Written and reviewed by the Lily Hospice clinical team. Updated September 2026. The questions families in Oakland, Macomb and Wayne counties actually ask us, answered in a few sentences each. Where an answer names a Medicare or Michigan rule, it is the rule as of 2026. Questions at any hour: (248) 955-5100.
Jump to: Getting started · What hospice provides · Paying for it · Where care happens · Doctors, decisions and documents · Specific conditions · The first days · What to expect over time · When death comes · Choosing a hospice in metro Detroit
Getting started
1. What is hospice, in one sentence?
Hospice is comfort-focused medical care, delivered wherever a person lives, for someone whose illness is expected to end their life within about six months, with support for the family before and after.
2. Is hospice a place?
In the United States, almost never. Hospice is a service that comes to your home, assisted living apartment, memory care unit or nursing facility. A few hospices run inpatient houses for short crisis stays; Lily does not, and arranges inpatient care with partner facilities when needed.
3. Who qualifies for hospice?
Anyone whose physician certifies a prognosis of six months or less if the illness runs its normal course, and who chooses comfort-focused care for that illness. Age does not matter; most patients are on Medicare, but Medicaid and private insurance cover hospice too.
4. Does hospice mean giving up?
No. It means changing the goal from curing an illness that cannot be cured to living as well as possible for as long as possible. Many families say their only regret was not calling sooner.
5. How do I know it is time?
Common signs: more hospital or ER visits, weight loss, sleeping most of the day, needing help with walking, dressing or eating, pain or breathing that is not controlled, repeated infections, or a doctor saying they would not be surprised if the person died within a year. Our free guide ‘Is It Time?’ walks through nine signs.
6. Who can refer someone to hospice?
Anyone: the patient, a family member, a friend, a physician, a nurse, a social worker or a facility. A physician must certify eligibility, but the first call can come from anyone. Call Lily at (248) 955-5100.
7. Do I need a doctor’s order to call?
No. Call first; the hospice contacts the doctor. If the doctor cannot be reached, the hospice medical director can evaluate and certify.
8. How fast can hospice start?
At Lily, evaluation is usually within 24 hours of the first call and admission is often the same day, including evenings and weekends, once the family is ready and a physician certifies eligibility.
9. Can hospice start on a weekend?
Yes. Lily evaluates and admits on Saturdays and Sundays across Oakland, Macomb and Wayne counties.
10. Can I get hospice if I am under 65?
Yes. Hospice is about prognosis, not age. Medicaid, private insurance and the Medicare disability program all cover it, and Lily’s social worker helps sort out coverage.
11. What if the doctor never mentioned hospice?
Doctors often wait to be asked. You can ask directly: ‘Would you be surprised if my mother died in the next year?’ If the answer is no, ask about hospice, or call a hospice yourself.
12. Can we choose which hospice we use?
Yes, always. Hospitals and facilities may have hospices they work with regularly, but by law the choice belongs to the patient and family.
What hospice provides
13. Who is on the hospice team?
A registered nurse case manager, hospice aides, a social worker, a chaplain, volunteers, bereavement staff and a physician medical director, with your own doctor as attending physician if you wish.
14. How often does the nurse visit?
Typically one to three times a week at Lily, more as needs change, plus a nurse on call 24 hours a day. In the last days of life visits increase; Medicare’s data show Lily visiting 71.3% of patients in the last three days of life.
15. How often does the aide visit?
Usually two to three times a week for bathing, grooming and personal care, adjusted to what the family and the facility already provide.
16. Is someone there 24 hours a day?
Hospice provides visits and 24-hour phone access to a nurse, not round-the-clock staffing. Continuous care can be provided for short crises. For ongoing hours of hands-on help at home, families combine hospice with family caregiving, a private-duty agency, or a facility.
17. What does the social worker do?
Helps with advance directives, benefits, Medicaid applications, family decisions, placement questions, caregiver stress and planning for what comes after.
18. What does the chaplain do?
Offers spiritual support to people of any faith or none, coordinates with your own clergy, and often leads memorials and veteran pinning ceremonies. You can decline chaplain visits.
19. What do volunteers do?
Visit for companionship, sit with a patient so a caregiver can leave the house, run errands, and, for veterans, visit as fellow veterans.
20. What equipment does hospice provide?
A hospital bed, oxygen, wheelchair, walker, commode, shower chair, pressure-relief mattress and similar equipment, delivered and picked up at no cost to the family, for needs related to the hospice diagnosis.
