There is a lot of confusion around what one can expect when engaging hospice services. First, a referral is made by a physician, hospital, nursing home, patient or family member. Then a doctor must sign an order stating that the patient is hospice-appropriate. In other words, based on the doctor’s best medical judgment, the life expectancy of the patient is six months or fewer. If you want to make a referral for yourself, speak to your physician about your wishes. If your doctor denies your request, see another doctor or contact a hospice provider directly. Sometimes doctors will not sign a request for hospice because they feel the patient is giving up on them or that they have failed their patient. However, if the patient is terminal and wishes to receive hospice care, then it is his or her decision to do so—not the doctor’s.
Next, the patient is admitted to hospice by a social worker and a nurse. The two will meet with the patient and their family to explain hospice, develop a plan of care and complete paperwork.
Once a patient is admitted to hospice, he or she will be visited by several members of the hospice team. The staff members include RNs or LPNs, chaplains, social workers, home health aides and trained volunteers. The nurse will provide a weekly assessment, and will make more visits if needed. With the interdisciplinary team, a patient will see a hospice staff member roughly three times a week. Although the staff members will not stay twenty-four hours a day, they will make as many visits as necessary to ensure the proper care is given. The length of their stay will vary depending on the condition of the patient.
During the visits, a patient’s physical, spiritual, emotional, and social needs are determined and addressed. A typical visit consists of checking health status, administrating medications, changing bandages, providing equipment, and/or talking with the patient. Visits may also include engaging the patient in a favorite activity or special event. Some visits may involve assisting with funeral arrangements, power of attorney and living wills. Each visit is adjusted to satisfy the need of the patient and their family.
Spreading the Word—