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WELCOME!

Our Mission in Hospice Care

Providing the Highest Quality of Care to Our Patients, Their Families, & Our Referring Sources.

As family and loved ones of our patients, you may receive a CAHPS Hospice Survey after your loved one has passed away.  The survey allows you to assess if we at Brighton provided exceptional customer service.  To ensure we are fulfilling this mission, we aim to apply the following customer-centric principles that we have summarized in the acronym CREATE:

C – Communicate, Communicate, Communicate

R – Respond Quickly

E – Educate with every interaction

A – Ask how we can better support

T – Treat everyone with respect

E – Every Visit on Time

We know that communicating with you is paramount.  We recognize that responding Quickly and being on time to every visit reflects how much we care.  We realize constant training and education ensure you and your loved one benefit from the best industry practices.  We welcome your feedback on how we can provide better support.  Finally, we appreciate the need for all involved to be treated with respect.  Please engage with your care team on how the hospice is CREATING an exceptional customer experience.

Your hospice care team will consist of: Physican, Nurses, Certified Nurse Assistant, Medical Social Worker, Spiritual Support, Volunteers, Music and Massage Therapist as needed.

Medication Education

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Lorazepam (Ativan)

  • Uses: Anxiety, agitation, and shortness of breath.
  • Possible Side Effects: Drowsiness, dizziness, nausea, constipation, and restlessness or excitement.
  • Inform your hospice nurse if: You have difficulty sitting still or experience slowed or shallow breathing.
  • Do not stop or skip taking doses before talking to your doctor or nurse.
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Docusate Sodium (Colace)

  • Uses: Constipation or to prevent constipation.
  • Possible Side Effects: Stomach cramps.
  • Inform your hospice nurse if: No bowel movement in the last 3 days or straining to pass hard stools.
  • Stop taking if you develop diarrhea.
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Zofran

  • Uses: Nausea and vomiting.
  • Possible Side Effects: Headache, constipation.
  • Inform your hospice nurse if: Your nausea is not well controlled.
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Acetaminophen (Tylenol)

  • Uses: Fever reducer and mild to moderate pain.
  • Possible Side Effects: Nausea, stomach pain, loss of appetite, dark urine.
  • Inform your hospice nurse if: Your pain is not well controlled.
  • Do not take more than directed.
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Morphine (Roxanol)

  • Uses: Moderate to severe pain and shortness of breath.
  • Possible Side Effects: Sleepiness, nausea, dry mouth, itchiness, dizziness, confusion, constipation (you’ll be placed on a stool softener/laxative).
  • Inform your hospice nurse if: Pain not controlled or you have slowed or shallow breathing.
  • Do not skip a dose. If pain decreases, tell your nurses before stopping the medication.

Morphine and End-of-Life Myths

  • Myth: Morphine Hastens Death
    Reality: Morphine doesn’t speed dying — it enhances comfort and relieves pain.
  • Myth: Morphine Causes Respiratory Depression
    Reality: When managed correctly, the risk is low and carefully monitored.
  • Myth: Morphine Sedates or Impairs Cognition
    Reality: Sedation is temporary and can be adjusted; patients often stay alert and comfortable.
  • Myth: Morphine Should Be Avoided Due to Addiction
    Reality: At end of life, pain relief and comfort are the priority — addiction is not a concern.

Training for Caregivers

You or your loved one may become restless and confused, and may start to see things that aren’t there, which can make them feel threatened and become agitated. 

Seek advice: Any signs of unsafe behaviors, including harm to self and others. Concerns about care or coping. 

Tips: Keep the room well-lit during the day. Minimize noise. Talk in a calm and reassuring manner. Try to find the meaning behind the behaviors (e.g., pain). Give PRN (as needed) medication if prescribed. Here are two identifying factors that make it better or worse:

 

1. Pulling a Patient Up in Bed 
  • Apply a draw sheet under the patient (a fresh sheet folded into fourths, placed 3-4 inches below the patient’s buttocks, and the remainder of the sheet should cover the buttocks and part of the lower back). 
  • Lower the head of the bed, and lift the feet as high as the electric bed will go (if the patient is known to aspirate, you can skip this step).
  • Use two people, one on each side, to grab the draw sheet and lift the patient in the upward position towards the head of the bed.
2. Repositioning 
  • Prevents skin breakdown. 
  • Regular pillows or body pillows will work.
  • Roll the patient to one side or the other, and place a pillow so it covers nearly one whole side of the buttocks, and the coccyx (tailbone) is not making contact with the mattress.
  • Reposition every 2 hours on the opposite side you did last, removing the pillow from the side it was placed on in the previous 2 hours.
  • If the patient is bedbound, it is a good idea to also do this to their feet by placing a pillow under their feet, so their heels are not touching the pillow but rather hanging off the pillow and “floating” (not making contact with the mattress).

