Is there anything I need to do/know before I request in home hospice care? Anything would be helpful, I've never done this before.

I think it is important to know the basics. That this must be ordered by an MD, and that it will only be ordered if the MD discusses with patient and family their wishes. That the expectation is that the patient will not live more than 6 months (though often patients DO, and Hospice is re-ordered). That there will no longer be medications given to "cure", but only to comfort and keep patient comfortable. That is to say an infection causes discomfort, and it is important to medicate it away if possible. Some other meds are meant to be curative, and would likely be removed. That comfort care will be given with discussion of family in terms of medication to relieve pain, anxiety and air hunger. That in some cases these medications may hasten death by some minutes, hours, days, weeks, but that the decision is now made for QUALITY of life, not QUANTITY in terms of time suffering. That this is END OF LIFE care.
We do see people on Forum all the time who claim that hospice hastened the death of their elder, that they didn't understand there would not be further diagnositic testing and etc.
It is important that ALL family involved meet with Hospice and ask any and all questions they can thing of.
I sure do wish you all good luck.

Hospice will send a nurse out to your home once a week to start with, to check your MIL's vitals and such. They will also send an aide out about twice a week to bathe her. So 99% of her care will still fall on you. They will also supply any needed equipment like a hospital bed, or oxygen, and will supply all needed supplies and medications, all covered 100% under your MIL's Medicare. Some hospice agencies are better than others, so make sure that you do your homework prior to bringing one on board. Typically the rule of thumb with qualifying for hospice care, is that her Dr feels that she has 6 months or less to live. But please remember that hospice is not God. My husband was under in home hospice care for the last 22 months of his life. May God bless you as you venture on this journey with your MIL.

Chances are that some poster will tell you that hospice kills. It’s not true, but it is worth knowing that the morphine they use to control severe pain can result in death earlier than anticipated. It reduces the body’s ability to fight to hang on, and this can lead to sleep and then death sooner than you expect – particularly if MIL is already declining quickly in the end stages. This is exactly what happened with my own mother, and I have no regrets about her death being quicker. She was dying of cancer, and it was the cancer that killed her, not the morphine.

The alternative for you may be to prolong the end by a few days while MIL is in real pain. I’d suggest that you ask Hospice how long they expect MIL to hang on, and when and what they will do to control pain. The people who object have often left things so late that the end is quicker than they expect, and the shock makes them blame hospice rather than the real killer.

I hope that hospice support will make things easier for both you and your MIL.

Call a hospice company. (Yelp.com is actually a decent source for reviews and recommendations.) They'll send someone to evaluate her to see f she's a candidate, but have as much of her medical info available as possible. (Just be able to provide some history.)

The beauty of hospice is that. You'll instantly have a large support network to help you and your MIL through this time of life. They're always there to answer the phone day or night, they nurses come to you, so you don't need to got her in the car for doctor visits, and best of all, the stress just melts away because someone else is sharing the load.

They'll walk you through everything and answer any questions you might have. They have no expectations that you know what's going on or what to do. Call tomorrow and start the process immediately. It'll be a huge burden off you and mom.

Oh, and Medicare pays 100% of hospice costs.

I am sorry you are going through this. At home hospice care is not 24/7 but will get you some help with her a few times a week. You cannot just order hospice. To be accepted there will be an evaluation done to determine her eligibility. It could be that she has a UTI which will cause rapid decline but relatively quick to treat when caught early. When did she last see her doctor?