In the first 48 hours of hospice care, a nurse will complete an admission visit, review your loved one’s medications and symptoms, and build an initial plan of care. Medical equipment, such as a hospital bed or oxygen, is typically delivered the same day or the next, and comfort medications arrive shortly after. Within the first two days, you’ll meet key members of the care team and have 24/7 access to a hospice nurse by phone.
If you’re reading this on the day of admission, take a breath. You don’t have to memorize anything. The team is coming to you, and they’ll walk you through each step.
Hour 0: The Admission Visit
Hospice care officially begins when a patient (or their authorized representative) signs the hospice election form. This is part of the admission visit, which is usually conducted by a registered nurse from the hospice team.
During admission, you can expect the nurse to:
- Review the plan of care and explain how the Medicare Hospice Benefit works
- Walk through paperwork, including consents, HIPAA forms, and advance directives
- Conduct a head-to-toe physical assessment of your loved one
- Review current medications and discontinue any that no longer support comfort
- Ask about pain, breathing, appetite, sleep, mood, and any active symptoms
- Identify what medical equipment needs to be delivered
- Order comfort medications (sometimes called a “comfort kit”) to be sent to the home
Most admission visits last 60 to 90 minutes. It’s okay if the patient sleeps through part of it. The nurse is there for both the patient and the family.
For a deeper look at how admission works, visit Starting Hospice Care.
Hours 1 to 6: Setting Up the Home
After the admission visit, things tend to happen quickly.
Equipment delivery. Hospice covers medical equipment needed for comfort, often including:
- A hospital bed
- A wheelchair or transfer chair
- Oxygen and related supplies
- A bedside commode
- Incontinence supplies and wound care items
A delivery company brings these to your home, sets them up, and shows you how to use them. If there are stairs or a tight space, mention it in advance so they can plan.
Medication delivery. Comfort medications are sent from a hospice-contracted pharmacy. Most homes receive a small starter kit with medications for pain, anxiety, nausea, breathlessness, and secretions. The nurse will explain what each one is for and only use what’s needed.
The on-call line. From this point on, you have 24/7 access to a hospice nurse by phone. You no longer need to drive to an ER or sit on hold with a doctor’s office. If something changes, you call hospice first.
Hours 6 to 24: First Care Visits and Adjustments
The first day usually includes one or two follow-up touchpoints to make sure everything is in place.
You may see or hear from:
- A registered nurse for a follow-up symptom check
- A hospice aide or CNA to schedule personal care visits (bathing, grooming, repositioning)
- The hospice medical director is reviewing the plan of care behind the scenes
- A care coordinator confirming scheduling and answering any new questions
This is also when families often start to notice small comfort wins. A medication finally settles pain. The patient sleeps without restlessness. The room feels less like a hospital and more like home. These shifts can happen fast once symptoms are managed.
It’s also normal to feel a wave of emotion in this window. The adrenaline of getting hospice started fades, and grief or relief (or both) can rise. There’s no negative reaction.
Hours 24 to 48: Meeting the Full Care Team
Within the first two days, you’ll typically meet additional members of the hospice interdisciplinary team. Each one has a different role.
- Social Worker — Helps with paperwork, family decisions, advance directives, community resources, and emotional support for the family. They can also help if your loved one has unfinished business, such as funeral planning or veterans’ benefits.
- Spiritual Care Provider / Chaplain — Available to anyone, regardless of faith background or no faith at all. They listen, support, and help families and patients process the meaning of this season.
- Hospice Aide — Schedules regular visits for personal care, comfort positioning, and light support around the patient.
- Volunteer Support — Trained companions who can sit with the patient, help with errands, or give caregivers a break.
- Bereavement Support — Even at admission, the bereavement program begins quietly in the background and continues for up to 13 months after the patient passes.
You don’t have to accept every visit. The plan is built around what your family wants and what your loved one needs.
For specialized situations, AlēvCare also offers focused programs for veterans, respite care, and child and teen grief support.
What’s Considered Normal in the First 48 Hours
Symptoms and patterns shift as the body adjusts to a new comfort-focused approach. Common and expected changes include:
- Increased sleep or drowsiness as pain is finally controlled
- Reduced appetite or thirst
- Changes in breathing patterns
- Quieter, calmer demeanor
- Temporary confusion as medications are adjusted
The hospice nurse will help you understand what each change means and when it’s part of the body’s natural process versus something to address.
When to Call the Hospice Team
In the first 48 hours, call your hospice on-call line if:
- Pain returns or seems uncontrolled
- Breathing becomes more labored
- Your loved one is restless, agitated, or anxious
- A new symptom appears
- Equipment isn’t working as expected
- You’re unsure what a medication is for
- You just need reassurance
There is no such thing as too small a question. The on-call nurse is part of the plan.
Hospice Admission in North Texas
AlēvCare Hospice provides admission and ongoing care across North Texas, including Tarrant County, Johnson County, Hood County, Parker County, Dallas County, and Ellis County. Most admissions happen the same day a family calls, including evenings and weekends, with care provided in private homes, assisted living communities, and nursing facilities.
Common Questions About the First 48 Hours
- Will a nurse stay overnight on the first day? Not under routine home care. The hospice team is on call 24/7 by phone, and the level of care can be increased to continuous home care if symptoms require it. To understand all four care levels, read The 4 Levels of Hospice Care Explained.
- Who delivers the hospital bed and oxygen? A contracted durable medical equipment company delivers and sets up the equipment, usually the same day or the next morning. The hospice team coordinates the order during admission.
- Can family members still give the patient food and water? Yes, as long as it’s safe and comfortable. The hospice nurse will guide you on what’s appropriate as the body’s needs change.
- What if we change our minds about hospice? Hospice is voluntary. A patient can revoke hospice at any time and return to curative treatment. Full details are explained in Medicare Hospice Benefit Explained.
When You’re Ready to Talk
If you’re preparing for admission, or you’ve just started and aren’t sure what comes next, the AlēvCare team is one phone call away.
Call (469) 630-2538 to speak with our team, or request a callback. For more guidance, browse our Hospice Care FAQs or the full AlēvCare blog.
You don’t have to figure this out alone. We’ll meet you where you are.
