at rest, needing more pillows or sleeping upright.
  
• Rapid fluid buildup with swelling in legs or abdomen.
  
• Frequent ER visits for diuretics or IV medications.
  
• Dizziness, chest discomfort, or persistent fatigue with minimal activity.
  
• Unintentional weight loss and reduced appetite.

How Hospice Helps In CHF:

• In-home medication adjustments for breathlessness and anxiety.
  
• Education on gentle activity, energy conservation, and comfortable sleep positions.
  
• Equipment like hospital beds and oxygen coordinated to your home setting.
  
• Emotional and spiritual support for patients and family.

COPD And Advanced Lung Disease: Clear Signs It Is Time For Hospice

For COPD (Chronic obstructive pulmonary disease) and similar lung diseases, hospice is often considered when breathing becomes difficult even at rest or with minimal activity. Other red flags include hospitalizations for exacerbations and persistent symptoms despite bronchodilators or steroids. 

What You Might Notice At Home:

• Shortness of breath while speaking, dressing, or eating.
  
• Dependence on oxygen most of the day, with little relief.
  
• Frequent bronchitis or pneumonia episodes.
  
• Fatigue, weight loss, and limited ability to walk room to room.

How Hospice Helps In COPD:

• Medications and techniques for breathlessness, including fan therapy, pacing, and positioning.
  
• Respiratory equipment delivered and set up in the home.
  
• Guidance for anxiety that often accompanies air hunger.
  
• Care plans that reduce hospital trips and keep you comfortable where you live.

Cancer: Clear Signs It Is Time For Hospice

With advanced cancers, hospice often begins when treatments are no longer controlling the disease, side effects are heavy, or functional status declines. Many clinicians use the Palliative Performance Scale (PPS). A PPS of 70% or lower typically indicates hospice may be appropriate because the person spends more than half the day resting, needs help with self-care, and has reduced intake. 

What You Might Notice At Home:

• Increasing pain or symptoms that are hard to manage between clinic visits.
  
• Significant fatigue, weakness, or weight loss.
  
• More time in bed or in a chair, difficulty walking across the room.
  
• Choosing to stop chemotherapy or immunotherapy because burdens outweigh benefits.

How Hospice Helps In Cancer:

• Strong symptom management for pain, nausea, breathlessness, and anxiety.
  
• At-home support from nurses, aides, social workers, chaplains, and volunteers.
  
• Medication delivery and equipment coordination.
  
• Respite care to give family caregivers a needed break.

What Happens When You Start Hospice In Los Angeles County

• Doctor Certification: Your doctor and the hospice medical director certify a six-month prognosis if the illness follows its usual course. This can be recertified, so care continues if criteria are still met.
  
• Care At Home Or In A Facility: Most care happens where you live. Visits are scheduled, and urgent support is available by phone day and night.
  
• Medications And Supplies For Comfort: Hospice covers medications and equipment related to the terminal diagnosis, which reduces out-of-pocket costs for comfort care.
  
• Family And Caregiver Support: Teaching, emotional support, spiritual care, and grief resources help the whole family.

Frequently Asked Questions From Families In Burbank

• Will Hospice Mean Giving Up Care?
  No. Hospice shifts the goal to comfort and quality of life. You still get active medical care for symptoms and strong caregiver support at home.
• What If My Loved One Lives Longer Than Six Months?
  Hospice can continue as long as a physician recertifies eligibility. Many families wish they had started sooner because support at home reduces crises and hospital trips.
• Can We Keep Our Current Doctor?
  Yes. Your existing doctor can remain involved while the hospice team coordinates day-to-day comfort care.

Get Quality Hospice Care Today

Call (818) 748-3427 or message us to start a conversation. You can ask questions, learn what hospice would look like in your home, and decide what feels right for your family. Journey Palliative and Hospice serves Los Angeles County, plus nearby areas like Ventura County, Orange County, Riverside County, and Kern County.