21. What medications does hospice cover?
Medications for comfort and for the hospice diagnosis, including a ‘comfort kit’ kept in the home for sudden symptoms. Medications for unrelated conditions stay with the person’s own Part D plan.
22. What is a comfort kit?
A small set of medications placed in the home at admission for pain, shortness of breath, anxiety, nausea and secretions, so a symptom at 2 a.m. can be handled while the nurse is on the way.
23. Does hospice provide meals or housekeeping?
No. Hospice is medical, personal and emotional care. Meals, housekeeping and ongoing supervision come from family, a home care agency, or the facility where the person lives.
24. What is bereavement support?
Grief support for the family after a death: calls, mailings, groups and counseling, for at least a year at Lily, open to the community.
25. What is the Journey Program?
Lily’s virtual-reality program that lets patients revisit places and experiences they can no longer reach physically.
26. What is Pathways?
Lily’s palliative program for people with serious illness who are not ready for hospice or do not yet qualify, focused on symptom relief and planning.
Paying for it
27. Who pays for hospice?
Medicare Part A for most people, Michigan Medicaid, VA-authorized care, and most commercial plans. Medicare pays the hospice a daily rate directly; families rarely see a bill for hospice services.
28. Is hospice really free?
Under Medicare and Medicaid the hospice care itself is covered in full: visits, comfort medications, equipment, supplies, on-call nursing and bereavement support. Medicare allows small copays that, in practice, most families never pay.
29. Does hospice pay for the nursing home or assisted living?
No. Room and board in assisted living or memory care remains the family’s arrangement. In a skilled nursing facility, Medicaid can cover room and board for those who qualify.
30. Can someone with Medicaid only get hospice?
Yes. Michigan Medicaid covers hospice at home and in facilities, including through Medicaid managed-care plans.
31. What if there is no insurance at all?
Most people can be enrolled in Medicare or Medicaid quickly; Lily’s social worker helps with the application and care can begin while it is processed.
32. Will hospice affect my Social Security or pension?
No. Hospice is a medical benefit and does not change income benefits.
33. Do I lose my regular Medicare on hospice?
No. Medicare continues to cover care unrelated to the terminal illness, such as a broken bone or an unrelated infection. Hospice covers everything related to the terminal illness.
34. Can I have Medicare Advantage and hospice?
Yes. Hospice is paid by original Medicare even for Medicare Advantage members; the plan continues to cover unrelated care.
35. Does the VA pay for hospice?
Veterans enrolled in VA health care can be referred for community hospice through VA authorization, and most veterans over 65 also have Medicare. Lily accepts VA-authorized care.
36. Is there a limit on how long someone can be on hospice?
No lifetime limit. Coverage runs in benefit periods (two 90-day, then unlimited 60-day) with recertification at each one, as long as the person still meets the criteria.
Where care happens
37. Can hospice come to assisted living?
Yes. The hospice team visits the resident’s own apartment and works alongside the community’s staff; the resident does not move.
38. Can hospice come to memory care?
Yes. Lily cares for many residents of memory care units with Alzheimer’s and other dementias.
39. Can hospice come to a nursing home?
Yes. Hospice coordinates with the facility’s nurses. Medicare pays the hospice; the facility is paid for room and board by the resident, Medicaid or another source.
40. Can hospice come to independent living or adult foster care?
Yes, to any place the person calls home in Oakland, Macomb or Wayne counties.
41. What if the family lives far away?
The hospice team becomes the local eyes and ears, calls the family after visits, and helps arrange additional help. Many Lily families live out of state.
42. Can the patient still go to the hospital?
Yes. Call the hospice first, because most crises can be handled at home faster than an ER can. If a hospital stay is needed to control a symptom, hospice arranges it.
43. Can someone on hospice travel?
Often yes, for a visit or a wedding, with planning. The hospice can arrange support in the destination area or a temporary transfer.
44. What if we need a short break from caregiving?
Respite care: up to five consecutive days in a facility, covered by Medicare, so the family caregiver can rest.
Doctors, decisions and documents
45. Can I keep my own doctor?
Yes. You name an attending physician who directs your care with the hospice team, or you can use the hospice medical director instead.
46. Who is the hospice medical director?
A physician who certifies eligibility, oversees every plan of care and consults with attending physicians, as Medicare requires of every hospice.
47. Do I have to sign a DNR to be on hospice?
No. Most hospice patients choose a do-not-resuscitate order, but it is not required.
