Hospice care is not one-size-fits-all. As illness progresses and needs change, hospice care adjusts to provide the right level of support at the right time. Understanding the levels of hospice care can help families feel more prepared, confident, and supported throughout the journey.
For families in Austin and Travis County, knowing how hospice works behind the scenes can ease uncertainty and help set realistic expectations. This guide explains the different levels of hospice care, when each is used, and how they work together to prioritize comfort and dignity.
What Are the Levels of Hospice Care?
Hospice care includes four levels of care, as defined by Medicare. These levels are not chosen by families alone. They are determined by the patient’s medical needs and can change over time.
The four levels of hospice care are:
- Routine Home Care
- Continuous Home Care
- General Inpatient Care
- Inpatient Respite Care
Each level serves a specific purpose, and moving between levels is a normal part of hospice care.
- Routine Home Care: The Most Common Level of Hospice Care.
Routine Home Care is the level most people receive when hospice begins.
This care is provided wherever the patient lives, including:- A private home
- An assisted living community
- A nursing facility
Routine home care includes: - Regular visits from hospice nurses
- Access to pain and symptom management
- Support from aides, social workers, and chaplains
- Medications, medical equipment, and supplies related to comfort
- On-call support 24 hours a day
This level of care focuses on managing symptoms, supporting daily comfort, and helping families feel confident caring for their loved one at home.
- Continuous Home Care: Support During a Symptom Crisis.
Continuous Home Care is used when symptoms become difficult to manage and require close, short-term monitoring.
This level of care may be appropriate when there is:- Severe pain
- Uncontrolled shortness of breath
- Intense anxiety or agitation
- Sudden symptom changes that need frequent nursing care
During continuous care: - A nurse or hospice team member stays for extended hours
- Care is provided in the home setting
- The goal is to stabilize symptoms and return to routine care as soon as possible
Continuous care allows patients to remain at home while receiving intensive support during a crisis.
- General Inpatient Care: When Symptoms Cannot Be Managed at Home.
General Inpatient Care is used when symptoms cannot be adequately controlled in the home environment, even with continuous care.
This level of hospice care may be provided in:- A hospice inpatient unit
- A hospital
- A contracted care facility
General inpatient care focuses on: - Aggressive symptom management
- Stabilizing complex medical needs
- Adjusting medications and treatment plans
Once symptoms are under control, patients typically return home to resume routine hospice care.
- Inpatient Respite Care: Temporary Relief for Caregivers.
Inpatient Respite Care is designed to support caregivers, not because of a change in the patient’s condition.
This level of care provides:- Short-term inpatient care for the patient
- Temporary relief for caregivers who need rest or support
- Up to five consecutive days of care at a time
Respite care helps prevent caregiver burnout and allows families to continue providing care with renewed strength and peace of mind. Learn more about respite care can help you and your family, read: How Hospice Respite And 24-Hour Care Support Family Caregivers
Hospice Care Levels Can Change Over Time
It is important to know that hospice care levels are flexible. Moving from one level to another does not mean something went wrong. It simply means care is adapting to current needs.
A patient may:
- Begin with routine home care
- Receive continuous care during a symptom flare
- Transition briefly to inpatient care
- Return home once symptoms are controlled
Hospice teams regularly assess needs and adjust care to maintain comfort and quality of life.
How Transitions Between Hospice Care Levels Work
Transitions between hospice care levels are a normal and expected part of hospice support. As symptoms change or new needs arise, hospice care adjusts to ensure comfort, safety, and peace of mind.
Hospice teams closely monitor physical symptoms, emotional well-being, and caregiver needs. Changes in care level are guided by medical assessments and ongoing conversations with the patient, family, and physician. Families are never expected to make these decisions alone.
A transition may happen when:
- Pain or symptoms become harder to manage at home
- Short-term, intensive nursing support is needed
- A caregiver needs temporary relief to rest and recover
- Symptoms stabilize and a higher level of care is no longer necessary
When a transition is recommended, the hospice team explains what is changing, why it is needed, and what to expect next. The goal is always to provide the right level of care at the right time, while minimizing disruption and maintaining dignity.
Most transitions are temporary. Many patients move between levels of care as symptoms fluctuate, often returning to routine home care once comfort is restored. Throughout each change, hospice teams remain focused on comfort, communication, and support for both patients and families.
How Hospice Teams Decide the Right Level of Care
Hospice care decisions are guided by:
- Medical assessments
- Symptom severity
- Safety and comfort needs
- Caregiver capacity
- Physician recommendations
Families are always included in these conversations and supported through each transition.
How Generations Health Care Supports Families at Every Level
At Generations Health Care, our hospice team works closely with families to ensure care feels seamless and supportive. We provide:
- Compassionate symptom management
- Emotional, social, and spiritual care
- Respite support for caregivers
- Veterans hospice services
- Bereavement support for families
We proudly serve Austin, Travis County, and surrounding communities with personalized hospice care that adapts as needs change.
Speak With a Hospice Professional Today
If you have questions about hospice care levels or want to understand what support may be appropriate right now, a conversation can help bring clarity. Talk with our hospice team, call (737) 240-3003 or reach us online.
Generations Health Care is here to support patients and families with compassionate hospice services throughout Austin and nearby areas.