How do Hospice Admissions Work?
AMOREM’s Service Podcast serves the mission to provide quality, thoughtful, loving care to patients and support to their families and to offer education and grief support to communities served. This podcast is intended to transform the way that people view and experience serious illness and end-of-life.
In episode seven of AMOREM’s Service Podcast, How do Hospice Admissions Work, Access and Enrollment Specialist RN, Lee Dula, and Access and Enrollment Specialist Cierra Wilcox, guide a conversation through the logistics of a hospice admission, services and comfort care provided to patients and how AMOREM supports a patient’s family and loved ones through the end-of-life journey.
Dula begins the conversation by explaining that a hospice admission in a nutshell involves the Access and Enrollment team meeting with a patient and family to better understand the needs of each patient. They are looking at where the patient is now and what the patient’s goals are for the future. Typically, when a hospice admissions team is called, they focus primarily on comfort care and symptom management. At this point, a patient has sought out all the aggressive treatment that they desire and are solely focused on the quality of life remaining. Typically, these conversations take about an hour unless the family and patient have additional questions and concerns that they would like to speak with the Access and Enrollment team about.
During a traditional visit from the Access and Enrollment team, a social worker and a nurse will travel together to meet with the patient and family. The team will sit with the patient and family and typically have the patient enrolled in hospice services as soon as the end of the visit. The questions asked during a visit with the Access and Enrollment team are usually standard questions, however, they do occasionally need to be tailored to specific patient needs. The AMOREM team needs to be able to gain an understanding of the patient’s medical history and what their wants and needs for care are.
When determining if a patient is eligible for hospice, the team is looking for a variety of things but, two things are essential- Medicare and/or insurance and a terminal diagnosis. This means that the patient’s healthcare provider has given them a prognosis of six months or fewer. The other element to this is based on a recent decline in the patient and recent needs from the patient.
When discussing the levels of care available to AMOREM patients, Wilcox explains that most patients are cared for in their homes or wherever they call home. This kind of care is called routine home care. AMOREM also has patient care units that are available to the community. At those facilities, care teams can provide end-of-life care, or what the organization calls, general inpatient care. There is an additional layer of care that is called respite care which allows for caregivers to have a bit of relief and tend to things that they may not be able to tend to while providing care for their loved one.
In terms of working with a provider or medical professional that a patient has been seeing before enrolling in hospice, the AMOREM team blends in and becomes a part of the care team as a whole. The family doctor who was being seen before hospice enrollment is what the organization calls the attending physician.
The AMOREM care team traditionally includes a registered nurse, a social worker, CNAs, chaplains and volunteers. If a patient does not have a primary healthcare provider, AMOREM has providers that will become a part of the patient's care team so that no one is without a doctor during this journey. AMOREM believes in holistically serving the patient, meaning that they serve mind, body and spirit. This is why the AMOREM care team is so diverse and includes medical and spiritual team members.
Wilcox also explains that AMOREM social workers play a large role in helping patients and families with advance care directives, healthcare power or attorney, living will and other planning elements that many often overlook until a need arises. She explains that AMOREM social workers have educational materials that they can walk patients and families through and even have notaries on staff to help patients and their families complete such documents.
When it comes to symptom management and comfort care, the AMOREM care team continually asks the patient about what symptoms are most important to them, whether that be pain, nausea, anxiety, shortness of breath or anything in between. These symptoms can fluctuate and change day to day so, the AMOREM care team is constantly checking in to see what interventions they can offer to assist a patient.
Wilcox says that many people would be surprised at the levels of additional care that can be provided by AMOREM. Alongside clinical care, AMOREM teams, especially the volunteer services team, offer care such as aromatherapy, massage therapy, haircuts, pet therapy and many other interventions.
Another element that the Access and Enrollment team finds important to share is the care and support offered to families after the loss of a loved one. Grief Support Services will offer grief support to bereaved family members for up to 13 months after the loss of their loved one. Oftentimes, the grief support team works with families and loved ones even after 13 months.
If you or someone that you know could benefit from AMOREM services, please visit www.amoremsupport.org or contact a team member at 828.754.0101.
AMOREM’s Service Podcast is proudly brought to you by AMOREM, your local, nonprofit, hospice and palliative care provider. AMOREM has provided services to the community for more than 40 years, formerly as Burke Hospice and Palliative Care and Caldwell Hospice and Palliative Care, and has served the High Country for more than 10 years. To learn more or to make a referral, visit www.amoremsupport.org or call 828.754.0101 to speak with a local team member.