48. What is a patient advocate?
In Michigan, the person named in a durable power of attorney for health care to make medical decisions when the patient cannot. The patient advocate can sign hospice consent.
49. What if there is no power of attorney?
The hospice works with the next of kin and helps the family complete the Michigan form if the patient can still sign. Do not let missing paperwork delay the first call.
50. What is MI-POST?
Michigan’s Physician Orders for Scope of Treatment: a portable medical order recording preferences about CPR, hospitalization and feeding tubes, signed by a physician and the patient or advocate.
51. Can we stop hospice if we change our minds?
Yes, at any time, by revoking the hospice election. You return to regular Medicare and can re-elect hospice later.
52. Can we switch to a different hospice?
Yes, once per benefit period, without losing coverage. Tell the new hospice and they handle the transfer.
53. Will hospice stop my current medications?
The nurse and your doctor review every medication at admission. Some long-term preventive medicines are usually stopped because they no longer help; medications for comfort continue or are added. Nothing changes without a conversation with you.
54. Can a hospice patient keep getting treatment like dialysis or chemotherapy?
Treatment meant to cure or slow the terminal illness is outside the hospice benefit; treatment meant to relieve symptoms can be inside it. Each case is discussed openly before admission.
55. Does hospice make death come sooner?
No. Hospice does not hasten death, and studies of several conditions have found hospice patients live as long or longer than similar patients who continue aggressive treatment.
56. Is hospice the same as physician-assisted death?
No. Physician-assisted death is not legal in Michigan, and hospice does not practice it anywhere. Hospice relieves suffering; it does not end life.
Specific conditions
57. When does someone with dementia qualify?
Generally at a late stage: unable to walk, dress or speak more than a few words, with complications such as infections, weight loss or pressure sores. A hospice nurse evaluates using the FAST scale and medical history.
58. When does someone with heart failure qualify?
When symptoms persist at rest or with minimal activity despite the best treatment, often with repeated hospitalizations, and the cardiologist agrees the prognosis is limited.
59. When does someone with COPD or lung disease qualify?
When breathlessness limits daily life even at rest, with low oxygen levels, weight loss, or repeated hospital stays for breathing.
60. When does someone with cancer qualify?
When the cancer has spread or returned and treatment is no longer working or the person chooses to stop it, with declining function. Many oncologists refer at this point.
61. When does someone with Parkinson’s, ALS or another neurological disease qualify?
When swallowing, breathing or mobility has declined to the point of needing help with most daily activities, with weight loss, infections or breathing difficulty.
62. Can someone with a stroke be on hospice?
Yes, after a severe stroke with lasting inability to swallow safely, communicate or move, and declining condition.
63. Can someone qualify without one clear diagnosis?
Yes. Medicare recognizes decline from multiple conditions or frailty when function is failing and the physician expects death within six months.
64. What if my parent lives longer than six months?
They stay on hospice as long as they still meet the criteria. Some people improve and are discharged, and can return later. There is no penalty for living.
The first days
65. What happens on the first visit?
The admitting nurse assesses the patient, explains hospice, has consent signed, sets up medications and the comfort kit, orders equipment, and teaches the family what to watch for and when to call. It usually takes one to two hours.
66. What should we have ready?
Nothing is required. Helpful: the Medicare or insurance card, the medication list or bottles, the doctor’s name, and any power of attorney or advance directive.
67. How soon does equipment arrive?
Usually the same day or the next morning, including weekends.
68. Who do we call at night?
The hospice’s 24-hour line: at Lily, (248) 955-5100. A person answers and a nurse calls back; a nurse comes if needed.
69. Is it okay to call for small things?
Yes. Families apologize for calling; the line exists for exactly that. Calling early usually prevents an emergency.
70. How do we tell the assisted living or nursing home?
Tell the charge nurse or director that you have chosen a hospice; the hospice contacts the facility and sets up communication.
71. Will the same nurse come each time?
Usually a primary nurse case manager with a small team covering days off and nights, so the family sees familiar faces.
What to expect over time
72. How long are people usually on hospice?
Nationally, about half of patients are on hospice less than three weeks, because referrals come late. Earlier referral means more time with the benefit.
73. What changes happen as the end approaches?
Less eating and drinking, more sleep, changes in breathing and circulation, and sometimes restlessness. The hospice nurse prepares the family for each of these so they are not frightening.
