I am a social worker for the pediatric team. My daughter (only child) who has cf is 4. I was in the position at hospice before she was diagnosed. After her diagnosis, I took a year and a half off, worked with adults some, but the peds position reopened and I was ready. Hospice guidelines vary state to state in terms of how much/ what types of care they are able to provide and how it is paid for but most hopices are greatly funded by donations so even if insurance is used or people are billed some, the Hospice doesn't run on that $ , rather from donations, fundraising etc. Some hospices offer palliative care and it is available even when the doctor cannot say the patient is "dying" or terminal, or has less than 6 months, but rather that the person's life is "threatened" or has a chronic "life-limiting " illness. Traditional hospice care focuses on a person's dying process being as comfortable and tolerable for the patient and caregiver. Palliative care focuses on a sick person feeling better , but not necessarily getting better, if that makes sense. For example, in my work, we help quite a few children with cerebral palsy, or who had trauma at birth and may live a while, but have limited abilities. We do a lot of parental support. One of the biggest things that happens to people going through caring for a sick child is isolation, our visits relieve that. We also offer as many options as possible in terms of meds/ treatments, ideas for keeping someone comfortable, not judging the patient/ family on their decision. For example, if pain is an issue, some folks want no pain, even if that means the patient is always sedated. Some say, no I want to be awake, talk to my family and I am ok with a little pain. They can help you understand the body's way of dealing with the symptoms of the disease, the dying process and help you feel prepared. I agree with some of the comments , that the agency can reassign you a nurse/ social worker or chaplain if you don't like who you are asigned, but let me say I'd be surprised if you'd need that. I work with a hospice of approx 200 employees and in 3 years of meeting with probably at least 150 familys, i've probably only heard of personality conflicts once or twice. I don't say this to brag, but i believe hospice caregivers are some of the best people in the world, especially when theyenter the home of a hospice patient. Back at the office, they are all human, but there is a special presence that takes over when we are with those who are going through what you are going through. And it is always your perogative to say, we are not feeling up for a visit today. At our hospice its 24 hour service, if and when you need it, with average being a nursing visit once 2-4 times a month and a chaplain/ social worker visit biweekly. At ours there are also special units to go to if needed during care-giver crises or increased pain, or doing a major decline. But also,sometimes you can get nursing care for 8 hour incremens when things are intense. All of these things vary state by state. Bereavement services that are offered at most hospices are great too. Far more beneficial than traditional groups or counseling because all the work is focused on people who've lost someone. It's very specialized. If you and your son are able to talk now about the things that are important to him, issues of privacy, how much medical intervention he can tolerate etc....Hospice can help guide you to make sure his wishes are honored even when if he is too weak to make decisions. Please let me know about the nurse's visit and pass on any questions you still have after that.