Hospice Care for the Terminally Ill

Hospice refers to the type of care and services provided to those who are terminally ill. According to the National Association for Home Care & Hospice, Hospice Services, the structure and services offered will differ from program to program and from state to state. To the greatest extent possible, care is structured to keep families together and services are provided in the least restrictive environment possible. In-patient care, provided by a licensed hospital, licensed skilled nursing facility, or the hospice’s own in-patient facility, is kept to a minimum. A wide range of services is provided by nurses and other health care providers within the hospice program. The variety of services provided by the hospice care team includes the following:

1. Nursing Care - Registered nurses coordinate the care for every patient, provide direct patient care, and check symptoms and medication. Patient and family education is an important part of every visit. The nurse is the link between the patient and his or her family and the physician. The nurse can also help evaluate the patient’s condition.

2. Medical Social Services - The social worker provides advice and counseling to the patient and all family members during the crisis period. The social worker assists other care team members in understanding the family dynamics and acts as an advocate for the patient and family in making use of community resources.

3. Physician Services - The patient’s physician approves the plan of care and works with the hospice team. In a full hospice program a hospice medical director is available to the attending physician, the patient, and the hospice care team as a consultant and a resource.

4. Spiritual Support and Counseling - Clergy and other counselors are available to visit and provide spiritual support to the terminally ill at home. Programs also use churches and congregations to aid the patient and family as requested.

5. Home Care Aide and Homemaker Services - Home care aides provide personal care for the patient, such as bathing, shampooing, shaving, and nail care, and homemakers may be available for light housekeeping or meal preparation.

6. Continuous Care in the Home - If the patient’s needs require it, or if the family can no longer manage the level of care required around the clock, hospice staff will provide care for eight-hour to 24-hour periods on a short-term basis.

7. Trained Volunteers for Support Services - Early hospices were founded and operated by volunteers. These dedicated people continue to be the backbone of today’s hospice. They are trained in good listening skills and provide compassionate support for both patient and family. They offer companionship and help with everyday tasks such as shopping, babysitting, and car pooling, which are part of the family’s routine. Volunteer services may also include professional and personal care services as described in the above sections.

8. Physical, Occupational, and Speech Therapies - Daily living tasks such as walking, dressing, or feeding oneself can become frustrating and impossible during an illness. Therapists help the patient develop new ways to accomplish these tasks.

9. 24-Hour On-call Availability - A hospice team member is on call 24 hours a day, seven days a week. If a problem should arise, the team member may offer advice over the phone and, if necessary, make a visit.

10. Hospice In-patient Care - Although hospice care is centered in the home, it sometimes becomes necessary to admit the patient to a hospital, extended care facility, or the hospice in-patient facility. The hospice can arrange for this care and will stay involved in the patient’s treatment and with the family, resuming in-home care when appropriate.

11. Respite Care - To provide relief for family members, the hospice may arrange a brief period of inpatient care for the patient.

12. Bereavement Support - Bereavement is the time of mourning that we all experience following a loss. The hospice care team works with surviving family members to help them through the grieving process. Support may include a trained volunteer or counselor visiting the survivors at specific periods during the first year, or phone calls and/or letter contact and the opportunity for family members to participate in support groups. The hospice will refer survivors to medical or other professional care if necessary.

To view the entire consumer guide in PDF form visit:
www.nahc.org/haa/consumerInfo

Locate a Hospice:

U.S. Department of Health & Human Services:
Healthfinder.gov


National Association for home care & hospice: nahc.org