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.
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
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 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
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
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
Participates at the team meetings as a medication resource
Recommends medication usage and dosage, alternative medications, and optimal medications for symptom management
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.
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
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
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.
The Hospice Circle of Care
The Hospice Circle of Care depicts the holistic continuum of care provided by hospice professionals and trained volunteers working together as a team to assess and meet the patient and family’s unique needs at end of life.
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.