Home Care and the End of Life Process

Hospice care and home health care are actually similar in philosophy: they’re both about ways to improve a patient’s quality of life, whether someone needs skilled service for a shorter period of time or a more extended period of time.

In some communities, patients may consider moving to facilities for end-of-life care or communities that offer nursing/assisted living care. But not everyone wants to or is able to relocate if given the choice.

Many patients prefer to remain in their own homes for either home health care or hospice care, because it’s usually more comfortable to be surrounded by familiar items and their possessions, plus unlimited friends and family, rather than having to relocate to a more sterile, unfamiliar building with other patients.

In some cases, home health care may be able to transition a patient easily into hospice care, especially if their medical needs become more pronounced, or a disease or condition progresses, and they begin to meet their health care provider or insurance provider’s standard for hospice care.

Home health care patients may be recommended to have this service indefinitely, or for a certain amount of time. Contact us for recommendations.

Many home health care companies can offer both traditional care and hospice services, with nurses trained and experienced in both areas, or perhaps nurses who focus on one or the other.

Some similar types of care can include:

Pain management.

Patients receiving home health care may be dealing with high levels of pain, but their provider may not want to prescribe something especially addictive or in a high dose. However, for a patient who is part of a hospice program, there may be less concern about long-term effects and more interest in reducing current pain levels and symptom management.

Grooming.

Skilled nursing care can still assist patients in basic grooming and looking presentable, especially tasks they may not have the strength or abilities to perform, such as shaving.

Massage.

A massage therapist can help relax patients by stretching their muscles, a service that benefits anyone in any condition. Hot or cold treatments may be recommended to help inflammation or improve damaged muscles as part of home health care, or simply reduce pain and help a patient relax in case of hospice services.

Companionship.

A good nurse sometimes does a lot of good even when he or she isn’t actively performing any specific medical task. Patients enjoy it if they take the time to converse at any stage of care. Hospice patients may especially appreciate the company and the perspective of a nurse who is more experienced with end-of-life conditions. Part of hospice training often includes how to have these emotionally supportive discussions, especially when the patient initiates them. But generally it comes down to being a good listener.

Proper Nutrition.

Proper nutrition helps the body function but sometimes patients need assistance eating. In a home health care situation, people may be hungry but they may need help. At a hospice setting, people may not be interested in eating anymore, but a nurse can decide on options to keep them fed and hydrated, such as a modified diet or even an IV.

Certain time limits.

Insurance or a provider may recommend someone for hospice care if they have less than six months to live. Sometimes their condition may already be quite advanced and they may have days or weeks, instead of months. If the patient continues to live after six months, a provider may extend or modify the recommendation. With home health care services, a provider also may make a recommendation for certain conditions or types of care over a certain period, with the expectation that improvement be shown. This could vary by patient – return to work, move to an assisted living facility, stop care altogether, or transition into hospice care.

Other professionals.

Home health care may include visits by an occupational therapist, a speech therapist, a physical therapist, or other skilled professionals who will help the patient focus on rebuilding skills that may have been lost due to injury or other medical conditions. For instance, a stroke or brain injury could cause aphasia which affects the ability to speak or write. A therapist can work with that patient to re-learn these skills or build new skills, and with their family members to figure out ways to understand each other with less frustration.

In a hospice situation, there’s less of a focus on rehabilitation and more attention to making their time meaningful. Professionals that might accompany a nurse could include a member of the clergy, a bereavement specialist, or other people who could discuss benefits and the hospice process.

Availability.

Hospice care can usually be provided any time, day or night. Some home health care programs also offer 24-hour scheduling if needed or requested. However, people should check with their provider or insurance benefits since some programs may only authorize daytime visits.

In some cases, a nursing program can provide patients with home health care services or hospice services, depending on the patient’s condition. Patients received skilled services, and this is often more convenient than having to work with separate organizations for each service.