Hospice Services

The hospice intake admission nurse is responsible for assessing your need and readiness for hospice and consults with the hospice physician before accepting you into the program.

Prior to initiating hospice care, your admission nurse will assess your medical records, engage in discussions with you and your family, and elucidate the hospice process and ethos. Collaboratively, you will determine the extent of hospice care needed and formulate a personalized plan.

Intake admission nurses play a pivotal role in orchestrating collaboration among various team members, such as doctors, nurses, therapists, and dietitians. This plan encompasses choices regarding payment for your care, your preferred location of stay, potential relocation scenarios, and the frequency of visits from your dedicated case manager nurse.

Your hospice case manager nurse is responsible for assessing and managing your overall plan of care. Once you are admitted, your hospice case manager nurse will do a complete assessment of your needs and fill the hospice physician’s orders for your medication and equipment. You will also discuss which tasks you and your family can do for yourself (such as changing catheters and administering medication injections) and which you need assistance with.

Your hospice case manager nurse will regularly visit you and will begin the process of teaching you what you need to do on your own, how to recognize the need to call for assistance, and how to call for help. Ideally, only one case manager nurse is assigned to you to foster a trusting relationship and allow for continuity of care.

A hospice visiting nurse will attend to your immediate requirements, and they may also oversee regular care tasks, including wound care, to ensure your comfort and well-being.

If you are staying at an assisted living facility or a nursing home, you may see staff hospice nurses, or you may get visits from a visiting nurse, depending on the type of facility.

The hospice triage nurse is ready to receive your calls, whether you’re at home or with your family. During the call, the nurse will evaluate your condition, offering guidance for symptom management or medical care. If necessary, the triage nurse collaborates with the hospice physician and informs the case manager or visiting nurse to arrange a visit.

A home health aide’s responsibilities are tailored to each patient’s individual requirements and typically encompass a range of tasks, such as:

• Assisting with bathing, whether in a shower, tub, or bed
• Providing shaving assistance
• Aiding with dressing
• Attending to hair washing and combing
• Offering oral and denture care
• Supporting toileting and incontinent care
• Managing and cleansing foley catheters
• Administering nail care
• Providing soothing back rubs and massages
• Ensuring comfort by repositioning immobile patients
• Safely transferring patients between bed and chair, or vice versa
• Assisting with ambulation (walking)
• Conducting range of motion exercises
• Changing bed linens
• Performing light housekeeping duties

While home health aides do offer a specific level of care to patients, it’s important to note that they do not possess nursing qualifications. As a result, they are unable to administer any form of professional nursing care or provide medical guidance to either the patient or the patient’s circle of family and friends.

The responsibilities of home health aides revolve around executing a care plan that has been developed by a registered nurse (RN). This care plan is overseen by the RN, who also supervises the care administered by the home health aide. This collaborative approach often involves the RN participating in occasional joint visits with the home health aide. These visits serve the purpose of observing the care being delivered by the aide and, if necessary, providing additional instruction or guidance.

A home health aide is a covered service under the Hospice Benefit, although the need for a home health aide must be documented for the service to be covered. This could imply that patients who maintain their independence and can self-manage may not meet the criteria for home health aide services. Generally, home health aide coverage is reserved for those who require assistance with the fundamental aspects of self-care.

Social workers have in-depth knowledge and expertise in working with ethnic, cultural, and economic diversity; family and support networks; multidimensional symptom management; bereavement; interdisciplinary practice; interventions across the life cycle; and navigating health care systems. They are concerned with enhancing the quality of life and promoting well-being for patients, families, and caregivers.

The responsibility of the social worker entails delving into the patient’s life within the framework of their personal and familial background. It is crucial to grasp essential details, such as identifying whether the family is undergoing unique stressors, comprehending their perspective on the process of dying, and recognizing any distinctive or exceptional anxieties related to death. It might fall upon the social worker to assist family members in reconciling with their loved one’s choices regarding their impending passing and to aid them in handling the aftermath, particularly in cases where emotional responses or individual divergences arise concerning decisions connected to hospice care.

In the hospice and palliative care setting, the social worker may help with any number of the following:

• Providing support to patients and families in making informed healthcare decisions aligned with their personal care objectives.
• Ensuring that the patient’s end-of-life preferences are well-documented and understood, offering assistance with advance directives, do not resuscitate (DNR) directives, and Physician Orders for Life-Sustaining Treatment (POLST) forms.
• Liaising with local organizations and community resources that can offer assistance to patients and families, such as hospice agencies, Meals-on-Wheels, and Life Alert services.
• Aiding in managing insurance, Medicare, and Medicaid paperwork to simplify the administrative aspects of care.
• Offering guidance in funeral planning to alleviate the burdens associated with end-of-life arrangements.
• Recognizing and addressing the emotional and spiritual needs of patients and their loved ones and facilitating access to suitable support services.
• Facilitating family reconciliation efforts whenever feasible, including assistance in securing temporary visas for family members from abroad, thereby fostering a sense of unity.
• Providing support to surviving family members in managing essential arrangements and paperwork in the aftermath of a loved one’s passing.
• Assisting bereaved individuals in accessing appropriate grief counseling services to aid in the healing process.
• Identifying additional needs within the patient’s support network and offering assistance as required.

