Authors: Dr. Ruth Thomson, Four Seasons Chief Medical Officer

When people think of hospice care, they often picture care in a hospice inpatient unit or hospice house, like Four Seasons’ Elizabeth House, where hospice patients receive 24-hour care provided by hospice professionals or volunteers. While a small percentage of hospice patients do need care in an inpatient setting, most receive care in the place they call home. That can be a personal home or apartment, an assisted living or skilled nursing facility, or a motel or homeless shelter.

So, you might be thinking, “care wherever you call home. What does that mean? Who comes to the home? What does the care look like? Will someone be there when needed?”

Let’s unpack that a bit.

Every hospice patient has an interdisciplinary team that works together to support them and their family. The hospice team consists of a doctor, nurse, nurse’s aide, social worker, spiritual counselor, and volunteers. Members of the hospice team make regular home visits, adjusting how frequently they visit based on the patient’s individual needs.

The hospice nurse case manager is the nucleus of the team, and typically visits weekly but can come more often if the patient needs it. The nurse case manager assesses the patient’s condition and symptoms, reviews their medications, and provides training about changes to the patient’s condition and care. The hospice aide may come 2 to 3 times per week if the patient needs help with things like bathing, dressing, or light housekeeping. The hospice social worker and spiritual counselor commonly make monthly visits to provide psychosocial and spiritual support based on the patient and family’s needs and wishes.

There is a common misperception that hospice care at home is provided by hospice professionals or volunteers 24/7. While this is not the case in most instances, hospice does provide on-call services 24/7. This includes a triage nurse who can answer questions and provide support over the phone day or night, and on-call nurses and social workers who can make house calls after hours to assess and address needs that arise outside of normal business hours. Hospice also has physicians on call, who can collaborate with the nurses after hours to prescribe or adjust medications to manage uncontrolled symptoms or provide medical advice and guidance.

Some patients’ care needs become too much for family caregivers to manage, which is when the hospice social worker can help with caregiving resources. They may offer a short-term option, respite care, which is 5 days of care in a hospice inpatient unit or nursing facility to provide the patient’s caregiver relief from care. The social worker can also provide resources for hiring private duty caregivers or help with the transition to an assisted living or nursing facility.

We are always here to answer your questions about what in-home hospice care looks like for your loved one. Four Seasons is here for you. Contact us today with your questions and concerns regarding your loved one’s in-home care and one of our knowledgeable and helpful staff members will be happy to talk with you about how Four Seasons can support you.