Hospice is a special concept of care designed to provide comfort care and support to patients with a life-limiting illness and their families. Comfort care, or palliative care, is designed to provide aggressive pain and symptom management with spiritual and emotional support. The Interdisciplinary Hospice team helps to formulate a plan of care with the goal of meeting the individual needs of the patient and family. The specially educated hospice team including a Medical Director, Registered Nurses, Social Workers, Chaplains/Spiritual Counselors, Certified Hospice Aides, Volunteers, Bereavement Counselors, Pharmacists, and Therapists.
The Hospice Circle of Care (view diagram below) provides a visual reference of the interdisciplinary Hospice team.
Medical Director
- Certifies that the patient is terminally ill with life expectancy of six months or less
- Leads the interdisciplinary team in the development of the plan of care and provides ongoing education/training to the staff
- Provides consultation to other physicians regarding hospice care
Primary Care Provider
- Can be a physician or Nurse Practitioner
- Can also be the Hospice Medical Director, if desired
- Nurse Practitioner: Primarily used for face-to-face home assessment May be involved in the hospice plan of care for the patient
- Involved with any changes in medications, procedures, tests, etc.
- Works with the Hospice team to address comfort measures for the patient
- Consults as needed with the Hospice Medical Director to achieve good symptom management and quality of life
Hospice Nurse Practitioner
- Primarily completes face-to-face home assessments for hospice patients after they have been on service over 180 days.
Case Manager (Registered Nurse)
- Oversees ordering durable medical equipment, health care supplies and prescriptions that relate to the Hospice diagnosis and end-of-life care of the patient
- Initiates all medication ordering, supply and prescription gather for the patient
- Provides regular communication with primary care provider, hospice medical director, family, caregivers, and community agencies
Registered Nurse/Licensed Practical Nurse
- Introduced at the beginning of hospice care
- May be assigned as the registered nurse case manager
- Assesses comfort and any other symptoms which may need attention, such as pain, nausea, etc.
- Performs procedures such as wound care, bowel care, blood draws, and placing and maintaining any IV medications, catheters, etc.
- Teaches the caregivers about medications, symptom management, dressing changes, etc.
- Suggests and helps obtain needed equipment and services
- Offers support and education as physical changes occur
Social Worker
- Works closely with patients and families to create and maintain a supportive caregiving system
- Helps address personal, financial and emotional issues
- Identifies community resources
- Helps family to arrange added caregiving support at home or in alternative care settings
- Provides information on Advance Care Planning including 5 Wishes, Living Wills, Durable Powers of Attorney, and POLST
- Assists in funeral planning and arrangements
- Suggests coping techniques through relaxation, guided imagery
Volunteers
- Volunteers are extensively trained and carefully screened
- Provide intermittent respite to families/caregivers
- Read and actively listen to patients
- Run errands, grocery shopping, laundry, light housekeeping, prepare meals, walk pets, etc.
- Offer outings and companionship for patients
- Assist with writing memoirs and capturing your life story
- Socialize with patients in nursing homes and assisted living facilities
Hospice Aide
- Provides personal care needs such as bathing, changing linens, shampooing, shaving, etc.
- Offers light homemaking services
- Assists in toileting and patient transfers
- Watches for skin care issues
- Teaches personal care techniques to families and/or caregivers
Hospice Chaplain/Spiritual Counselor
- Meets with patients and families to share hopes, fears, dreams and concerns, whether spiritual or otherwise
- Explores unresolved issues surrounding the meaning and value of life
- Helps with spiritual concerns using a non-denominational approach
- Supports exploration of struggles with spiritual and/or emotional issues
- Provides spiritual counseling, respecting your personal beliefs
- Assists in funeral planning, memorial services, or other observances
- Contacts clergy services from the denomination of your choice
Bereavement Counselor
- Offers grief support to families and caregivers through the first 13 months of bereavement, which may include visits, telephone calls, informational packets, and short-term counseling
- Encourages use of the Hospice library as a resource on grief work
- Refers to other community resources as needed for grief support
- Facilitates bereavement support groups
Pharmacist
- Participates at the team meetings as a medication resource
- Recommends medication usage and dosage, alternative medications, and optimal medications for symptom management
Optional Therapies
Optional therapies may include physical therapy, occupational therapy, and speech language pathology providing the following services:
- Evaluate specialized medical equipment
- Assess transfer safety, strength, and ambulation to improve quality of life
- Teach safe swallowing/eating techniques
- Evaluate communication difficulties
- Teach family/caregivers exercises and positioning for the bed bound patient that might relieve pain and discomfort
Additional costs may apply depending upon availability of services.
Music Therapy
- Uses live patient-preferred music to patients and families with end-of-life issues
- Creates a therapeutic relationship between the professional certified music therapist and the patient by facilitating each session following a specialized plan
- Helps with pain control and anxiety
- Provides an opportunity for relaxation and emotional expression
Massage Therapy
- Creates a therapeutic relationship between the professional massage therapist and the patient by facilitating each session following a specialized plan
- Helps with pain control and anxiety
- Provides mental and physical relaxation, improved sleep, and stress relief
Pet Therapy
- Visiting with animals can help people feel less lonely, and less depressed. Visits from dogs can provide a welcome change from routine. People may become more active and responsive both during and after visiting with animals.
- An animal visit can offer entertainment or a welcome distraction from pain and infirmity. People often talk to the dogs, and share with them their thoughts and feelings and memories. Animal visits provide something to look forward to, as stroking a dog or cat can reduce a person’s blood pressure.
- The pet makes it easier for two strangers to talk. It gives people a common interest and provides a focus for conversation. A dog pays little attention to age or physical ability, but accepts people as they are.
QUESTIONS?
Please contact us if you have any questions regarding home health or hospice services in your area or visit our jobs page if you would like to become a part of our team.