Purpose: It is critical to assess hospice professionals' discrimination between adaptive and maladaptive reactions to terminal illness in persons at the end-of-life to assure targeted intervention aimed at maintaining quality of life. The proposed measure, the Hospice Professionals Understanding of Preparatory Grief scale (HPPG), contains affective, behavioral, and cognitive reactions to terminal illness and asks respondents to identify which reflect adaptive and maladaptive responses. Methods: Hospice professionals across three states (n = 196) completed the novel HPPG via online survey. Results: Initial evidence via expert panel review, confirmatory factor analysis, and domain restructuring suggests good content and factorial validity. Final reliability (a stratified = 0.861) indicates good internal consistency. Discussion: The HPPG is the first measure to assess hospice professionals' understanding of reactions to terminal illness and serves as an initial examination of this critical skill in hospice professionals including social workers. The HPPG can be used as a self-assessment or measure of continuing education.