Hospice Levels of Care
One of the biggest misconceptions about hospice is that it is a place. Hospice is a type of care that can happen where ever the patient calls home. This includes houses, apartments, skilled nursing facilities, assisted living facilities, hotels, and more. While there is a level of care called general inpatient that happens in a “place” it only makes up for 4.8% of hospice Medicare patients.
There are four levels of care in hospice, each was created to meet patients’ needs. Each patient has different intensities of care during their time on hospice. The level of care is determined by your hospice team coordinating with your physician, the hospice physician, and you.
Routine Level of Care
93.8% of hospice care was provided at a routine level of care. The routine level of care is provided wherever the patient calls home. It is a team approach to ensure you or your loved one has their symptoms managed and has a death that includes comfort and dignity. Routine level of care includes care for the interdisciplinary team (Nursing, Certified Nurse’s Aides, Social Workers, Chaplains, Volunteers, and Physicians) the team members visit intermittently based on the care plan you create with them. It also includes supplies and equipment needed to ensure comfort such as hospital beds, oxygen, bedside commodes, and much more. Medication-related to comfort and the hospice diagnosis are included as well.
Continuous Care
Continuous Care makes up 1% of hospice care. This level of care takes place in a patient’s home, assisted living, independent living, or other locations where there are no nurses on staff 24/7. This level of care is for when you or your loved one is experiencing a medical crisis and severe symptoms such as unrelieved pain or shortness of breath. A nurse and/or Home Health Aide will spend an extended amount of time in your home coordinating with the physician to help get your symptoms under control. Once symptoms are managed you will return to a routine level of care.
General Inpatient Care
General Inpatient Care makes up 4.8% of hospice care. This level of care is what you think about when you think of Hospice as a place. Some hospices have their own inpatient unit where people go when symptoms are so extreme and need an advanced level of care. The goal of this level of care is to get your loved one’s symptoms managed so they can return to their home. This level of care does not have to be provided in a hospice inpatient unit. It can take place in skilled nursing facilities, hospitals, and hospice inpatient units.
Respite Care
Respite care is the fourth level of care and makes up only .4% of total hospice care. This level of care is a short-term respite for unpaid family caregivers. Caring for a loved one can be exhausting and sometimes you may need a break. In this level of care, your loved one will spend 5 days at a nursing home. The hospice team will continue to visit your loved one during this time.
The goal of hospice care is to not only help you have comfort and dignity during your final journey but also helping you live with the most quality and comfort as possible during the final stages of your life. Our society tends to associate hospice so much with death and dying- and of course that will likely be the outcome, but our attention really is to maximize the time our patients have left to enjoy and focus on what matters most to them.