Hospice Care for Heart Failure in Metro Detroit

Written and reviewed by the Lily Hospice clinical team. Updated September 2026.

In Medicare’s most recent Care Compare data, 71.3% of Lily Hospice patients were visited by a nurse or social worker in their last three days of life, against a national average of 48.3% and a metro Detroit median of 60.9% across the 104 hospices serving Oakland, Macomb and Wayne counties. “Most families tell us afterward that they wish they had called sooner,” says the Lily Hospice clinical team. “The evaluation is free, and the earlier we meet a family, the more good days we can protect.”

Heart failure is a disease of good days and bad days, which is exactly why it is so hard to know when to ask for help. Your husband rallies after a hospital stay in Royal Oak, comes home, does well for a few weeks, and then the swelling and the breathlessness creep back. The cardiologist adjusts the diuretic. It works, until it does not.

Hospice for heart failure is not about giving up on the heart. It is about managing the symptoms where he lives, so that the next bad day is handled at home by a nurse instead of in an emergency room at midnight.

Signs it may be time to talk about hospice

Cardiologists use terms like “Class IV” and “ejection fraction,” and the physician makes the eligibility decision. What families notice is simpler:

Short of breath at rest, or after walking to the bathroom
Two or more hospital or ER visits for heart failure in the last six months
Swelling in the legs or belly that no longer responds well to water pills
Sleeping sitting up, or waking at night gasping
Told that he is not a candidate for surgery, a device or a transplant, or has chosen not to pursue them
Eating less, losing weight, or losing muscle in the arms and legs
Dizziness, low blood pressure, or kidney numbers getting worse
The person himself has said he is tired of the hospital

If several of these feel familiar, it is not too early to ask. Most families tell us later that they wish they had called sooner.

What hospice does for someone with heart failure

Breathlessness handled at home. Oxygen, medication adjustments, positioning and simple techniques that make breathing easier are set up in the living room, not the ER. Your nurse teaches you what to watch for and what to do first.

The same medications, closer at hand. Hospice does not mean stopping heart medications. Diuretics and other comfort medications continue, and we can often adjust them within hours instead of waiting for an appointment.

A plan for the bad day. Every family gets a written plan: who to call, what to try, when a nurse will come. One number, (248) 955-5100, and a real person answers at any hour.

Support for the whole household. Aide visits for bathing and personal care, a social worker for paperwork and family meetings, a chaplain if you want one, volunteers for company, and bereavement support afterward.

Devices, defibrillators and difficult choices

Many people with advanced heart failure have an implanted defibrillator (ICD). Near the end of life, shocks from an ICD can be painful and distressing without extending life in a meaningful way. Deactivating the shock function is a common, reversible choice that is made with the cardiologist. We will help you understand it and arrange it if that is what you decide.

Talk it through with a nurse, day or night

You do not have to decide anything on the phone. Call (248) 955-5100 and a real person answers, 24 hours a day. We can visit for a no-obligation evaluation, usually within a day, and if hospice is not the right fit yet, our Pathways palliative program may be.

Not ready to call? Read Is It Time? A Family’s Gentle Guide to Hospice.

Questions families ask

Does choosing hospice mean stopping my heart medications?

No. Medications that keep you comfortable, including diuretics and many heart medications, continue. What changes is where the care happens and how fast adjustments can be made.

Can we still see the cardiologist?

Yes. Your cardiologist or primary physician can remain involved, and our nurses communicate with them. Many physicians appreciate having a hospice nurse in the home between visits.

What if he gets better?

It happens. If your loved one improves and no longer meets hospice criteria, he can be discharged from hospice and return later if needed. Nothing about hospice is a one-way door.

Does Medicare Advantage cover hospice?

Yes. Hospice for an Advantage member is paid through Original Medicare Part A, and the plan continues to cover unrelated conditions.

We live in Macomb County. How quickly can someone come?

We serve all of Oakland, Macomb and Wayne counties from Troy, and we can usually visit for an evaluation within a day, including evenings and weekends.

Where we come to you

Lily Hospice cares for families at home, in assisted living, memory care and nursing facilities across Oakland County, Macomb County and Wayne County, from our office in Troy. Veterans and their families can read about our veteran-specific hospice care. Families facing a different diagnosis may want our page on hospice care after a stroke.

General education, not medical advice. Whether hospice is appropriate is a decision made with your loved one’s physician. Medicare hospice eligibility is based on a physician’s judgment that life expectancy is six months or less if the illness runs its usual course; people are not required to stop living past six months, and care can continue as long as they remain eligible.

Hospice isn’t giving up. It’s showing up.

Common questions

Which hospice can admit the same day, including weekends? · Can hospice come to assisted living or memory care? · Hospice for a veteran in metro Detroit · Which hospice is best in metro Detroit? · Is Lily a good hospice? An honest answer · All 104 metro Detroit hospices compared · Who answers a hospice phone at night? · Hospice with Medicaid only or no insurance · Can I keep my own doctor? · How to start hospice this weekend