One of the little-known aspects of Hospice is the plethora of services that it provides. In fact, the actual list of services is almost endless since each organization has the option of adding and removing many optional services as it determines its patient’s preferences. Here we’ll break down the services into two main groups: Standard & Optional.
Standard
Physician Care
When entering into Hospice care, each patient has the option to choose to keep their own doctor. Their doctor (PCP) can continue to oversee their care as a part of the Hospice team. However, every patient will be monitored and managed by the Hospice Medical Director as well. This physician is a specialist in Hospice care and will be the main point of contact for Hospice staff. They can order medications as well as supportive services and equipment. While patient’s probably won’t see them often (if at all), they work diligently behind the scenes to make sure the patient is cared for!
Nursing Care
Nursing care is provided to each and every Hospice patient, typically on a weekly basis (or more if deemed necessary) for patient’s residing at home, and daily for those residing in Hospice inpatient facilities. Nurses provide services such as monitoring the patient for symptoms, communicating with the physician on behalf of the patient, coordinating the use of the other services, providing wound care, educating the family and patient on the proper use of medications, requesting supplies and equipment for the patient, emotional support and more! Known as the “Case Manager,” the nurse is the patient’s point of contact for just about any need that arises!
Personal Care
Personal Care, provided by Certified Nursing Assistants (CNA’s), is provided to those who need assistance with bathing, dressing, eating, cooking, cleaning, etc. The CNA, assigned to a patient that they’ll see regularly, gets to know the patient’s specific needs and wants. In much the same way that the nurse does, they arrive to provide assistance on a regular schedule (usually 2-3 days per week, but more if deemed necessary). CNA’s are often our most loved staff as they spend the most time with the patient and get to know them best! For those who reside in nursing homes and other facilities, CNA services can be added in addition to the services provided by the facility, giving the patient a little extra 1:1 care!
Social Work
Hospice social workers are an amazing resource! While they are usually scheduled for less frequent visits (monthly or so), they do a tremendous amount of work on behalf of their patients! Social workers tend to take their time getting to know the patients and then provide resources and assistance for just about any social need that may come up. I’ve seen them organize Meals-On-Wheels, help find programs to assist with utility bills, assist in funeral planning, and organize the granting of last wishes!
Spiritual Care
Spiritual Care services are typically provided by a pastor, but I have found that even those with no faith background benefit from their support! Their primary purpose is to support patients in their specific spiritual needs. It is not designed as a recruitment or evangelism practice. Instead, the Spiritual Care Coordinators focus their attention to the patient’s desires. They can provide active listening, organize religious ceremonies, coordinate the use of other religious leaders in the community, or provide friendly visits and emotional support. I’ve even heard patients who identify as Atheists say that their favorite visits are from Spiritual Care!
Bereavement Care
Bereavement Care, or care of those who have suffered a loss, is provided as a supportive service to those who are affected by the patient’s death. Most of the time, this is the immediate family or friends, but can also be extended to caregivers as well. The service can include options such as support groups, emotional support, and a plethora of resources that can be provided depending on need. The interesting thing about Bereavement Care is that it can begin before a person’s death (Anticipatory Grief can happen anytime leading up to death), and is often extended to families and loved ones for a year or more after.
Volunteers
Volunteers are probably one of the most useful, and yet under-utilized services that Hospices offer. They are so important in fact, that Medicare actually REQUIRES that Hospices offer volunteer services. Hospice Volunteers are well trained in what they do and offer an array of services such as friendly visits, sitting vigil, running errands, singing, and more!
Respite Care
Respite Care is used for patients who reside at home, but whose caregivers require a break in their duties. Basically, it refers to a temporary stay at a nursing facility in order to allow primary caregivers at home to have a break due to caregiver fatigue, or to travel for work or vacation. The reasoning for needing the assistance of a Respite is not important as it can be used for any reason. Typically, each Respite can be as long as 5 days and can be taken every 30 days. The facility must be Medicare approved, and must have availability at the time so each Respite stay should be coordinated through the Hospice team. Note: Some costs may occur when utilizing the respite services, so be sure to ask ahead of time about financial responsibility.
Veteran Services
Veterans often experience a unique set of challenges. From physical and emotional scars, to difficulty navigating the VA system, they require a very specific set of resources. Hospices are more than happy to provide for those needs, though some are more involved than others. If you or your loved one is a Veteran, be sure to ask about this service before choosing a Hospice provider!
Optional
Music Therapy
While all Hospices may not offer this service, many do and the patient’s tend to love it! Music is very powerful and having a specialist to bring song into a patient’s life is a real blessing to those who opt for it! Music therapists may play music, have the patient participate in playing an instrument or sing, or even play games with the patient as the music plays!
Massage Therapy:
Massage therapy services are another option for many on Hospice. It should be noted here that most massage therapists who work in Hospice are specifically trained to work with Hospice patients. There won’t be any deep tissue or rough massages that could cause harm, as they focus more on pain relief and relaxation.
Pet Therapy
Pet therapy is a wonderful option for those who love animals! These animals are typically trained as service or therapy animals and their mere presence can transform the feel of a room. From a Golden Retriever, to a cat, to a guinea pig, just about any animal can be used for pet therapy as long as it’s deemed safe to do so!
Reiki Therapy
Reiki therapy has gained popularity over recent years, and some Hospice providers have begun to offer the service. It is suggested that Reiki, without the use of any physical touch, can create similar calming affects as a massage.
Final Wishes
I’m often moved by the simple and sweet nature of the last wishes of the dying. Their requests are often easily fulfilled and usually involve time with loved ones. From a wedding that never happened, to a dinner with family, Hospice staff often organize (and even pay for) last wishes to be granted. These are the moments that remind us why we do what we do and are a true reminder of what is really important in life.
Each patient has a unique set of expectations for their Hospice provider. Regardless of what those expectations are, many of them can be fulfilled within these services. If you’re currently looking for a Hospice provider, be sure to ask about the services that they offer!