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What are the 4 levels of hospice care?

4 levels of hospice care

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What are the 4 levels of hospice care?

Hospice care is a type of medical service that focuses on providing physical, emotional, and spiritual support to people facing terminal illnesses. It is designed to address the patient’s and their families’ needs. As you or a loved one nears the end of life, it’s important to understand the four levels of hospice care.

An Overview of the 4 Levels of Hospice Care

Hospice care is provided by an interdisciplinary team of professionals and caregivers, including physicians, nurses, counselors, social workers, chaplains, home health aides, and volunteers. There are four levels of hospice care available to patients in need.

Hospice care includes four levels of service delivery that address different aspects of end-of-life care: routine, general inpatient, respite, and continuous care.

Level 1 - Routine Home Care:

Routine Home Care involves visits from a hospice nurse once or twice weekly. These visits provide symptom management, counseling services, and 24-hour access to a nurse if the patient should require it. The patient may also receive physical therapy and other medical treatments as needed. Home health aides are available for more extensive care if necessary.

Level 2 - Continuous Home Care:

Continuous Home Care requires 8 hours or more per day of nursing services for up to 7 days for pain control or crises. This level of care is usually used when the patient’s symptoms cannot be managed with routine home care alone.

Level 3 - Inpatient Respite Care:

Inpatient Respite Care provides short-term hospitalization for up to 5 days when the family caregiver needs relief from their duties due to exhaustion or illness.

The goal of respite care is to ensure that the primary caregiver has enough time away from their duties to recharge and rest properly so they can return to caring for their loved one with renewed energy and enthusiasm.

Level 4 - General Inpatient Care:

General Inpatient Care requires 24-hour supervision by hospice nurses to manage severe symptoms that cannot be managed at home, such as uncontrolled pain or difficulty breathing due to fluid build-up in the lungs (pulmonary edema).

This level is usually only used when all other methods have been exhausted. The patient will likely not survive more than several days in this setting before transitioning into end-of-life care.


Understanding what types of hospice care are available can help you make informed decisions about how best to support your loved one during this difficult time. Knowing which level is most appropriate can help ensure your loved one receives the right level of comfort and support while remaining within your family’s budget constraints.

By taking advantage of these four levels of hospice care, you can ensure that your loved one’s final days are as comfortable and pain-free as possible while providing them with emotional and spiritual support throughout their journey into death with dignity and grace.

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