Hospice is designed to provide comfort and support to patients, so they may live out the last phase of their lives with dignity in a familiar setting. The goal of hospice care is to improve the quality of a patient’s last months by offering comfort, dignity and care in a familiar setting, whether that be in the patient’s own home, assisted living, or skilled nursing facility. Brighton Hospice recognizes that the dying process is a part of the normal process of living and focuses on enhancing the quality of remaining life. Our team is made up of a Palliative Certified Hospice physician, nurse case managers, aides, social workers, chaplains, a dietitian, therapists, a consulting pharmacist, volunteers, a bereavement team, and a stellar support team. We are able to provide many levels of care for hospice, including: Routine Home Care, General Inpatient Care, Respite Care, and Continuous Care. Brighton Hospice will provide you and your family with the quality care you deserve.
Determining Level of Care
A patient can be admitted to hospice on any level of care that is necessary at that time. A patient may also be transferred between levels of care as their needs change. The decision to treat someone on a higher level of care falls to the hospice physician and is documented by the physician and the hospice nurse. With four levels of care in place, no patient should ever be left in a crisis situation alone.
This level of care is used more for the family than for the patient. If the patient does not meet criteria to qualify them for continuous care or inpatient care but the family is having a difficult time, respite care may be an option. If a patient’s family is the primary source of care and cannot meet the patient’s needs due to caregiver stress or other extenuating circumstances, a patient may temporarily be admitted to an inpatient environment to give the family a needed break or respite. Respite care is limited to five consecutive days at a time. Once that period expires, the patient would be discharged back to home.
General Inpatient Care
Some patients may have symptoms so severe that they cannot get adequate treatment at home or they may feel more comfortable getting treatment at an inpatient facility. For these patients, inpatient care may be an option. Some patients may already be living in a facility that offers inpatient level of care and can benefit from its services. Others would have to be admitted to an inpatient facility.
Symptoms requiring inpatient care are the same as those requiring continuous care (above), only the setting of care may be different. With inpatient care, nurses are available around the clock to administer medications, treatments, and emotional support to make the patient more comfortable. The inpatient hospice services can be provided in a:
- Hospital – A hospice company may lease a unit in the hospital to provide inpatient care. In this case, hospice trained staff would provide around the clock care. A company may also have a contract with a hospital which would allow hospital staff to provide 24 hour care with hospice staff supplementing care.
- Long term care facility – As with a hospital, a hospice company may lease a unit in a nursing home or contract with the nursing home to provide care.
As with continuous care, inpatient care is considered short term and would be discontinued once a patient’s symptoms were under control and they were comfortable. If the patient was admitted to an inpatient unit, they may then be discharged back home.
Routine Home Care
Routine home care is the basic level of care under the hospice benefit. It includes:
- Nursing services – A nurse usually visits 2 times per week based on patient’s needs. Can be more often if needed.
- Physician participation – attending physician, following physician, hospice physician, and specialists as necessary
- Medical Social Services
- Hospice Aide Services – A hospice aide usually visits 7 times per week based on patients’ needs
- Counseling services (pastoral, spiritual, bereavement, dietary, and others as necessary)
- Medications related to terminal illness
- Medical equipment related to terminal illness
- Medical supplies related to terminal illness
- Lab and diagnostic studies related to terminal diagnosis and deemed appropriate by hospice team
- Therapy services (physical, occupation, speech) if needed
- Volunteer Services
If a patient develops physical or emotional symptoms that aren’t easily managed with routine care, continuous care may be an option. Continuous care provides more intense care in the patient’s home environment. A nurse and/or a hospice aide will remain in the patient’s home environment for a minimum of 8 up to 24 hours per day to administer medications, treatments, and support until the symptoms are under control. Some examples of symptoms requiring continuous care would be unrelieved pain, severe nausea and vomiting, severe shortness of breath, anxiety or panic attacks, or a breakdown in the primary caregiver support system. Continuous care is considered a short term level of care and is reevaluated every 24 hours.
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