Hospice programs rely on interdisciplinary team (IDT) collaboration in the delivery of quality care at the end of life. The hospice philosophy advocates patient autonomy in decision making, and treatment of the patient and family as a unit of care. Including patients and families in IDT meetings regarding their care is a logical corollary of this philosophy. Hospice professionals in one Midwestern US state were interviewed by phone to determine the extent of patient and family involvement in their IDT meetings. A few programs had direct experience with patients and families attending IDT meetings, but attendance was not routine. Better communication was recognized as a potential benefit. The patient's frailty and the burdens of caregiving for the family were noted challenges to participation. Video-mediated communication is offered as a potential solution.