What Happens in the First 24-48 Hours of Hospice Care?
The First Hours of Hospice
The first 48 hours in hospice can be a little chaotic, but shortly after entering hospice care, patients report feeling more secure and comfortable! During the initial few days, our hospice team will spend time getting to know the patient, understanding their needs, and initiating the first steps to maximizing their comfort. The hospice team provides an assessment at the home of the patient. This assessment helps us understand and evaluate the patient’s needs. Having a comprehensive understanding of the patient’s needs makes it easier for us to see signs of distress. Our personalized care plan helps our team track goals with the patient and makes it easy to maintain clear communication with the family members and the patient’s existing doctors. In those first 48 hours, we create the foundation that will guide the team throughout the patient’s time in hospice care.
Hospice Care Team Introductions
When a patient transitions into hospice care, it sometimes is a jarring transition. During the first week of hospice care, the patient will become acquainted with the care team that will be supporting them. The care a patient receives is from a team of healthcare professionals that together create an excellent care team. Every member of these teams offers support in their own way, which helps lift the entire family. A patient will meet with the registered nurse who will be overseeing their care, handling symptom management, and working with loved ones to ensure strong family support. Hospice physicians work alongside the registered nurse, approving treatment plans and medications that reduce the patient’s symptoms. Social workers assist with financial and legal questions, and can bring the patient emotional comfort. Hospital chaplains provide spiritual support at the request of the patient. In some circumstances, a home health aide can provide support, an option that many patients select during palliative care. Patients and families during the first hours of hospice care find reassurance once they meet the wonderful team of professionals that will be providing support.
The Hospice Admissions Process
When patients decide to enter hospice, they will go through a brief and informative admissions process. The patient’s physician will provide a referral, and the hospice team will then contact the family of the patient. During this admission process, we handle consent forms, insurance, and other paperwork. We’ll provide detailed information on how hospice care works and answer any questions they may have. We will go over all the physicians’ notes and records to ensure we’re all on the same page about the patient’s state of health and their ongoing needs.
Hospice Care Intro Assessment
The initial hospice care assessment occurs when the patient officially enters a hospice care program. One of our nurses meets with the patient to learn about how we can best serve them and bring them the most comfort during their time in our care. We look for obvious signs of discomfort like trouble breathing, problems with physical comfort, difficulty taking medications, and provide a thorough exam looking for more subtle symptoms. This assessment becomes the guideline on how we will care for the patient, how we will build our care plan, and what our team needs to be prepared for to offer proper care.
During this meeting, we assess general vitals, breathing, oxygen levels, cognitive function, fatigue, and energy evaluations. We perform a physical evaluation to check mobility, nutrition, skin, and strength, and determine whether or not the patient is a fall risk. We perform a review of the patient’s medications, including both over-the-counter and prescription drugs. It’s important for us to keep a close track of what medications the patient is on to avoid any unwanted interactions. Understanding the patient’s emotional needs gives us a clearer guide on how we can offer emotional support. We take all of this information and create a final care plan that empowers our hospice team to focus on comfort, management of symptoms, and creating a better quality of life.
Personalizing A Care Plan
Once patients go through that initial assessment, our team creates a personalized plan of care. This plan takes into account the patient’s physical needs, medication schedule, family involvement, spiritual support, home health aides, and more. The hospice team assigned to the patient will work together to provide the best care possible. While we take the family into account while building the personalized care plan, we can consult the loved ones of the patient. This allows the family a chance to provide feedback on cultural and spiritual preferences, as well as better incorporate their own methods of care. We keep patient condition charts that allow the team to seamlessly stay up to date on everything going on in the patient’s day-to-day.
Education and Family Support
While aspects of hospice care are to provide direct care to the patient, we also empower the families by educating them in the ways they can contribute. Family involvement is key during hospice care. Maximizing quality of life and comfort is our main goal, but that doesn’t just include symptom management. Creating a fulfilling social life for the patient is crucial in the last stage of their life. We want to continue incorporating the family into the patient’s daily life. There is a misconception that a hospice nurse will take all care away from the families once the patient enters hospice, but that isn’t true. Our goal is to work alongside families to provide a better quality of life and comfort for the patient.
Changes Family Members Notice
There are some misconceptions associated with hospice care, especially regarding the quality of life of the patient. Because the nature of hospice care is for patients who are no longer seeking treatment, many associate hospice care with death. While hospice care is typically the last stage of one’s journey, our goal is to provide the best possible experience.
Families report that their loved one’s symptoms are reduced and more easily controlled. They feel more involved and informed because of the direct communication that’s available with hospice nurses. Families themselves are less stressed with the support they get from the hospice staff. Improvements like this happen within the first several days, making everyone’s experience more positive.
Medical Equipment And Medication Deliveries
Medical equipment and medications are quickly ordered and delivered to the patient’s home. One of the main goals is to provide the patient with an immediate increase in comfort as they transition into hospice care. Typically, nurses will bring a comfort kit to the home of the patient that includes standard supplies to manage symptoms like pain, nausea, breathing problems, anxiety, and more. Many hospice care patients receive supplies and equipment like a hospital bed, oxygen for breathing, pain medications, care supplies, gloves, mobility assistance devices, shower chairs, and special mattresses to relieve pressure. Often these deliveries arrive as early as the same day, or within the 24 hours after your first visit with the initial visit with your nurse. Once these items are delivered, technicians will set up everything and provide simple tutorials on how to operate the equipment. Our hospice team isn’t solely there to provide comfort, but to provide assistance for the family members and empower them to care for their loved one.