When a loved one is facing a terminal illness, making decisions about their care can feel overwhelming. One of the most important decisions families encounter is whether hospice care should take place at home or in a community environment. Each option provides compassionate support focused on the individual’s dignity and comfort. The right choice depends on a variety of personal and practical factors.
At Bethesda Senior Living Communities, we understand how deeply personal this decision can be. In this article, we walk through the key differences between in-home hospice and community-based hospice care, the benefits and challenges of each option and helpful considerations to guide you as you support your loved one in their final journey.
Hospice care is for individuals who are nearing the end of life and no longer seeking curative treatments. Instead of focusing on recovery, hospice emphasizes comfort, dignity and quality of life. It’s a compassionate form of care that supports both the individual and their family during a profoundly emotional time.
Hospice care typically begins when a person has a life expectancy of 6 months or less. It can be provided in various settings, including private residences, assisted living communities and specialized hospice centers. A multidisciplinary team composed of doctors, nurses, social workers, chaplains, aides and volunteers works together to meet the emotional, physical and spiritual needs of the individual. Families also benefit from services such as counseling, respite care and bereavement support.
Hospice care is about living well for as long as possible, whether it takes place at home or in a community setting. Its goals include:
In-home hospice allows individuals to receive care in the comfort of their own home, including assisted living apartments and long-term care settings. For many, this creates a peaceful and familiar environment during a difficult time.
With this option, a hospice team visits on a scheduled basis to provide medical care and emotional support. However, they don’t provide day-to-day care. Instead, family members or paid caregivers typically take on these responsibilities. Equipment such as hospital beds and oxygen tanks may be delivered to the home for the individual’s comfort and safety.
The primary advantages of in-home hospice care include:
Some drawbacks of in-home hospice care include:
Community-based hospice care provides end-of-life services in a dedicated hospice community or within a long-term care center, such as a nursing home or assisted living community. These environments offer around-the-clock support, promoting the individual’s comfort and safety along with the family’s peace of mind.
With community-based hospice care, individuals live in a setting staffed by trained professionals who specialize in end-of-life care. The care team is available around the clock to help with symptom management, medication administration and emotional needs. Family members and friends are encouraged to visit freely and participate in their loved ones’ care as much as they’re comfortable doing so.
The primary advantages of community-based hospice care include:
The drawbacks of community-based hospice care include:
Choosing between in-home and community-based hospice care comes down to what’s most important for your loved one and your family. While both options offer compassionate end-of-life support, they differ in caregiver responsibilities, flexibility and the level of medical oversight available.
Community-based hospice care provides 24-hour access to skilled staff, which can be reassuring for families concerned about medical emergencies or complex care needs. On the other hand, in-home care relies on scheduled visits, so families have a larger role in monitoring and responding to medical emergencies between appointments.
In-home hospice care requires a strong support network, as family and paid caregivers are responsible for all hygiene, personal care, meals and mobility assistance. In contrast, in a hospice community, trained caregivers handle these tasks, reducing the emotional and physical load on families.
In-home hospice care offers the comfort of familiar surroundings and a more personalized routine. In hospice communities, individuals benefit from structured environments with built-in accessibility features and access to social support.
In-home hospice allows for continuous presence and participation for families, which can be meaningful and therapeutic at this stage of life. Families who opt for a community setting remain involved in their loved ones’ care but aren’t responsible for managing every aspect of it.
Choosing between in-home and community-based hospice care is a deeply personal decision. By understanding your options and what each setting offers, you can make the choice that best supports your loved one’s comfort and peace.
