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The best time to learn more about hospice and ask questions about what to expect from hospice services is before you need help. Thinking about hospice can be hard but also offers a lot of relief.

Sharing what is important to an individual as they get sicker can greatly reduce stress when the time for hospice is needed. By having these discussions in advance, patients and their loved ones are not forced into difficult bedside decisions. Instead, patients can make an educated decision that includes the advice and input of family members and loved ones.

Once hospice has been requested hospice staff arrange to meet with the patient and their loved ones. Hospice care begins once the patient/family consent to admission, a hospice nurse completes an assessment, and a physician certifies the hospice admission is needed. Usually, hospice care is ready to begin within a day or two of the first call. However, in urgent situations, hospice services may begin sooner.

Every hospice patient is visited by a registered nurse, and may be visited by a social worker, home health aide, chaplain, and/or a trained volunteer (also known as the interdisciplinary team). For each patient and family, the interdisciplinary team creates a care plan based on patient/family wishes, and visits intermittently to support the needs of the patient and their loved ones.

Hospice care is available ‘on-call’ after the administrative office has closed, seven days a week, 24 hours a day. Most hospices have nurses available to respond to a call for help within minutes, if necessary. Some hospice programs have chaplains and social workers on call as well.

Many patients may have pain and other challenging symptoms with a serious illness. Hospice staff receives special training to care for all types of physical and emotional symptoms that cause pain, discomfort and distress.

Keeping the patient comfortable and pain-free is an important part of hospice care. Being pain free is different for each patient and the hospice team works with patients and families to provide tools to maximize comfort but allow patients and families to lead the discussion and use of these tools. Hospice staff works with the patient’s physician to make sure that medication, therapies, and procedures are designed to achieve the goals outlined in the patient’s care plan.

Hospice volunteers are generally available to provide different types of support to patients and their loved ones including running errands, preparing light meals, staying with a patient to give family members a break, and lending emotional support and companionship to patients and family members.

Because hospice volunteers spend time in patients’ and families’ homes hospice has an lengthy training program for their patient care volunteers. Volunteers are trained to understand hospice, confidentiality, working with families, have good listening skills, patient symptoms, and when to call the hospice team for patient needs, loss and grief and bereavement support.

Hospice services can be provided to a terminally ill person wherever they live. This means a patient living in a nursing facility or long-term care facility can receive specialized visits from hospice nurses, home health aides, chaplains, social workers, and volunteers, in addition to other care and services provided by the nursing facility. The hospice and the nursing home will have a written agreement in place in order for the hospice to serve residents of the facility.

Florida Hospital HospiceCare offers inpatient hospice care at HospiceCare facilities throughout Volusia and Flagler counties. Most insurances cover inpatient care when a patient has symptoms that are difficult to manage without a 24-hour nurse present.

Yes. There are state licensure requirements that must be met by hospice programs in order for them to deliver care. In addition, hospices must comply with federal regulations in order to be approved for reimbursement under Medicare. Hospices must periodically undergo inspection to be sure they are meeting regulatory standards in order to maintain their license to operate and the certification that permits Medicare reimbursement.

References

[1] National Hospice and Palliative Care Organization – website www.nhpco.org.