What Qualifies for Inpatient Hospice Care?
Hospice care is healthcare that is provided to the terminally ill during the end stages of life, typically when a doctor estimates they have six months or less to live. There are four different levels of hospice care that patients can receive at any time during their hospice benefits. These four levels are routine care, continuous care, respite care, and inpatient care. What exactly are these different levels and what qualifies for inpatient hospice care? Let’s delve a little deeper and take a look at what each level involves and the criteria for inpatient hospice care.
The Four Levels of Hospice Care
Routine Care
Routine hospice care is the most common, as other levels of hospice care tend to be short-term and temporary. Routine care is a combined effort between the hospice care team and the primary caregivers. The primary caregivers are usually family members, but they may also be staff members at assisted living facilities and nursing homes where the patient resides. While receiving routine care, hospice nurses and certified nursing aids aim to provide comfort and manage the patient’s symptoms. They may help with the patient’s everyday hygiene, administer medications, prepare the patient’s meals and provide dietary advice, and perform light household duties with which the patient struggles.
The patient also receives visits and assistance from the rest of the hospice team. They may get diagnostic services like x-rays and lab work from physicians, follow-ups and additional resources from social workers, and speech and physical therapy from therapists. Patients and their families are also entitled to bereavement and spiritual counseling to help everyone come to terms with the impending loss. Family members can continue to receive counseling for up to a year or more after the death of their loved one.
Continuous Care
At any time during the patient’s end stages of life, they may be faced with a medical crisis when their symptoms become acute. When the primary caregivers can’t manage the patient’s symptoms on their own, continuous hospice care comes into effect. In order to honor the patient’s wishes to remain within their home, hospice nurses may work in shifts for up to 24 hours to help manage symptoms. What qualifies for inpatient hospice can be similar to what qualifies for continuous care, but the symptoms are typically less acute. Continuous care typically lasts from 2-5 days and the goal is to stabilize the patient so that they may return to receiving routine care. During this time, the patient may receive support from a hospice physician who will make communications with the patient’s primary physician.
Respite Care
When family members are the primary caregivers, the whole situation of their loved one passing soon and needing intensive care can get overwhelming. Family members may suffer physical effects of fatigue, loss of sleep, and a change in eating habits that can be draining. On top of the physical effects, they will also face mental and emotional challenges as their loved one continues to change or deteriorate. These combined effects are called ‘caregiver burnout’.
In order to properly care for another person under hospice conditions, primary caregivers will also need to take care of their own health. This is when respite care can offer a much-needed break to recharge and refresh one’s physical and mental well-being. Respite care lasts from 1-5 days and can also be used when the primary caregiver needs to attend a special event like a wedding. During respite care, hospice healthcare professionals will take care of the patient 24 hours a day.
Inpatient Hospice Care
The last level of hospice care can be considered the most intensive care a patient can receive. Inpatient hospice care is needed when the patient’s symptoms can no longer be managed in their own home. The patient is moved to an inpatient hospice facility which may be a freestanding facility or within a hospital. A team of hospice professionals including physicians, nurses, and nursing aids provide care to the patient around the clock. Unlike acute hospital care, a hospice inpatient unit is designed to be home-like and comforting for the patient. The healthcare team members respond appropriately to situations, but are not hurried when providing care. Visitors are allowed during specific times to come visit with the patient.
What Qualifies for Inpatient Hospice Care?
In general, what qualifies for inpatient hospice care are intense symptoms that can’t be cared for within their residence. The patient needs the constant care of physicians and nurses along with advanced medical equipment and medications. What qualifies for inpatient hospice care can vary greatly from patient to patient, but we can give you some of the most common examples of the criteria for inpatient hospice:
Uncontrollable pain
Excessive nausea and vomiting
A sudden deterioration in the patient’s physical state
Pathological fractures
Unmanageable respiratory distress
Complex wound care that requires frequent dressing changes and monitoring
IV infusion medications for symptom relief that need close monitoring
Excessive seizures
Extreme agitation and restlessness that can’t be managed at home
Minor surgical procedures that will make the patient more comfortable
These are just a few of the situations of what qualifies for inpatient hospice care. A physician will communicate with the interdisciplinary hospice care team to decide if they meet the criteria for inpatient hospice care.
What Qualifies for Inpatient Hospice Care Discharge?
As we mentioned earlier, inpatient care is designed to be temporary. The goal of inpatient care is to stabilize the patient so they may return to their home and continue to receive routine care. What qualifies the patient for release from inpatient hospice care is:
Symptoms have stabilized
The patient is being transferred to another level of hospice care such as continuous care
The medications being administered no longer require assistance from skilled hospice nurses
If you still have questions about what qualifies for inpatient hospice care based on the needs of your loved one, please don’t hesitate to call A & H Hospice. We will be happy to help explain the criteria for inpatient hospice and give you a free consultation about the complete services we offer. Contact A & H Hospice today if you or your loved one live within our service area in Southern California.