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 of the referral. However, in urgent situations, hospice services may begin within hours.
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). 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 twelve different families. Social workers usually work with about twice the number of patients/families as nurses. Hospice aides, who provide personal care to the patient, typically visit more frequently.
All visits, however, are based on the patient’s specific goals 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 request. 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 rendered via a scheduled visit date & time. For additional or urgent needs on weekends or after hours, each discipline on the care team has someone available seven days a week, 24 hours a day. Cima has nurses available to respond to a call for help typically within minutes, if necessary. Cima also has chaplains and social workers who are on call as well.
How does the hospice 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, Cima has developed programs to measure how comfortable the patient is during the course of their hospice care. Our staff works with the patient’s physician to make sure 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?
Cima 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 our volunteers spend time in patients’ and families’ homes, Cima has an application and interview process to assure the volunteer is right for this type of volunteer work. In addition, our programs have an organized training curricula for our patient care volunteers. Areas covered by these training programs often 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?
Yes, Cima hospice services can be provided to a qualifying patient wherever they live. This means a patient living in a nursing facility or long- term care facility can receive specialized visits from hospice nurses, hospice aides, chaplains, social workers, and volunteers, in addition to other care and services provided by the nursing facility. Cima and the nursing home will have a written agreement in place in order for the our care team 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?
Cima has relationships in each of the communities we serve with nursing facilities to provide General Inpatient care. These are typically fairly short lengths of stay and the continuation of this level of care is evaluated by the Interdisciplinary Team on a daily basis.
Do state and federal reviewers inspect and evaluate hospices?
Yes. There are state licensure requirements that must be met by all hospice programs in order for them to deliver care. In addition, hospices must comply with federal regulations in order to be approved for reimbursement under Medicare. Hospices must periodically undergo inspection to be sure they are meeting regulatory standards in order to maintain their license to operate and the certification that permits Medicare reimbursement.
How can I be sure that quality hospice care is provided?
In addition to standard quality measures used in most hospices, Cima has developed a number of programs to more specifically monitor our care plans to enable us to see how well we are doing in relation to hospice benchmarks. In addition, Cima uses family satisfaction surveys to get feedback on the performance of our program. We also are members of the National Hospice and Palliative Care Organization, the Texas/New Mexico Hospice Organization and Texas Home Health & Hospice Association to ensure that our processes and programs take advantage of the latest innovations in the industry and meet all recommended standards entitled ‘Standards of Practice for Hospice Programs’.