Hospice Quiz

For many people, the decision to receive hospice care is made following the diagnosis of a life-limiting illness. Even so, some families still question this decision. Click the link for a brief survey to help determine if hospice care is right for you or for a loved one.


Take The Quiz

Please check the box next to all that apply.

Have you or a loved one…

    Fallen several times in the past 6 months?
    Experienced some weight loss, causing clothes to fall loosely?
    Started spending most of the day in a chair or bed?
    Noticed forgetfulness, and/or misplacing frequently used items, such as eyeglasses, more regularly?
    Made more frequent visits to the doctor?
    Been to the emergency room, or hospitalized more than twice in the past six months?
    Noticed a shortness of breath, even while resting?
    Started taking medication to lessen pain?

    Enter this code to prove you are human: captcha

    Someone will contact you based on the information you submit in this quiz to discuss your care options.

    Please feel free to contact us on your own accord if you’ve checked any boxes above.

    Have I selected the proper end-of-life care options for my loved one or for myself? The answer to that question can be difficult to answer.

    Hearts For Hospice understands that it is important to thoroughly research the many different hospices in the community before choosing one. Hospices are not all the same, and no one should have to settle for one that is not the best choice.

    Hearts For Hospice is dedicated to educating patients, families, and the community about end-of-life care. This makes us different from other hospices.

    Even if you don’t choose us, we will explain the details and benefits of hospice care and provide any additional information needed so the right decision can be made with confidence.

    Click to view a printable PDF version of this survey.