It’s two in the morning, and something has changed. The breathing sounds odd, or your loved one is looking at you as if they don’t know where they are. You stand in the hall in your socks, and the question loops in your head: is this bad enough to call? Few moments in home care feel as lonely or as scary as that one.
The short answer is: When you’re unsure, call the hospice line, day or night. A hospice nurse answers, talks you through what to do, and can come to your home if needed. Calling is what the line is for.
What Counts as Urgent in Hospice Care?
Hospice care aims at comfort, so the bar for calling is lower than you might think. Pain that won’t settle and breathing that turns hard both deserve a call. So do a fall and a sudden change in how clearly your loved one thinks. If something is causing distress for your loved one, or for you, that is reason enough. Hospices keep nurses on-call 24/7 for a reason.
Who Answers the Phone at Night?
A hospice nurse. The nurse can talk you through the problem by phone and come to your home when it’s needed. You should have been given a number for after-hours calls. Keep it on the fridge and in your phone, and ask the nurse at the next visit if you can’t find it.
What Should You Know Before You Call?
Take a moment to look at your loved one, since the nurse will ask what you see. Notice how they are breathing and how awake they seem, and write down any new symptom. Jot down the time it started and what you’ve given so far. Keep your name and address handy. If you feel scared, don’t hold the call to gather facts. A call with few details is still a good call, and the nurse will ask you questions to give them whatever other information they need.
What Happens After You Call?
The nurse will ask a few plain questions and may suggest comfort steps to try while help is on the way. If your home has pills or drops set aside for symptoms, the nurse can guide you through using them. If your loved one needs a hands-on visit, the nurse will come. The team knows your loved one’s plan and has the records, so you don’t have to explain it all from the start, even at three in the morning.
Should You Call 911 Instead?
Ask the hospice team ahead of time which signs call for outside help and which call for the hospice line. If you ever feel you can’t wait, calling for outside help is yours to do. Know this, though. Without a signed DNR order in the house, the crew that comes is often bound to try to restart a heart, even when your loved one wouldn’t want that. Calling the hospice line first, when you can, keeps your loved one’s wishes in the lead. Your own doctor’s office is not the place to start at night.
How Can You Get Ready Before Something Happens?
Plan now, while the house is calm. At a visit, ask the nurse what changes may come and what to do about each one. Ask what pills and drops are in the home and how they’re used. Many hospice teams leave a folder or binder with contacts and notes that fit your loved one, so ask for yours and keep it by the bed. Write the after-hours number on a card and tape it where you’ll see it. Then ask the nurse to walk through a few “what if” moments with you, such as a fall or a hard night of breathing. A plan you’ve heard once is far easier to follow when you’re tired and afraid.
What If You Feel Silly or Afraid to Call?
Most people do. You might worry that it’s too small, or that it’s too late at night. The team hears from scared, worn-out people every night. A call that turns out to be small is a fine call, and a nurse would rather hear from you than have you wait and wonder.
What Should You Do While You Wait for the Nurse?
Sit with your loved one and keep your voice low. Turn on a soft light and hold a hand. Unlock the door and flip on the porch light so the nurse can find the house. Keep the phone close, and follow the nurse’s steps as given. If you’re alone, you can put the call on speaker and stay at the bedside.
Can You Call More Than Once?
Yes. Things can change within the hour, and a second call is no trouble. If your loved one gets worse while you wait, or the first steps don’t help, call again and say what’s new.
What If You Just Need Someone to Talk To?
Fear can be reason enough to call. Tell the nurse you’re struggling, and ask about talking with the social worker or the spiritual care team in daylight hours. A rough night is easier to face when the day brings more help.
What Is It Like to Make the Call?
Scary, often, and tiring. The nurse who answers knows you may be frightened or worn out, and responds with skill and kindness. Many people say that knowing help is a phone call away lets them stay in the room with their loved one, instead of lying awake over what might go wrong.
You never have to make a hard night’s choices alone. The hospice team is there to share this work with you, any day and any hour.