Normally, a single social worker is designated to a patient in order to ensure consistent and uninterrupted care. This social worker establishes a rapport with the hospice patient and their network of support, working collaboratively to identify areas that require attention. Additionally, many hospice organizations make available the services of an on-call social worker to address urgent patient and family requirements during non-standard hours.

The value of hospice volunteers cannot be overstated. Volunteers are commonly perceived by hospice patients and families as ordinary members of their local community. This bond offers patients, as well as their families and friends, a sense of normalcy. Volunteers frequently establish profound, personal connections with patients, offering the hospice care team valuable perspectives on the comprehensive effects of the comfort and care being administered. Medicare-certified hospice programs are also federally mandated to integrate hospice volunteers into administrative or patient services. The U.S. government mandates that hospice volunteers collectively contribute a minimum of 5% of the total patient care hours offered by compensated hospice staff and contracted personnel.

Before beginning volunteer service, hospice volunteers are often provided with training. This training prepares volunteers for the administrative services they may perform for the hospice or how they will be directly assisting patients, caregivers, and families. Though each hospice organization may have a unique training program, most hospice volunteer training includes:

• Exploring the Essence of Hospice Care Principles
• Recognizing the Limits of Volunteer Engagement When Interacting with Patients and Families
• Surveying the Spiritual, Psychological, and Physical Requisites of Patients and Their Families Throughout the End-of-Life Passage
• Unveiling the Array of Supportive Services Extended by Hospice Organizations
• Mastering Effective Communication Techniques with Patients, Families, and Companions
• Aiding Patients and Families in Navigating the Terrain of Grief, Loss, and Mourning
• Grasping the Importance of Patient and Health Information Confidentiality

An integral aspect that contributes to the significance of hospice volunteers and their role as impactful members of a patient’s care team lies in the distinct life perspective and individual demeanor they bring. While every volunteer brings their unique qualities, there are several common attributes that define an effective hospice volunteer:

• Demonstrating empathy and comprehension for individuals navigating their end-of-life journey.
• Respect for all ways of life, cultural customs, and religious views
• Keen understanding of personal limits
• The ability to listen and be comfortable in silence

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Proficient hospice volunteers understand that their purpose revolves around offering compassionate assistance. The contribution and support offered by hospice volunteers are directed at ensuring that patients, caregivers, and families ultimately encounter the utmost comfort and empathy during the end-of-life journey.

Hospice volunteers contribute their time and energy to hospice organizations in various ways. These include providing direct support to patients, caregivers, and families, as well as assisting with administrative tasks. The diverse skills of each volunteer are harnessed effectively to offer assistance, and their service generally falls into two categories: direct care volunteering and indirect care volunteering.

Hospice volunteers who work directly with patients, caregivers, and families are considered direct care volunteers. Direct care volunteers play a pivotal role in offering patients and families various forms of support and solace. These dedicated volunteers lend a helping hand in several areas, some of which include:

• Preparing meals for patients and families
• Providing transportation to patients, families, and the children of the families
• Assisting in light household chores
• Sitting with patients to provide companionship and a comforting presence
• Playing music for patients to provide a soothing and joyful atmosphere

For volunteers who choose not to engage directly with patients, their time and dedication can be channeled into aiding the hospice organization through administrative and general office responsibilities. Indirect care volunteers often provide valuable assistance in tasks such as:

• Helping prepare mailings and newsletters for community outreach
• Assisting in general data entry tasks and other clerical duties
• Helping in preparations and set up for special community events and outings

Whether opting to be directly or indirectly involved with patient and family care, hospice volunteers can use their unique talents and skill sets to support hospice organizations and provide patients and families with a more comfortable end-of-life experience.

Hospice volunteers play a pivotal role in offering patients and their families a compassionate presence and unwavering assistance throughout the final stages of life. The deep sense of personal connection and support these volunteers offer contributes significantly to enhancing the overall satisfaction of end-of-life care among patients who are part of hospice programs. A study conducted by the National Hospice and Palliative Care Organization (NHPCO) in 2010 underscored this impact, revealing that hospice initiatives marked by heightened direct care volunteer engagement consistently demonstrated heightened levels of contentment in the care provided, as reported by families who had lost their loved ones under hospice care.

While hospice volunteers have a tremendous impact on the lives of the patients, caregivers, and families they serve, the volunteers themselves also benefit from the giving of their time and talents. Hospice volunteers, particularly those who work directly with patients and families, commonly report:

• Enhanced gratitude for life and a clearer recognition of what holds genuine significance.
• Heightened comprehension and embrace of the role of death within the continuum of life.
• Enriched insight into diverse cultures and varying viewpoints on life.
• A feeling of accomplishment and a valuable sense of giving back to the community.

For those seeking to volunteer at a hospice program, contacting Royal Hospice Care, Inc. is a great way to get started. The NHPCO provides a complimentary online tool for locating hospice services, which can serve as a starting point for individuals interested in initiating their search for nearby hospice volunteer opportunities.

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The impulse to dedicate time and skills selflessly to those on their end-of-life journey arises from a compassionate heart and a generous spirit. Whether offering hands-on assistance or behind-the-scenes help, hospice volunteers play a vital role within the hospice team, ensuring top-notch care and unwavering support. Embracing hospice volunteering empowers compassionate individuals to leverage their talents and abilities, contributing to the provision of a tranquil and comforting end-of-life journey for patients, caregivers, and families. Join us as a volunteer today!