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Situations

You Just Got the Call No Family Is Ready For

A terminal diagnosis changes everything — and almost nothing, all at once. The person you love is still here. They still want their coffee a specific way. They still want to be home. What changes is the gravity of every decision in front of you. This page is the field guide we wish more Southeast Michigan families had in their first week.

The First 72 Hours

Four things, in order

The first three days after a terminal diagnosis are emotional, not logistical. Resist the urge to solve everything before sundown. Do these four things in order and the rest will follow.

1

Let the news land

A terminal diagnosis is a shock to the whole family. The first 24 hours are not the time for big decisions. Sleep when you can. Eat. Tell only the people who actually need to know today.

2

Get the medical picture written down

Ask the oncologist or specialist for a one-page summary: diagnosis, expected trajectory, what to call about, and who is on the care team. Without this, every later conversation starts from scratch.

3

Decide where they want to be

Most people, asked plainly, say they want to be home. That choice changes every plan that follows — equipment, staffing, hospice timing, and who in the family does what.

4

Call a hospice and a home care agency

These are two different services that work together. Hospice manages the medical side a few hours a week. A home care agency provides the daily human presence the rest of the time. Both calls can happen the same day.

Hospice + Home Care

Two services, one team

Hospice is one of the most compassionate things American healthcare does, and one of the most misunderstood. Hospice provides intermittent visits — a nurse two or three times a week, an aide two to five times a week, a social worker, a chaplain, equipment, and the comfort-medication kit. What hospice does not provide is continuous in-home staffing. The twenty-two hours a day between visits belong to the family.

That gap is what a non-medical home care agency fills. We come in, follow the hospice nurse's plan of care to the letter, reposition every two hours, watch for comfort cues, support the family through the long quiet, and stay through active dying until the funeral home has come and gone.

If your family is not ready for the word hospice, that is okay too. We still provide care, and when the family is ready we coordinate seamlessly with whichever hospice they choose.

What We Bring

The everyday architecture of being home through this

For a terminal diagnosis, this is what 24/7 in-home care actually looks like — written by a second-generation owner who has watched our family build it around hundreds of these cases since 1989.

Around-the-clock presence

Two Care Pros per day on 12-hour shifts so someone alert is always in the room — overnight as well as daytime.

Mobility, PT, and dignity

Safe transfers, walker assists, and reinforcement of whatever the physical or occupational therapist asks us to carry through between visits.

Strict infection control

Mandatory pre-shift health screens. A Care Pro who fails the screen is not allowed to work. Non-negotiable for treatment-affected immune systems.

Quiet emotional presence

We do not fill the silence. We sit, we listen, we hold a hand if invited, and we follow the family's lead.

Respite for the well spouse

Predictable blocks of time where the spouse can sleep, see a doctor, or step outside without the house holding its breath.

Long-term care insurance billing

We initiate the claim, submit visit logs and plans of care in the carrier's preferred format, bill directly when allowed, and track benefit caps so the family always knows where they stand.

The Well Spouse

The person we worry about most is usually not the patient

In a long marriage, the well spouse becomes the patient too — quietly, without anyone noticing. They stop sleeping. They stop eating real meals. They stop seeing their own doctor. They start lifting more than their back can carry. By the time the family catches it, the spouse is the one who needs care.

Our schedules build in predictable respite blocks the spouse can count on — time to sleep without one ear open, time to take a walk, time to sit alone in their own kitchen for an hour. We also document what we see on every shift and report changes back to the hospice nurse so the spouse is not carrying that observation alone.

Read more about caregiver burnout in our "I Can't Do This Alone" guide.

Long-Term Care Insurance

If a policy exists, we handle the paperwork

A long-term care insurance policy is written almost exactly for the situation a terminal diagnosis creates — someone who needs help with the activities of daily living, in their own home, for an extended period of time. Most families come in dreading the paperwork and are stunned at how little of it actually lands on them.

  • • We help initiate the claim with the carrier and walk the family through the elimination period.
  • • We submit caregiver visit logs and the plan of care in the carrier's preferred format.
  • • We bill the carrier directly when the policy allows, or provide turnkey reimbursement packets when it doesn't.
  • • We track the benefit cap so the family always knows where they stand.

Read the full breakdown in our long-term care insurance and home care guide.

What 24/7 Costs

Around-the-clock care for an advanced illness

A terminal diagnosis is treated as a specialized-care case. Typical Southeast Michigan home care agency rates for specialized care average $35-$42 per hour. The exact rate for any one family depends on the shift structure and the specific skill match required. Our standard 4-hour visit and 12-hour weekly minimums do not apply at 24/7 volume.

For the deeper clinical picture of advanced cancer at home, see our Cancer Care at Home page.

FAQ

Common Questions in the First Week

What families ask after a terminal diagnosis

Hospice provides intermittent visits from a nurse, aide, social worker, and chaplain — typically a few visits per week. They don't provide continuous in-home staffing. We provide the daily human presence between hospice visits. The two services work together — see our hospice support care page for details.
Not necessarily on day one — but earlier than most families do. Hospice is appropriate when a physician believes a person has six months or less to live. Many families wait too long. If the diagnosis word is terminal, a hospice consultation that same week is reasonable.
For most Southeast Michigan families we can have two Care Pros covering 12-hour shifts in the home within 24-48 hours of the first call. Around-the-clock coverage is built around a continuity team of the same handful of faces. Contact us to start.
In almost every case, yes. Long-term care policies are written for exactly this situation. We initiate the claim, submit documentation in the carrier's preferred format, bill directly when allowed, and track the benefit cap for the family. See our long-term care insurance guide.
A terminal diagnosis is treated as a specialized-care case. Typical Southeast Michigan home care agency rates for specialized care average $35-$42/hr. The exact rate depends on shift structure and skill match. Our standard visit and weekly minimums do not apply at 24/7 volume. Use our cost calculator or contact us for a quote.
The spouse is often the person we worry about most. We build predictable respite blocks into the schedule — time the spouse can count on for sleep, a doctor appointment, or simply leaving the house. We also document what we see and report changes back to hospice so the spouse is not carrying that alone.
Yes. Our Care Pros stay through active dying, support the family with comfort positioning and mouth care, and remain present until the hospice nurse arrives after death is pronounced. The shift does not end because death has happened.
We still provide care. We follow the family's lead. If hospice is added later, we coordinate seamlessly with whichever hospice the family chooses.
Yes. There are no deposits, no minimum contract length, and no cancellation fees. Schedules can scale up, scale down, or end with no penalty.
No. We are a non-medical home care agency. Medical care is provided by the physician, hospice, or skilled home health team. Our Care Pros support activities of daily living, mobility, meals, hygiene, companionship, and the careful presence that lets someone stay home.

When You're Ready, We're a Phone Call Away

A second-generation family owner picks up. Not a call center. We can have care in the home within 24-48 hours.