Those first 48 hours can feel like changing planes at night, with new faces, quick decisions, and a lot of emotion. Hospice turns that handoff into a plan. By regulation, a registered nurse completes the initial assessment within 48 hours of electing hospice, or sooner if you request; comfort medications are reviewed; and essential equipment begins to arrive. Your team sets a simple schedule so you know who is coming, when to call, and how to keep your loved one comfortable. 

This guide walks you step by step through the first two days, explains who will visit and why, outlines the equipment and supplies to expect, shares quick home setup tips, and gives you the key questions to ask along with how to use the 24/7 line with confidence.

What Happens First

• Intake Call: You share symptoms, preferences, and the best contact person.
  
• First Visit Window: A nurse or another team member arrives quickly to start care. Many organizations aim to visit within 24 hours of referral, and iServe Hospice prioritizes same day or next day starts whenever possible, guided by your needs and safety.
  
• Initial Nursing Assessment: Completed within 48 hours of hospice election, which confirms urgent needs and launches the plan of care.
  

Hour-By-Hour Guide for the First Two Days

Hours 0-2: Stabilize And Orient

• The nurse reviews symptoms, medications, allergies, and vital concerns.
  
• Comfort orders begin, which may include pain, anxiety, nausea, or breathing relief.
  
• You receive the 24/7 phone number and clear instructions about when to call.
  
• Paperwork is kept simple. The focus is on comfort and safety at home.
  

Hours 3-12: Equip and Support

• Durable Medical Equipment (DME): A hospital bed, pressure-relief mattress, bedside commode, or oxygen may be delivered if needed.
  
• Supplies: Incontinence items, wound care basics, and protective pads are stocked.
  
• Caregiver Coaching: You learn positioning, fall prevention, and how to give comfort medications correctly. National guides note that equipment delivery, medication setup, and caregiver education are standard early steps.
  

Hours 12-24: Round Out The Team

• Hospice Aide: Helps with bathing, grooming, and gentle personal care.
  
• Social Worker: Reviews goals of care, advance directives, and practical resources.
  
• Chaplain (If You Choose): Offers spiritual support consistent with your beliefs.
  
• Visit frequency and your preferred schedule begin to take shape.
  

Hours 24-48: Set A Steady Rhythm

• The nurse confirms that symptoms are controlled and that equipment is working well.
  
• The plan of care is refined and the visit cadence is set.
  
• You get a short list of red-flag symptoms and a direct number to reach the on-call nurse at any time. Many families notice fewer emergency visits once this rhythm is in place. 

Who Comes To The Home And Why

• Registered Nurse: Leads symptom control, teaches caregivers, and coordinates with the hospice physician. Must complete the initial assessment within 48 hours of election.
  
• Hospice Aide: Provides dignified personal care and skin protection.
  
• Social Worker: Supports decision-making, benefits, and family coping.
  
• Chaplain: Offers spiritual care centered on your values.
  
• Medical Director or Nurse Practitioner: Guides the clinical plan and medication adjustments.
  
• On-Call Team 24/7: Answers urgent questions and can visit for crises. Reputable programs emphasize rapid response and predictable visits in the first days. 

What You Can Do To Prepare Today

Create A Calm, Safe Space

• Clear walkways and remove loose rugs.
  
• Add nightlights to reduce confusion and falls.
  
• Place a sturdy chair with armrests near the bed for transfers.
  

Gather A Simple Care Kit

• Disposable gloves, wipes, barrier cream, oral swabs, and extra linens.
  
• A small locked box or caddy for comfort medications and dosing tools.
  
• A printed list of the hospice 24/7 number by the phone and saved in contacts.
  

Set Expectations With Family

• Choose a primary point person for the team to call.
  
• Write the top three goals for the next 48 hours, such as comfort, rest, and privacy.
  
• Decide who will be present for the first bath or equipment delivery.
  

Medication, Comfort, and Safety Basics

• Pain And Breathlessness: Your nurse explains each medication’s purpose and dosing. The goal is relief with clear thinking whenever possible.
  
• Anxiety Or Agitation: Non-drug steps come first, such as quiet space, familiar music, and a reassuring presence.
  
• Swallowing Changes: The team may shift to liquids, crushed tablets when appropriate, or non-oral routes.
  
• Skin Safety: Turning schedules, moisture control, and pressure-relieving surfaces prevent injuries.
  
• Emergency Plan: You will know what to do if pain, shortness of breath, or confusion suddenly worsens, and who will come if you need a visit at night.
  

Common Questions In The First 48 Hours

• How Fast Does Care Start?
  Many agencies aim to start within 24 hours of referral, and regulations require the RN initial assessment within 48 hours of election unless an earlier timeframe is requested. 
• Will Hospice Take Over All Care?
  No. Hospice adds a skilled team, equipment, supplies, and 24/7 support. You remain central to daily routines and decisions. Hospice is described as a partner, not a replacement for family care.
• What Equipment Will We Get?
  It depends on need. Common items in the first days include a hospital bed, pressure-relief mattress, bedside commode, shower chair, oxygen, and mobility aids. Delivery and setup are coordinated by your team.
• What If My Loved One Is Actively Dying?
  The team increases visit frequency and support. Some large providers publish protocols for last-day’s intensity to ensure a calm, dignified passing. 

Ready To Start Or Ask Questions

You deserve a calm plan and quick support. Call iServe Hospice at (469) 480-1130 or send a message to begin services in Dallas–Fort Worth with clear guidance, essential equipment, and a team you can reach any time. If you prefer, request a visit online and we will call you to schedule.

Service Areas

iServe Hospice supports families at home, in assisted living, and in nursing facilities across Collin, Dallas, Denton, Ellis, Kaufman, Rockwall, and Tarrant counties.