Hospice Care Definitions

HOSPICE (See definition in home health grid definitions)

Services Provided:

N-Nurse – Assesses patient’s physical needs, develops and coordinates the plan of care, ensures symptom control and management, provides patient/family teaching as needed.

SSW-Social Worker – Assesses patient and family emotional and social needs, develops a plan of care, provides counseling, referrals and support to meet identified needs.

Chaplain – Assesses patient and family spiritual needs, develops a plan of care, provides counseling, assists with memorial preparations.

Home Health Aide – Provides direct personal care to patient, emotional support to patient and family, reports identified needs to RN.

Volunteer – Provides respite and needed non-medical services for patients and their families, offers support at time of death and during bereavement.

Levels of Care:

RO-Routine Care – Occurs when regularly scheduled visits are adequate in maintaining the individual’s symptom management. Care is provided at the individual’s residence, this can be their private home, a retirement community, an assisted living, or a skilled nursing facility.

RE-Respite Care – Provided when the family needs time to rest or go out of town for a short time. Ideally, this service is provided for five consecutive days. Care may be provided in a long-term care facility depending on the condition of the individual. Hospice is responsible for financial arrangements with the Long-term care facility, at no cost to the patient or the family.

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– General In-Patient Care –

Provided in a skilled nursing facility when the symptoms cannot be managed elsewhere. The skilled nursing facility must have 24-hour R.N. coverage as deemed by Medicare guidelines. General in-patient care is usually short in duration. This level of care is usually due to symptoms which are out of control and more intensive nursing services are required. If an individual is at a care facility, room and board are covered by hospice during this period.

CC-Continuous Care – Provided to prevent the individual from going to the hospital when a crisis occurs. Continuous care also is given when more help is needed to assist the individual and family in coping with the crisis. This level of care is usually provided at the individual’s residence no matter where that may be.

The criteria for continuous care may include: Severe pain or symptoms which are out of control, psychotic episodes, breakdown of caregiver, imminent death and family unable to cope. Continuous care is typically reserved for end of life or other crises that requires a constant presence by a nurse or care team. alternative to those who can’t take medication or prefer not to, massage therapy has become essential in hospice care. This is not reimbursed by Medicare; it is an added benefit that select hospice companies have decided to provide for their patients.

24/7 ADMISSIONS – Can a patient be admitted to the particular hospice agency 24/7? If a patient qualifies for hospice care, they should be admitted as early as the family requests. Many agencies admit patients to hospice, 24/7, evenings weekends, and holidays.

Grief

SUPPORT GROUPS – Grief is the normal and universal reaction humans have to the loss of those they love. When your loved one passes, you may go through a period of bereavement and experience grief. Each hospice agency will have a grief and bereavement support program. Many provide grief groups that meet and address issues of grief in a supportive group setting.

INDIGENT PATIENTS – Does the hospice accept non funded or indigent patients? This is usually on a case by case basis and at the determination of the hospice company. Many have a non-profit organization that can help support the care of non-covered patients. Many Hospice agencies utilize social workers to help find resources for indigent families.

LICENSED MASSAGE THERAPY –

Massage has become one of the fastest growing trends in therapy for hospice patients. Used as a method for relaxation to alleviate stress, anxiety and pain with a light handson approach, as well as providing an

MUSIC THERAPY – Music Therapy is an established healthcare profession that uses music to address physical, emotional, cognitive, and social needs of individuals. A music therapist is not just a music performer, but actually trained in counseling and music. A music therapist creates goals and objectives for their patients and uses music activities and music experiences (listening, composition, improvisation, or playing/singing a familiar song) in order to achieve those goals. This is not reimbursed by Medicare; it is an added benefit that select hospice companies have decided to provide to their patients.

PAIN PUMPS AVAILABLE –

Many patients have their symptoms controlled through oral medications. Some situations require a pain pump where medications are administered through an IV pump. If this is the situation, inquire with the hospice RN case manager to see if pain pumps are available through their agency.

PCP-OVERSIGHT – Can the hospice patient retain their own primary care physician in addition to the

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