EDITOR’S NOTE: Cheryl Medawattage, RN, BSN,CHPN,CHPCA, has 19 years of hospice experience. She is a registered nurse, board certified for pain management and on the national board for pain management. Here, she shares her thoughts on the benefits of hospice and how it can complement in home care assistance and home care services for seniors.
Q: How can hospice and home care assistance companies such as SYNERGY work together?
A: I think there needs to be a lot of “synergy” between the two. There needs to be that continuous care. There are a lot of patients in home care assistance environments who can truly benefit from hospice, the palliation. But the nurses on the home care side need to recognize it, and that’s not their area of expertise or not something they first think about.
Hospice can really help with home care assistance as far as hospitalization because right now there is tremendous scrutiny on quality of care, quality initiatives, making sure patients -- when they are discharged from a hospital -- are not going back to the hospital within 30 days with the same diagnosis.
For example, those patients who are real “frequent flyers,” who go back and forth to the emergency room for congestive heart failure, are ideal hospice candidates.
The hospice role would be to keep them home and manage their symptoms. Hospice can identify those patients in home health and help decrease their hospitalization rates, as well, because they are evaluated on their hospitalization rates.
It’s recognizing that this patient is not “rehab-able,” is way too fragile, is not going to get better. Hospice can provide additional pain management, the comfort and symptom management to keep these people from going back and forth to the hospital. And home care assistance can make the transition so much easier for the patient and the family.
Q: When should a family reach out to hospice?
You have to have a doctor’s order to initiate hospice services. However, hospice does get calls from families who just want information. They are not sure if their loved one qualifies for the service. And if hospice decides this patient may eventually qualify for hospice, hospice may collaborate with the attending physician to see what his or her thoughts were. He has to concur and give the order to initiate hospice services. Because hospice is a government program, it is trying to make sure the patients who come to hospice are truly appropriate for the program and it is not being abused.