Hospice is not a “place”, but rather a specialized service aimed to improve the quality of life of patients with terminal illnesses. Hospice care will often address the physical, social, emotional, and spiritual needs of the patient, while providing the family with education and reassurance as the illness progresses. While hospice organizations differ, most follow the same basic set of regulations and standards to ensure the utmost quality care for patients. These guidelines are put in place to expand the number of patients who receive hospice and to take the necessary steps to provide patients and their families with health care, emotional support, spiritual encouragement, personal care, and personalized compassion.
Admissions
Hospice aims to provide care services to all patients and families who need and want such services. Throughout the hospice process, hospice will do its best to honor the wishes, values, and concerns of the patients and their families in relation with the organization’s unique policies and the law. The organization must apply non-discriminatory admission policies and admit patients regardless of their sex, race, religion, and other discriminatory markers. Hospice must also admit patients in a timely manner, regardless of the time of day or day of the week. During admissions, patients and their families should be given accurate and easy-to-understand information. Hospice should also inform patients of all of their rights and responsibilities.
Nursing Care
The law requires hospices to provide adequate nursing care to meet the unique needs of each patient. Most hospices have a skilled nursing team with an RN case manager who will oversee all nursing services to ensure that the patient receives the individualized care he or she needs to maintain a high quality of life. This includes, but is not limited to, factors like adequate staff, supplies, equipment, and medications. From the time that your loved one is enrolled, hospice services are ordered and provided soon after.
Hospice nurses are specifically trained to provide patients with nursing care according to the industry’s accepted standards of practice. You can learn more about the “Code for Nurses” online or by contacting the American Nurses Association. When under hospice care, a patient has the right to receive professional nursing care consisting of skilled nursing procedures and all necessary aspects of nursing tasks and bedside care. When in a facility, an RN will be physically present at every shift, round-the-clock, to ensure that all nurses are providing adequate care.
Federal regulations state that hospices that run inpatient facilities must offer 24-hour nursing services to meet the needs of all patients according to their individual plans of care. Each patient has the right to receive treatments, nutrition, and medications as prescribed in their plan. They also have the right to remain clean, comfortable, groomed, and protected from injuries, infections, and accidents. Hospices are also required to provide in-home nursing services in the event of a crisis. A crisis may include severe pain, seizure activity, uncontrolled agitation, respiratory distress, uncontrolled bleeding or vomiting, or the active phase of dying.
Conflicts of Interest
Hospice aims to avoid activities that may conflict with the organization’s responsibility to provide proper care to patients and their families. Avoiding conflicts of interest help to protect the best interests of the patients without exploiting people, organizations, or the community. This consists of not reducing or diminishing the quality of services due to financial reasons or a patient’s inability to pay. Hospice staff should not use information gained through relationships with patients or family members for personal gain. Staff should also not use their position for financial or personal gain.
Discontinuation of Care
Hospice must make all reasonable efforts to provide patients and their families with quality care and compassion while enrolled. Care should only be discontinued upon the voluntary consent of the patient or if the patient becomes no longer medically eligible for hospice care. Discontinuation of care may also be warranted if the organization can no longer provide care without compromising the professional or ethical integrity of the organization or the safety of its employees. Hospice staff must provide full disclosure to patients and their families regarding discontinuation of care policies.
Discharge of patients should be made fairly according to the organization’s discharge criteria. Hospice should also have an appeals process in place for patients who disagree with the organization’s decision. If a patient wishes to voluntarily withdraw from hospice care, their decision should be honored and occur without coercion from any volunteers or employees. If needed, the organization should provide referral information such as further healthcare or support services to ensure that the patient continues to receive a high quality of care. Before making a discharge decision, hospice must facilitate dialogue with the patient and possibly the patient’s family and healthcare team.
Confidentiality
Hospice patients have the right to respect and confidentiality while under the care of the organization. Employees should also respond with sensitivity in the event that any necessary delivery of care results in an interruption of privacy. Employees, volunteers, and caregivers should respect the patient’s personal boundaries and avoid activities that could question the organization’s judgement, such as getting involved in a patient’s private family life. Patient information should never be given to another healthcare provider without a proper release signed by the appropriate parties. All personal and financial records should also be kept secure and confidential in accordance with HIPAA standards.
A Standard of Hospice Excellence
Hospice is an invaluable service that offers patients and their families everything from pain management to spiritual support. If your loved one is dealing with a terminal illness, you may be considering hospice care or have already made the necessary steps to enroll. It’s important to understand the various regulations and standards in the hospice industry to ensure that your loved one is receiving the highest level of care possible in accordance with state and federal laws and the organization’s individual policies and standards of care. For more information about regulations and standards in the hospice industry, contact Harbor Light Hospice today.
