Understanding Hospice Care: Finding Comfort, Dignity, and Meaning at Life’s End

Caring for someone with a serious illness looks different at every stage, and having the right support can make all the difference. 

At University Medical Center New Orleans, the Hospice and Palliative Care Program helps patients and families navigate that journey with compassion, comfort, and dignity. Palliative Medicine helps people live well with serious illness, while hospice focuses on supporting those nearing life’s end. 

“Palliative Medicine is the care of anyone living—and I always emphasize living—with their serious illness,” explained Sonia Malhotra, MD, medical director of the Palliative Medicine Program at University Medical Center and Associate Professor of Internal Medicine and Pediatrics at Tulane University School of Medicine. “When we move toward hospice, we’re truly focused on end-of-life care.” 

Hospice Care typically starts when a doctor determines that someone may have six months or less to live. That doesn’t mean care ends after six months. Many patients live longer and continue receiving hospice services as needed. 

“The goal,” Dr. Malhotra said, “is to provide effective pain and symptom management, open communication about the dying process, and support for both patients and their families.” 

Where Hospice Care Happens 

Hospice Care can take place wherever patients feel most comfortable—often in their homes. A hospice nurse typically visits several times a week to check vitals, adjust medications, and provide hands-on care. 

“When patients go home with hospice, the nurse comes in for about an hour, three to five days a week,” Dr. Malhotra explained. “The rest of the care is truly done by the family.” 

Hospice aides may help with bathing, dressing, or daily needs, while volunteers or caregivers can offer companionship or respite time for family members. 

The Palliative Care Program’s social workers play a pivotal role in this transition. Working closely with physicians, the nurse navigator, and hospice agencies, they help families understand their options, complete referrals, and decide whether home or inpatient hospice best fits the patient’s needs. 

“Our job is to walk families through the process,” said clinical social worker Maxine Kimbrell, LCSW. “We talk about what hospice can provide, what level of support each family has at home, and which agencies might best meet those needs. We want families to feel informed and supported, not overwhelmed.” 

Kimbrell and the team also provide counseling for families as they prepare emotionally for this next phase of care. “It’s not just paperwork—it’s about helping people cope with the transition,” she explained. “Families are often grieving even before loss occurs, and our role is to make sure they never feel alone in that process.” 

The hospital chaplain is also deeply involved during this phase, ensuring that each patient’s faith, rituals, or final wishes are honored. Whether offering prayer, presence, or guidance in coordinating with outside clergy, the chaplain helps families find comfort and spiritual peace during a profoundly emotional time. 

This collaboration ensures that when a patient moves into Hospice Care, they do so with a clear plan and a trusted network of support already in place. 

For patients who need more intensive symptom management or are in the final days of life, Inpatient Hospice Care is another option. These facilities are designed to provide specialized medical support in a calm, peaceful environment. “Inpatient Hospice Care is generally for highly symptomatic patients who have less than two weeks to live,” Dr. Malhotra said. “It allows us to manage complex symptoms and provide comfort during the time a person is actively dying.”  This is a level of service that University Medical Center offered in the past and is gearing up to reinitiate in March of 2026. 

Normalizing Death as Part of Life 

While the subject of death can be difficult, Dr. Malhotra sees Hospice Care as an opportunity to bring light, meaning, and even peace to an experience that many fear. 

“I don’t find my field depressing,” she said. “In fact, I find it full of light and change. We fear death and dying as a society, but each of us will go through it—personally or with someone we love. There are two givens in life: birth and death. We celebrate birth with joy, and we can choose to approach death with the same acceptance and grace.” 

For her, Hospice Care is not about loss—it’s about love, connection, and reflection. “Doing this work has taught me what life is really about,” she said. “It’s taught me not to stress about the little things. We can still find joy despite the challenges of the world, because none of us is guaranteed the next moment. When we live with that awareness, we live fuller, more meaningful lives.” 

The Power of Conversation and Planning 

Conversations about end-of-life wishes can be hard to start, but they are among the most meaningful gifts families can share. 

“What a privilege it is to be able to say, ‘Mom, tell me what your wishes are—what’s acceptable to your body and what’s not,’” Dr. Malhotra said. “Having those conversations early helps ensure that, when the time comes, families know how to carry out those wishes with love and confidence.” 

Whether it’s deciding on treatments, considering a nutrition tube, or choosing where people choose to spend their final days—at home, in a hospital, or in hospice—these discussions help families prepare emotionally and practically for what lies ahead. 

Accessing Hospice Care 

Hospice Care is covered by both Medicare and Medicaid, which include comprehensive hospice benefits. Most private insurance plans also cover hospice services, though coverage levels may vary. 

To begin the process, patients or families can speak directly with their physician about a hospice referral. The Palliative Care team’s social workers at University Medical Center often guide these referrals, helping families understand their insurance coverage and coordinating with hospice agencies on their behalf. 

“There are many hospice agencies in the community,” Dr. Malhotra explained. “Some offer more nursing support, others provide additional caregiver services or specialized interventions. If you don’t have a preference, your doctor or palliative care team can help you choose one that fits your situation.” 

A Shift Toward Peace, Not Sadness 

At its heart, Hospice Care is about living fully until the very end—honoring each person’s dignity, preferences, and values. 

“Death doesn’t have to be sad or depressing,” Dr. Malhotra reflected. “It can be uplifting. Hospice Care gives families the space to express love, share memories, and find peace in knowing they’ve cared for their loved one in the best way possible.” 

For more information about Palliative Medicine and Hospice Services at University Medical Center New Orleans, visit Hospice & Palliative Care | University Medical Center New Orleans