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How Do Hospice Services in a Nursing Homes Work Together?


Dear Crossroads,

My grandmother’s doctor recently told my family that it may be time to consider having the “hospice conversation.” I was taken by surprise when I heard the doctor say this because my grandmother is already in a nursing home. I visit her often and she gets all kinds of care and great support. I really like the nurses and the facility, too.

What is the difference between this care and hospice? Why would the doctor suggest this if my grandmother likes where she is? It seems like a disruption to her care would only make it more complicated for her.


Confused Granddaughter


Dear Confused Granddaughter,

Thank you for reaching out. I understand how your doctor’s question about the “hospice conversation” may have created more confusion and anxiety for you and your family. Many people hear those words and immediately think the end is near for their loved one. But that’s not always the case. 

When your doctor mentioned having this conversation, they probably meant to say, “What are the goals of your grandmother’s care?” Having goals and understanding what it takes to achieve them will not only improve your grandmother’s quality of life, but it will also help you get the most out of the time you spend with her. This is something we should all be thinking and talking about when it comes to end-of-life care.

Here at Crossroads Hospice & Palliative Care, we treat these conversations with great care. We also believe it’s important to be open and honest when discussing a loved one’s end-of-life options and the decisions surrounding it. Being honest about where your grandmother is in her journey might help ease your anxiety around whatever might be coming next.

Next, I think it’s important to define what hospice care is to help clear up any confusion you may have. First, hospice is not a place where your grandmother will be sent – nor is it any variation of her current nursing home. Rather, hospice is a type of care that works hand-in-hand with your grandmother and her nursing home to achieve her goals and meet her care needs. 

With Crossroads, when patients begin to receive hospice care, we go to wherever that person calls home. That can be your grandmother’s home or it can be her nursing home. Wherever your grandmother is most comfortable and at ease, her Crossroads team will meet her there. Since your grandmother currently lives in a nursing home (and enjoys it!), she can begin receiving hospice care from the comfort of her room. Rest assured, she doesn’t have to leave or have her care disrupted.

Also, it seems like you are happy with the care being provided by the nursing home – this is great news! At Crossroads, we prefer to work with nursing homes, especially since hospice is a supplemental service, not around-the-clock caregiving service. The job of the nursing home is to be the caregiver, and our job is to help guide and direct that care so it makes the most sense for someone who may have limited life expectancy or to provide them with maximum comfort. 

Every two weeks, the hospice team at Crossroads will meet to discuss your grandmother’s care and any subtle changes we see. During these meetings, we listen to everyone who interacts with her. This is an opportunity to adjust her care plan as needed and direct what medications she will be taking. These conversations help to guide the care provided by both her hospice and nursing home teams.

It is central to Crossroads’ mission to treat our patients as whole people, each with unique relationships and needs. We use any resource available to provide them with the best possible care at the best possible time.

I know that change can be challenging, especially when it involves someone as beloved as your grandmother. With Crossroads, you have a team of nurses, doctors, aides, chaplains, social workers, and volunteers to help you through every step of this process. We will do this together.


Lauren Maxwell, RN
Site Educator
Crossroads Hospice & Palliative Care


For more information on how Crossroads supports patients at the end of life, give us a call at 888-564-3405.


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