What Happens When a Hospice Patient Dies at Home

The death of a loved one is a trying time for families and caregivers. At VITAS Healthcare, our role is to provide the tools for those who are closest to patients to be prepared for this time. We support families and caregivers in gaining a clearer understanding of what happens when someone dies in hospice.

What to Expect When a Loved One Dies at Home

Death is a natural event. There are no rules on how to die or how to witness a loved one’s last moments—or last months. Some family members may attend early or frequently in the process, then not be there for the death itself.

Be confident that your presence remains with your loved one. Dying unfolds over many moments.

The following information is not intended to predict what will happen, but to give you an idea of what to expect or where your loved one may be in his or her dying process, in the hope that you can make the most of your time together.

Symptoms of Active Dying

The final days of patients’ lives are generally accompanied by specific clinical symptoms. A few of these indicators leading up to the final week include:

  • Delirium and confusion
  • Decreased speech
  • Cold extremities

The final 2-6 days of a patient’s life are indicated by the shutting down of normal bodily function. This period is often accompanied by:

  • Reduction of consciousness
  • Inability to swallow food or water
  • Labored breathing

Patients may also be aware of when the end of their life is drawing nearer. Clinical symptoms aside, emotional signs of death can include:

  • Social withdrawal
  • The desire to conduct a life review
  • A focus on funeral planning

Saying Goodbye

Realizing a loved one is dying can be emotionally trying, yet saying goodbye, even if your loved one is no longer conscious, can be a significant part of the grieving process. According to studies, hearing may be the last sense to leave a person who is actively dying.

Take the opportunity to say what is in your heart to your loved one reaching end of life. Though the vulnerability of opening up can be daunting, it may later be reassuring to know you took the chance to share your feelings.

Reminiscing is another way to connect meaningfully during the final days and hours.


Processing the death of a loved one is one of the most difficult experiences we face in life. Remember that grieving takes time, and each person has their own process for grieving. Taking care of yourself is easy to forget during this time of mourning and remembering, yet it is so important.

What to Do After a Hospice Patient Dies at Home

Call Hospice

VITAS is here to provide comfort and assist with bereavement once your loved one has passed. With the expertise and experience of our interdisciplinary care team members, we offer empathic support to family members and other loved ones.

Under the Medicare hospice benefit, families are entitled to bereavement support from their hospice care provider for at least 12 months following the death of their enrolled loved one. At VITAS, we are committed to being as involved in the bereavement process as the family would like us to be. This can include assistance such as aiding in the arrangement of the funeral or spiritual support from a chaplain.

Pronouncement of Death

In the moments after a patient passes away, death should be officially pronounced as quickly as possible. This can be done by a doctor or hospice clinician, who will also need to fill out the necessary legal papers to certify the time, place, and cause of death.

Timely action is imperative because it will begin the process of issuing a death certificate. This document is necessary for various responsibilities such as matters related to life insurance and financial/property issues.

Check for Advance Directive Documents

Advance directives map out a patient's wishes regarding the care they would like to receive as they reach the end of their life. Advance directives are important not only prior to death, but after as well. These legal documents often include information on whether the deceased wanted to become an organ donor. Locating these documents quickly is important because the process of preserving organ function for donation is time sensitive.

Body Transportation

Prior to the death of a patient, VITAS will serve as a resource for information on funeral homes that best suit the needs and preferences of the family. In the case that a patient is enrolled in VITAS for only a few days prior to death, VITAS will still facilitate the process of choosing a funeral home.

Body transportation will be coordinated between the family and the funeral home, with VITAS serving as an aid in the smooth planning of this process. To reduce stress in the moments following the death of a loved one, it is useful to anticipate these needs and plan ahead.

Notify Family, Doctors, Employer, etc.

Hospice care providers should assist the family in reaching out to all parties that need to be informed of the death. If families would like our involvement in notifying relatives and friends of the passing of their loved one, VITAS does so in a sensitive and considerate way. Family doctors will also be informed of the death, and VITAS social workers can assist in notifying employers.

Caring for Yourself When a Loved One Passes

If you have provided care for a long time and have watched the gradual decline of the person you love, you’ve probably become worn down. Maybe you neglected your own health to care for him or her. If your loved one died suddenly, you likely went through a period of shock and stress. In either case, you’re probably depleted—physically, mentally, emotionally, and spiritually.

You may still have a lot to take care of, including new tasks you never had to do before. To help you cope during this difficult time, we recommend leaning into our many resources, including counseling and bereavement specialists.

We offer a variety of remote bereavement support groups, free of charge.


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