Understanding the Four Levels of Hospice Care

Level 1: Routine Home Care

Everyday Hospice Support Where You Live

Routine home care is the most common level of hospice and what most families picture when they think of “hospice at home.” It includes:

• Scheduled visits from hospice nurses for symptom management
• Hospice aides to help with bathing, dressing, and personal care
• Social workers for emotional support, planning, and resources
• Chaplains or spiritual support when desired
• Volunteers when available and appropriate
• Medications, equipment, and supplies related to comfort and the hospice diagnosis

This level of care focuses on comfort, preventing crises when possible, and teaching caregivers what to do between visits. Our 37-step Perfect Visit brings predictability, calm, and structure to each visit.

Level 2: Continuous Home Care (aka Crisis Care)

Extra Support During a Symptom Crisis at Home

Continuous Home Care is designed for short periods when symptoms suddenly worsen and require intensive nursing support but the goal is to remain at home. During Continuous Care, AlēvCare Hospice may provide:

• Extended nursing presence in the home for several hours at a time
• Frequent assessment and rapid symptom intervention
• Close coordination with the hospice physician
• Teaching and reassurance for caregivers who are frightened or overwhelmed

The goal is to stabilize the crisis so your loved one can remain in the setting they prefer whenever possible.

Level 3: General Inpatient Care

Inpatient Support When Symptoms Cannot Be Managed at Home

Sometimes symptoms become too complex or intense to safely manage at home, even with Continuous Care. When this happens, hospice may recommend General Inpatient (GIP) Care, provided in a contracted inpatient setting.

Families can expect:

• Ongoing, close monitoring by nurses
• Access to IV medications and advanced symptom management
• Frequent adjustments from the hospice physician
• Emotional and spiritual support for both patient and family

The focus remains the same: comfort, dignity, and relief, but with access to a higher level of clinical care.

Level 4: Inpatient Respite Care

Short-Term Relief for Caregivers

Caring for someone at the end of life is meaningful and can be exhausting. Even the most devoted caregivers need rest.

Inpatient respite care provides a short stay, in a facility, for up to five days to give so caregivers can:

• Rest
• Attend to important appointments
• Spend time with family
• Simply breathe

During respite:

• Your loved one receives hospice support in a contracted facility
• The hospice team continues to coordinate care and visit the patient
• You can step away knowing your loved one is safe and supported

Respite is an important part of caring for the whole family. At AlēvCare Hospice, we encourage caregivers to view respite not as “failing” but as a healthy, wise way to sustain care.

How AlēvCare Hospice Supports You Across All Four Levels

Because we are locally owned and guided by our Grow Small philosophy, we focus on how care feels to real families in North Texas, not just what regulations require.

Across all four levels, you can expect:

• A consistent, highly trained team using our 37-step Perfect Visit model to bring structure, comfort, and reliability
• Registered Nurse-answered calls 24/7, with an RN-only backup triage team for additional support
• A “say yes when it matters” mindset, especially around equipment, supplies, and reasonable clinical requests that improve comfort and safety
• Support for children and teens through our full-time Child Life Specialist
• Clear communication so families always understand why a level of care is changing and what to expect next

Changing levels of care does not mean starting over with a new team. You stay supported by the same team who already knows your loved one’s story.