First, each patient situation, and each hospice, will be unique. No two experiences will ever be exactly alike.
Where I am, hospice is for people who are no longer seeking treatment and are not expected to live past six months or so. (If still in active treatment, Palliative care is recommended instead.)
Both of DH’s parents had hospice services at home, with FIL eventually going to a hospice house when his needs exceeded what could be provided by family (basically he was becoming confused and combative to caregivers). He passed within one day of being there - they do not hold back on giving medications.
I was closest to the situation of my own mother receiving hospice care in our home. They stressed upon intake interview that this was our experience and we could make it what we wanted. We had two nurses at home, myself and my daughter, and others to help, so we did almost all of her care ourselves. They came to take vital signs, assess her, and count medications. Dressings were already changed, she was cleaned and sitting up in bed well taken care of. We didn’t even have aides come in to wash her up because they could not be scheduled at regular times, and I needed to know when someone was coming for my work schedule. (As it was there were some days that nurses were very late coming, like, a couple of hours, but I knew that they were tied up somewhere else, as our nurse was the day Mom died when she stayed with us for three hours getting the paperwork done, counting meds, calling our family doctor, waiting for the funeral home, and supporting us, etc. I really appreciated that. But I imagine that not everyone would be so patient, understanding that people often have things to do outside of the stress of caring for a dying loved one at home.)
The two most helpful things that hospice did for us was provide equipment like a hospital bed, a lift, a suction machine (which was delivered at midnight one night), all supplies for her wound cleansing and dressings, urinary catheters, and medications, etc. They also provided a pamphlet that was very helpful to me that described the stages of dying and what could be expected to happen at each. I relied on that quite a bit at the end, even though I’d taken care of many dying patients myself in the hospital, this was different being at home and the primary care providers 24/7. Things I found unhelpful were what I already described about changes in scheduling and delays in care, a system I wasn’t used to as far as medicating people, a few disagreements with the doctor about treating illnesses like pneumonia or UTI, and one time a nurse not even on the hospice team who came in for a wound consult and offered an unsolicited opinion I didn’t appreciate. (I asked that she not return.)
I hope that’s helpful. It’s a hard thing to go through but hopefully, with good people and support, it can be a mostly positive experience. I’m glad overall my mother was comfortable and well cared for. In the days before she passed she was happily talking about seeing things “upstairs” that were “fantastic” and “beautiful”.