The goal of our hospice agency is to provide comfort to the patient and heighten quality of life. How comfort is defined is up to the patient or, if the patient is incapacitated, the patient's family. This can mean freedom from physical, emotional, spiritual and/or social pain.
Another aspect of the hospice philosophy is that the care is patient-centered. In our hospice, this patient-directed care is integral and interwoven throughout the care which is provided and reflects the philosophy of all our activities.
To achieve these goals, we work as a team. Our team members include hospice medical director, physicians, pharmacists, registered nurses, social workers, counselors, home health aides, and of course volunteers.
Hospice medical director is responsible for coordinated work or our company and provides the most support to the clinical staff providing care to the patient and family. The hospice medical director is also required under Medicare to recertify patients.
Our physicians involved in patient care may include an attending physician, including a hospital physician who can provide valuable information about a patient's medical history, as well as physicians affiliated with our hospice team. With their knowledge, they primarily provide support to other members of the hospice team, primarily nurses, but can also provide care directly to the patient.
Our Registered Nurses are responsible for coordinating all aspects of our patient's care and insuring symptoms (physical or otherwise) are being addressed and managed. Primary care nurses visit our patients a minimum of twice weekly, and the content of their visits can vary greatly. When patients are experiencing few symptoms and/or are early in their diseases, the registered nurses visit may just be a short checkup. If a patient's symptoms worsen, the nurse will visit more often, make recommendations. Many patients on hospice may require complex treatments: respiratory care, wound care or even Intravenous therapy (IV therapy) at home. In most cases, the nurses of our hospice are trained to handle these unique needs as well.
In addition to registered nurses, we also have Hospice Aides (Home Health). Most of our patients may receive this service too. The hospice aide typically visits anywhere. His or her functions include providing respite to the primary caregiver and physical support to the patient, including bathing, dressing, or feeding. Important, the hospice aide is not a licensed nurse and therefore cannot administer medications, treat wounds, handle IV's or similar treatments. Many times, it is the hospice aide who develops the closest relationship with the patient, due to the frequency of visits.
Every patient we assign a social worker who visits at the time of admission to hospice. The function of our social worker can vary from providing superficial support to patients and families to intensive crisis-oriented counseling. Additionally, with a terminal illness often comes more complicated financial stressors; the social worker can be instrumental in connecting the patient and family with community resources including services such as Meals on Wheels. Lastly, if a patient is unable to be cared for at home, the social worker will work to find a safer place for the patient to receive hospice care.
Typically, the role of counselors is filled by a Chaplain or Spiritual Counselor, but social workers or other persons, sometimes specially trained, may also serve. Our hospice also is able to provide regular and consistent Chaplain services. Our Chaplains are available to provide spiritually supportive counseling, life review and may connect a patient with clergy they are comfortable with. Our hospice Chaplain can officiate at a patient's funeral as needed.
Our team also includes Pharmacists who manage a patient's drug therapy, which includes filling prescriptions, monitoring for drug interactions and adverse effects, anticipating problems, and assessing the appropriateness of drug therapies in the context of patient-oriented goals.