Hospice tends to depend on the referral process for growth. Note that to be qualified for hospice, a person is expected to have a life expectancy of six months or less. And to be referred, individuals must have been obtaining steady and reliable medical treatment from a qualified physician who must have analyzed their situation to know that they will benefit from receiving hospice care.

Also, note that anyone living with an incurable life-limiting condition can also self-refer for hospice. To be referred for hospice, a client is expected to first see their primary care physician. The physician will then provide them with insights about hospice.

The physician will also have to carry out certain tests to determine things concerning the individual’s health. The physician will then have to provide a medical diagnosis that there is no hope for their recovery and that they only have a life expectancy of six months or less. Sometimes, the diagnosis will be terminal.

Note that the physician may also have to carry out other types of tests coupled with extensive physical or any other form of medical examination. If the physician can determine this with the examination, then the person will receive a referral from the primary care physician.

At this point, the primary care physician or patient can contact the hospice provider and inquire about what services they offer. After getting this information, the hospice provider will fix an appointment to provide an assessment. This is also when they get to get to know the patient’s loved one and the sort of care the patient needs.

They will also analyze any symptoms and also offer a consultation with other medical personnel who may offer advice on anything from physical therapy to a specialist if the patient has a decline in their physical or mental well-being.

Once the patient is accepted and the care is provided, the patient will be expected to sign an agreement that they fully comprehend and accept all terms and conditions for this care. If any changes occur in the patient’s health and well-being, they will have to inform the hospice team.

These changes can be anything from a decline in their physical or mental state to if their financial situation has changed.

Where Do Hospice Referrals Come from and Who Can Make Such Referrals?

Oftentimes, people are misinformed and believe that hospice care must be suggested or referred to by a healthcare provider. However, it doesn’t just have to start with the referral of a physician. In the United States, have it in mind that anyone can make hospice referrals. This includes:

  1. A Family Member

Note that a loved one or a family member can request for evaluation on behalf of the patient. Once you have requested care for your loved one, the hospice team is expected to contact the family or patient’s doctors to determine whether hospice is appropriate or not.

Also note that a loved one or family member can also begin the process by bringing up the idea to the patient’s doctor, and if they believe hospice care is suitable, then they will provide a referral.

  1. A Physician

Indeed, most hospice referrals come from physicians. While hospice care can be requested by anyone, a patient’s physician remains paramount especially since authority; trust, and expertise can make all the difference in making a hospice referral a timely, supportive and beneficial experience for both patient and family.

Having frank, gentle discussions with patients and their families about their prognosis and following up with the variety of options available to them has proven to be cathartic for both clinician and patient. Making available choices and offering an honest prognosis leads to acceptance and helps to alleviate their fears.

  1. A Friend

Referrals to hospice can also be made by friends of the patients too. It doesn’t need to only come from a physician. Once the referral is made, hospice professionals will put together the required medical information, confirm the patient’s appropriateness for hospice, and schedule the hospice admission team to visit the patient and/or family.

To begin the referral process, whether the patient needs in-home care, care in an assisted living or nursing home facility, or inpatient care, the friend only has to contact the hospice provider and inquire about what services they offer.

  1. Spiritual Leader

A spiritual leader can also refer an individual for hospice as long as they qualify for the care. Aside from making referrals, it is also common for hospice patients to rely on religion or spirituality to help them deal with their terminal illness.

Have it in mind that the primary objective of providing Spiritual Care is to offer the patient a sense of purpose to help them heal spiritually before passing on.

Also note that spiritual care as part of hospice care is specifically carried out by the patient’s religious leader, member of the clergy, or hospice chaplain. This sort of hospice care is very necessary, even when a spiritual care provider is not available or the patient is not willing to accept a referral for spiritual care.

  1. Social Worker

Reports have it that using a social worker to gain admissions into hospice care is cost-effective, efficient, and it improves the length of stay (LOS) and connectivity, especially when they serve as an admissions coordinator. They also form a very crucial part of any interdisciplinary hospice care team.

Coupled with a registered nurse (RN), physician, aide, chaplain, pharmacist, and vigil volunteers, a social worker strives to listen, counsel, and connect families with community support systems. While a patient may want the direct nature of the doctor or the attentive care of the RN, they also need a shoulder to cry on, someone who can make sure they are connecting with the right resources to help them through the pain.

  1. Nurse

Although nurses are very well situated to facilitate communication about prognosis and hospice referral among patients, patients’ family members, and hospital staff, nurses do not always take up this task. As a nurse, have it in mind that you are ethically obligated to guarantee patients’ and families’ right to self-determination in making healthcare choices, especially when it comes to end-of-life care.

Note that early hospice referral can increase family functioning and caregiver satisfaction, reduce hospitalizations, and promote bereavement adjustment.

  1. The Patient

Patients can also self-refer themselves to hospice without going through somebody else. People tend to consult with hospice care providers to inquire about having hospice care provided for themselves, and this is not uncommon among hospice patients.

A patient can self-refer themselves for assistance with pain and symptom management, arranging palliative community supports from the hospital, establishing goals of care, or end-of-life care. They can also self-refer when experiencing any of the following:

  • When the illness is no longer responding to treatment.
  • When they want to live their remaining days to the fullest, making their care decisions.
  • When the immediate need is relief from pain and symptoms.
  • When they and/or family feel stressed and need someone to turn to for help.
  • When they begin to realize and accept that they’re not going to get better.
  • When the doctor thinks they would benefit from hospice care.
  1. Long Term Care Facilities

Indeed, referrals from nursing homes are difficult to come by. This is because there is a clash of organizational cultures, pass-through payments, and other reimbursement concerns that create barriers. Nursing homes also offer palliative and end-of-life care. In some cases, they don’t need to refer a patient to hospice.

However, home health care organizations can make hospice Referrals since the services they offer include physical, occupational, and speech-language pathology, as well as monitoring serious illnesses and those with unstable health status. Other long term care facilities that can make such referrals include;

  • Accountable care organizations (ACOs)
  • Assisted living facilities
  • Primary care
  • Independent physician association (IPA)
  • Personal care attendant companies


The primary objective of hospice care is to provide relief from suffering and improve the patient’s quality of life. Note that the patient receives the same medications and the same level of treatment they would receive in a hospital or any other type of nursing home.

Just as it was noted above, just anyone with a connection with the patient can make hospice Referrals, they only have to contact the hospice provider and inquire about what services they offer.