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Blog: Hospice Views

Addressing End-Of-Life Care


undefinedAddressing the needs for hospice and end-of-life care with patients and their families is never easy.

Sometimes, these conversations are impossible to begin for even the most-seasoned physician or nurse.

To help any of you who need to have these difficult conversations, we want to provide helpful ideas to ease discomfort and help physicians provide the best information and support possible.

As a starting point, Dr. David Casarett (a fellow at the Institute on Aging and a professor at the University of Pennsylvania School of Medicine) suggests you might want to ascertain some daily life information from your charge, including:

  •   Pain
  •   Fatigue
  •   Constipation
  •   Poor sleep
  •   Lack of appetite
  •   Nausea
  •   Diarrhea
  •   Difficulty breathing
  •   Sadness
  •   Worry
  •   Irritability
  •   Nervousness
 

Casarett also believes knowing the needs/wants for support services ahead of time can “help in the introduction of hospice as an appropriate plan of care.” Families and individuals are not always aware of all the hospice services including:

Support for emotional issues surrounding disease, including caregiving issues for family members.

  •   Caregivers take on a tremendous amount of burden and responsibility when caring for an ill loved one.  Seeking help andresources is key to avoiding caregiver fatigue.

Information about financial support services available in the community.

  •    SeriousIllness.org is one resource Crossroads Hospice recommends to find resources in your patient’s area. It’s a FREE one-stop online resource to help caregivers find what they need.

Home visits from a nurse who can serve as your “eyes & ears” - keeping you abreast of changes and relaying new instructions from you concerning medication, dosage, etc.

  •   As part of the Crossroads team, a registered nurse case manager coordinates care with the physician and hospice medical director, through initial and ongoing nursing assessments. A nurse visits the patient two or three times a week, or as needed, to ensure all distressing symptoms are effectively managed and that patient/family needs are being met. A RN supervises all care provided by the licensed practical nurse and home health aide, and coordinates care with the other members of the hospice team to ensure patient and family spiritual and psychosocial needs are met.

24-hour telephone access to trained personnel to assist with caregiving concerns.

  •   Crossroads staff are available 24-hours a day to address any concerns. We have nurses and aides available for visits during the day, overnight, and on weekends.

Visits from a bath aide several times a week.

  •   Home health aides assist patients and families with personal care needs, and light housekeeping. They also teach family members the correct method for providing personal care. The home health aide supplements the care provided by the nurse case manager.

Visits from a trained volunteer to provide respite for family members.

  •   Crossroads volunteers (Ultimate Givers) attend extensive training to prepare them to fully support patients and their families. The volunteers frequently perform needed errands and light housekeeping for the patient and family. They provide another set of “eyes, ears and hands” to ensure that every patient receives the pinnacle of care.

Expert & free consultation by the Medical Director, a specialist in palliative care.

  •   Hospice medical directors provide an oversight of patient care and support to the hospice team. The hospice medical director also attends a team conference to discuss the plan of care by assisting in establishing goals and participating in decisions regarding patient care.

Hospice care is designed to ensure that a patient and family are relieved of as much pain, stress, and discomfort as possible. Encourage your patients and their families to research and use all the services they might need.

Find out more about the end-of-life signs and symptoms now.