My mom passed away at Transitions. Everyone we worked with was kind and compassionate. Volunteers…read morecame in with a dog, to sing, and one even offered a Reiki session, which was something my mom had offered to others years ago. My mom's passing was gentle and peaceful. The staff was kind and respectful.

What I've come to understand about hospice orgs is that they seem to attract nurses who may be…read moreburned out from other jobs. This results in transactional care, checking off boxes to comply with Medicare but a lack of genuine compassion for the patient. (hospice enrollment recommendations below) Hospice affords more normal hours than working at a hospital. However, the trade off is probably that the nurses may have to drive 100 miles a day all over the county to serve patients. It's a crap shoot when it comes to the nurse case manager (weekly nurse) you get based on when you enroll in hospice care. And it's a crap shoot for the nurses too, who gets assigned to them. (see #4 below) Transitions was recommended to me by someone I trusted. I didn't know what I didn't know but my initial instinct during the first transaction with the intake nurse seemed off to me. She didn't listen, was not paying attention to what I said (about my Mom's care needs) and not educating us on how we should be looking at the whole hospice experience, especially medication management. We lasted a month and a half before I went to another company. The whole point of hospice is having continuity of care. The nurse case manager kept scheduling other nurses to come in her place which consequently caused us to have to orient a new nurse almost every week. Recommendations for Hospice Enrollment and Ongoing Management 1) Trust your instincts if your first interactions with the hospice org aren't stellar. Unless your family member is very close to death you probably have time to interview another company. 2) How medication is administration is explained and distributed (by mail or pharmacy pick up) is critical. 3) Understand that the first several intake people who call or visit may not be the regular providers you will be seeing. They have to check boxes for Medicare so they may only be marginally helpful. 4) The Clinical Manager who manages schedules and nurse performance is THE most critical role in the process. This person MUST be a great problem-solver, compassionate, caring, understanding and a good listener. Spend time up front describing your loved one's personality, likes and dislikes to hopefully get the best match possible nurse case manager (weekly nurse). 5) Once you get through the initial process, if you don't like the hospice care you're getting it's fairly easy to transition to another company (assuming you have POA for your loved one). 6) Make sure your POA and Healthcare POA are updated. If you had documents drafted years ago, they may not be specific enough for today's requirements. 7) If you have a life alert system you can give the hospice company number to the life alert system company so 9-1-1 won't get called in an emergency. 8) LPN's have more authority with medications than RN's but Medicare requires RN's to visit at least once every other week. 9) Hospice nurses understand that the closer to the end of life someone is, the less interested in eating they will be. Also, people at the end of life will sleep more. So keep track of eating and sleeping because the nurses will be most interested in that in addition to pain management. 10) Document changes in health in advance of nurse visits even if it's jotting small notes on a calendar because over time all the days blend together.