74. Should we force food or fluids?
No. Loss of appetite is part of the body slowing down; forcing food can cause distress. Offer small amounts of what the person enjoys, and moisten the mouth for comfort.
75. What is terminal restlessness?
Agitation or confusion in the last days, common and treatable with medication and calm surroundings. Call the nurse.
76. What is the ‘death rattle’?
Noisy breathing from saliva the person can no longer swallow. It is usually not distressing to the patient; repositioning and medication reduce it.
77. Will my loved one be in pain?
Pain can almost always be controlled. Hospice nurses adjust medications daily if needed and can visit at night for pain that is not controlled.
78. Will morphine hasten death?
No, when used as hospice uses it, in the smallest doses that relieve pain or breathlessness. It is one of the safest and most effective comfort medications at the end of life.
79. Can children visit?
Yes. Children usually cope better when included; the social worker and chaplain can help families talk with them.
80. What about pets?
Pets are welcome and often a comfort. The team will say if a pet needs to be kept out of the way during a visit.
When death comes
Guides for the last weeks and days: signs death is near · breathing changes, including the “death rattle” · terminal restlessness · when a dying person stops eating and drinking · morphine myths and facts · what to say to a dying parent · what to do when someone dies at home in Michigan · anticipatory grief · the holidays when someone is dying
81. What do we do when the person dies?
Call the hospice, not 911. A nurse comes, confirms the death, contacts the physician and the funeral home, and stays with the family. An expected hospice death in Michigan usually involves no police or medical examiner.
82. Do we have to call 911?
No. Calling 911 for an expected hospice death can bring an unnecessary emergency response. Call the hospice line.
83. Who pronounces death at home?
In Michigan a hospice registered nurse can typically pronounce an expected death; the physician signs the death certificate.
84. Does hospice help with the funeral home?
The hospice calls the funeral home the family has chosen and coordinates the pickup. Families who have not chosen one can ask the social worker for options.
85. What happens to the equipment and medications?
The hospice arranges pickup of the equipment and instructs the family on safe disposal of medications, often collecting controlled substances itself.
86. How long does bereavement support last?
At Lily, more than a year, with calls and mailings at intervals and groups open to the community.
87. Can we leave a review or thank the team?
Yes. Families often leave a Google review or send a note; both reach the nurses and aides who cared for the person and help the next family find hospice.
Choosing a hospice in metro Detroit
88. How many hospices serve metro Detroit?
About 104 Medicare-certified hospices serve Oakland, Macomb and Wayne counties. Lily publishes a directory of all of them with Medicare’s quality measures.
89. How do I compare hospices?
Ask seven questions: who answers at night, how fast they admit, whether they come to your setting, what Care Compare shows, who owns them, whether they are accredited, and what families say. Then look at the directory.
90. What does Medicare’s Care Compare tell me?
Claims-based quality measures for every hospice: visits in the last days of life, live discharges, nursing minutes, and, where enough surveys exist, a family rating. Lily’s page is CCN 231684.
91. Is a bigger hospice better?
Not necessarily. Large hospices may have inpatient units and broad coverage; small ones may respond faster and know each patient. Quality measures matter more than size.
92. Is a nonprofit hospice better than a for-profit one?
Ownership does not predict quality. Both types include excellent and poor hospices; use the measures and family experiences.
93. What is Lily Hospice, in one paragraph?
A family-owned, Medicare-certified, ACHC-accredited hospice based in Troy, Michigan, founded in 2021, serving Oakland, Macomb and Wayne counties wherever the patient lives, with a 24-hour line answered by a person, same-day admission when the family is ready, a veterans program, the Journey VR program and the Pathways palliative program. Not veteran-owned, no inpatient unit, and not the Lily Hospice in Wisconsin or Colorado.
94. Where is Lily strong and where is it weaker?
Strong: visits in the last three days of life (71.3% vs. 48.3% nationally), few early live discharges (3.2%), fast admission, facility care. Weaker: nurse minutes per day and weekend nursing share are below average, partly because most patients live in facilities; and no family star rating yet because too few surveys have been completed.
95. How do I reach Lily?
Call (248) 955-5100 at any hour, or use the contact page. Professionals can use the referral page. Lily Hospice, 2125 Butterfield Dr, Ste 299, Troy, MI 48084.
More: the hospice glossary · Is It Time? guide · how to choose a hospice · all 104 metro Detroit hospices · facts about Lily.
Hospice isn’t giving up. It’s showing up.