Hospital to home hospice

I learned a few things this week as an active participant in a dear client’s successful transition from hospital to home hospice. “Be prepared” sums up the lessons nicely. Some of what I learned may seem trivial but, I promise, even the small things make a difference for a weary patient that just wants a reprieve from change, pain, being poked and prodded.

  • Hospice provides a lot of the medical equipment and supplies a patient and their caregivers need: bed, bedside table, wheelchair, air mattress to reduce skin breakdown, inflatable “boots” to prevent heel skin cracks, disposable diapers, personal care wipes, disposable bed pads (called chux), lotions and salves, and comfort medications.  A big “but” here: it will take a couple of days for hospice to schedule and deliver.  Make sure you ask the hospital bedside nurse or discharge planner to provide a “care package” of supplies to cover for the first couple of days.
  • If appropriate for your circumstances, purchase a few hospital gowns in advance to have on hand. Find a medical supply store online or near you to purchase gowns as well as a 3-4 day supply of diapers, chux, wipes, etc. This is one of those tasks that you can do online or ask a friend to pick up for you.
  • Communicate often and clearly about your loved one’s level of discomfort. Ask him if he is in pain, ask for input from caregivers, keep a log of pain medications administered, and call your on-duty hospice nurse if the pain is unmanageable. “Stay ahead of the pain” is the critically important message here.
  • Monitoring pain may seem like a no-brainer but also keep a check on your loved one’s anxiety, nausea, and watch for excessive secretions because it is likely that the hospice nurse has provided comfort medications to alleviate any/all of these concerns.
  • Hospice team members are the best of the best. They offer expertise, compassion, reassurance, comfort, patience and affirmation. The team is multidisciplinary, responsive to physical concerns and symptoms, psychological, emotional and social needs, spiritual needs, and activities of daily living.  They are individuals I always want in my village.