The objective of hospice care is to give people support throughout the final phase of a terminal illness. The focus is on comfort and pain management, allowing patients to live out the remainder of their life as fully as possible.
When a patient is initially referred to hospice care by a physician or caseworker they are typically given a list a hospice facilities in the area. At times they may recommend one specific facility. Listen to their recommendation as they have the knowledge and expertise regarding what each facility has to offer. However, it is important to do some research on your own as well, to ensure you are the making the best decision for yourself and your family.
Things to Consider When Choosing a Hospice
While the reference from the physician or caseworker is very valid, you may want to talk to others in the field such as local hospitals, nursing homes or clinicians. Talk to other individuals who had loved ones in hospice care in the past to get their opinions.
What types of medical professionals are employed by the hospice? Are the doctors and nurses certified in palliative care? If they are not, this does not mean that the staff is not competent.
Type of Hospice
Is the hospice privately owned or is a non-profit? Is it accredited and, if required, state-licensed? Again, accreditation is not necessarily a requirement, and not having it does not mean that the hospice is not an excellent choice. What having accreditation means is that a third party has looked at the hospice’s operations and determined that they meet a reasonable standard of care.
Levels of Care Offered
There are 4 levels of care:
- Level 1 – Routine Home Care
- Basic level of care
- Nursing services
- Physician participation
- Social services
- Home health aide services
- Lab and diagnostic studies related to terminal diagnosis
- Level 2 – Continuous Home Care
- A nurse or home health aide remain in the patient’s home for 8 to 24 hours per day
- Short term level of care re-evaluated every 24 hours
- Level 3 – General Inpatient Care
- Treatment given at an inpatient facility/hospice
- Nurses are available 24 hours a day to administer medications, treatments and emotional support in order to make the patient more comfortable
- Level 4 – Respite Care
- Designed for care workers rather than the patient
- When family is not able to meet the patient’s needs due to stress or extenuating circumstances, the patient may be temporarily admitted to an inpatient/hospice environment to give the family some respite.
What expectations does the hospice have regarding the family’s role? Make sure that anything the hospice expects of the family is within the realm of the family’s capabilities.
Specific Needs and Concerns
Can the hospice meet your specific needs? Ask the staff about any concerns the family or patient has about care to determine how the hospice typically deals with those issues. How are patient or family concerns handled by the staff? Is there a clear process for family and patients to share their concerns with staff and making sure those concerns are being addressed?
How does the hospice measure and track quality? You just want to make sure that the hospice evaluates its own performance in order to ensure they are meeting top standards or taking steps to improve their performance.
Does the hospice offer bereavement services, and if so, what kind. There exists a wide range of bereavement services including individual counseling, support groups and educational materials.
Pay attention to your initial or gut impressions regarding the hospice itself and the staff. If it was not favourable, then there probably is a reason for that and it is better to look at a different hospice.