When is the right time to ask about hospice?
Now is the best time to learn more about hospice and ask questions about what to expect from hospice services. Although end-of-life care may be difficult to discuss, it is best for family members to share their wishes long before it becomes a concern. This can greatly reduce stress when the time for hospice is needed. By having these discussions in advance, patients are not forced into uncomfortable situations. Instead, patients can make an educated decision that includes the advice and input of family members and loved ones.
How does hospice care begin?
Typically, hospice care starts as soon as a formal request or a ‘referral’ is made by the patient’s doctor. Often a hospice program representative will make an effort to visit the patient within 48 hours of that referral, providing the visit meets the needs and schedule of the patient and family/primary caregiver. Usually, hospice care is ready to begin within a day or two of the referral. However, in urgent situations, hospice services may begin sooner.
Will I be the only hospice patient that the hospice staff serves?
Every hospice patient has access to a hospice volunteer, registered nurse, social worker, home health aide, and chaplain (also known as the interdisciplinary team). We try our best to ensure the same hospice team members will be available to you, for continuity and support. For each patient and family, the interdisciplinary team writes a care plan with the patient/family that is used to make sure the patient and family receive the care they need from the team. Typically, full-time registered nurses provide care to about a dozen different families. Social workers usually work with about twice the number of patients/families as nurses. If needed, home health aides, who provide personal care to the patient, will visit most frequently.
All visits, however, are based on the patient and family needs as described in the care plan and the condition of the patient during the course of illness. The frequency of volunteers and spiritual care is often dependent upon the family’s request and the availability of these services. Travel requirements and other factors may cause some variation in how many patients each hospice staff serves.
Is hospice available after hours?
Hospice care is available ‘on-call’ after the administrative office has closed. We have nurses available to respond to a call for help, if necessary. St. Francis Hospice has chaplains on call as well.
How does the hospice staff work to keep the patient comfortable?
Many patients may have pain and other serious symptoms as their illness progresses. Hospice staff receives special training to care for all types of physical and emotional symptoms that cause pain, discomfort and distress. Because keeping the patient comfortable and pain-free is an important part of hospice care, many hospice programs have developed ways to measure how comfortable the patient is during the course of their stay in hospice. Hospice staff works with the patient’s physician to ensure that medication, therapies, and procedures are designed to achieve the goals outlined in the patient’s care plan. The care plan is reviewed frequently to make sure any changes and new goals are in the plan.
What role does the hospice volunteer serve?
Hospice volunteers are generally available to provide different types of support to patients and their loved ones including running errands, preparing light meals, staying with a patient to give family members a break, and lending emotional support and companionship to patients and family members.
Because hospice volunteers spend time in patients’ and families’ homes, St. Francis Hospice has a rigorous application and interview process to assure the person is right for this type of volunteer work. In addition, we have a comprehensive, organized training program for our patient care volunteers. Areas covered by these training programs include understanding hospice, confidentiality, working with families, listening skills, signs and symptoms of approaching death, loss and grief and bereavement support.
Can I be cared for by hospice if I reside in a nursing facility or other type of long-term care facility?
Hospice services can be provided to a terminally ill person wherever they live. This means a patient living in a nursing facility or long-term care facility can receive specialized visits from hospice nurses, home health aides, chaplains, social workers, and volunteers, in addition to other care and services provided by the nursing facility. The hospice and the nursing home will have a written agreement in place in order for the hospice to serve residents of the facility.
What happens if I cannot stay at home due to my increasing care need and require a different place to stay during my final phase of life?
St. Francis Hospice has its own hospice inpatient facility, The Sister Maureen Keleher Center in Nuuanu, and has arrangements with nursing facilities to care for patients who cannot stay where they usually live. These patients may require a different place to live during this phase of their life when they need extra care.
How can I be sure that quality hospice care is provided?
St. Francis Hospice uses many tools to let us see how well they are doing in relation to quality hospice standards. In addition, we use family satisfaction surveys to get feedback on the performance of our program. We adhere to the National Hospice and Palliative Care Organization ‘Standards of Practice for Hospice Programs’ as one way of ensuring quality, and we are accredited by the Joint Commission, the premier international organization that evaluates healthcare providers to ensure that they are providing care that meets defined standards of the highest quality.