Transferring a patient from a wheelchair to a bed or commode requires careful planning, communication, and attention to the patient’s comfort and safety. The following step-by-step instructions can serve as a general guide, but it’s crucial to adapt them based on the patient’s specific needs, abilities, and any medical conditions. Additionally, having at least two people involved in the transfer is often recommended for safety.

Transferring from Wheelchair to Bed: 

1. Prepare the Environment:

  • Ensure that both the wheelchair and the bed are at an appropriate height for the transfer.
  • Lock the wheelchair wheels to prevent it from moving during the transfer.
  • Clear any obstacles or items that may obstruct the transfer path.

2. Explain the Process to the Patient:

  • Communicate clearly with the patient, explaining each step of the transfer to alleviate anxiety and ensure their cooperation.

3. Position the Wheelchair:

  • Place the wheelchair parallel to the bed, ensuring it is stable and on a level surface.

4. Brake the Wheelchair:

  • Engage the wheelchair brakes to prevent it from moving during the transfer.

5. Position the Bedside Commode (if using):

  • If transferring to a bedside commode, ensure it is appropriately positioned and stable.

6. Assist the Patient to the Edge of the Wheelchair:

  • Help the patient move to the front of the wheelchair, so they are close to the edge.

7. Lock the Bed Wheels (if applicable):

  • If the bed has wheels, lock them to provide stability.

8. Transfer Technique:

  • If the patient can stand with assistance, assist them to stand while supporting their weight.
  • Pivot the patient slowly and smoothly towards the bed, ensuring their feet are properly positioned.
  • Guide the patient to sit on the bed, allowing them to move at their own pace.

9. Position on the Bed:

  • Help the patient get into a comfortable position on the bed.

10. Arrange Bedding:

  • Adjust the bedding as needed to ensure the patient is comfortable.
Transferring from Wheelchair to Commode: 

The steps for transferring to a commode are similar to transferring to a bed. Here are some additional steps specific to using a commode: 

1. Position the Commode: 

  • If using a bedside commode, ensure it is positioned close to the wheelchair and the patient’s feet can reach the ground when seated.

2. Adjust the Commode Seat:

  • If the commode has adjustable height, set it to a level that allows for a smooth transfer.

3. Assist with Clothing:

  • Assist the patient in adjusting clothing as necessary for toileting.

4. Guide Patient to Sit on Commode:

  • Follow a similar process as transferring to the bed, guiding the patient to sit on the commode with their feet firmly on the ground.

5. Provide Privacy:

  • Once on the commode, provide privacy and allow the patient to use the facilities.

Always consider the patient’s comfort, communicate clearly, and be attentive to their needs throughout the transfer process. If the patient has specific medical conditions or mobility challenges, healthcare professionals may provide customized instructions based on their assessment. 

 

Dyspnea, commonly known as shortness of breath, is the subjective sensation of difficulty or discomfort in breathing. It can manifest as a feeling of breathlessness, tightness in the chest, or an inability to get enough air. Dyspnea can occur gradually or suddenly and may be associated with various medical conditions, such as respiratory, cardiovascular, or metabolic disorders.

When to Seek Advice Regarding Dyspnea: 

Patients experiencing dyspnea should seek medical advice promptly, especially if: it stops you from doing what you want to do. Skin turns bluish on face, ears, fingers, and toes. You feel fearful, anxious, nervous, or restless. When it is not relieved or gets worse.

Tips to Relieve the Effects of Dyspnea: 

Individuals experiencing dyspnea can consider the following tips to help alleviate symptoms:

1. Pursed-Lip Breathing: 

  • Inhale through the nose for two counts.
  • Exhale through pursed lips for four counts.
  • This technique helps regulate breathing and improve oxygen exchange.

2. Use of Breathing Techniques:

  • Techniques using stomach muscles can help improve lung function and reduce the work of breathing.

3. Positioning:

  • Sitting upright or leaning slightly forward may make breathing easier.
  • Propping oneself up with pillows while sleeping can also be beneficial.

4. Stay Hydrated:

  • Maintaining adequate hydration helps keep the respiratory mucous membranes moist, potentially easing breathing.

5. Avoid Triggers:

  • Identify and minimize exposure to triggers, such as allergens or environmental pollutants.

6. Medication Adherence:

  • Take prescribed medications as directed, especially for chronic respiratory or cardiovascular conditions.

7. Energy Conservation:

  • Prioritize activities and use energy-saving techniques to avoid overexertion.

It’s crucial to note that these tips are general suggestions and may not be appropriate for all individuals. Anyone experiencing dyspnea should seek guidance from healthcare professionals for a personalized evaluation and management plan based on their specific medical history and conditions. 

home health and hospice

Our care team is available during regular business hours, but is also just a phone call a way in the evenings, weekends and holidays.

On Call Questions

Examples of situation when you should contact on call nurse

  • Pain that does respond to pain medications
  • Difficulty breathing
  • New onset of agitation or restlessness
  • Fall occurs
  • Uncontrolled nausea, vomiting
  • Fever
  • Patient need to be taken to the hospital
  • Patient death

 

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