Under the Medicare guidelines, all hospice agencies must provide physician participation, nursing services, home health aid services, social services and spiritual care. The way this actually plays out at each hospice agency can be very different. You’ll want to look for these specific things in regard to staff:
- Medical Directors: You will want to look for a hospice agency that has a full-time medical director. If the medical director’s main job is to attend weekly care conferences for a couple of hours and be on-call for emergencies, you may miss out on all a palliative care physician has to offer. Ideally, a hospice medical director should be available full-time to make home visits, consult with other physicians, and act as a resource for nurses. There should always be a medical director on-call on nights and weekends.
- Nurses: Ideally, you want a case manager nurse directing your care. This should be the same nurse who visits you every time (unless she is sick or on vacation). This provides continuity of care and builds trust between the patient, family and nurse. You will also want to know what role licensed nurses play versus registered nurses. The majority of your visits should be from a registered nurse. Also find out how many patients each nurse is assigned. If she has a heavy caseload (for example, more than 10 patients), your loved one may not get the best care possible. It’s also worth asking how many of their nurses have been earned certification in their field. A Certified Palliative and Hospice Nurse (CHPN) has taken the time and effort to become specialized in their field and a hospice agency that has several of these is likely focused on quality.
- Home Health Aides: Ideally, a home health aid should be available two or three days a week to provide personal care to your loved one. Find out how often home health aides make visits and how long they typically stay. Like case managers, home health aides really shouldn’t have a huge caseload.
- Social Workers and Chaplains: Ideally, the hospice agency should have full-time social workers and chaplains. They are essential members of the team and you will want to have access to them when you need them.
- Volunteers: A really good hospice agency will likely have a lot of volunteers. Many hospice volunteers are family members and friends of former hospice patients and want to give back. That’s a good sign the hospice agency took good care of their loved one and will probably do the same for yours. Volunteers are an important part of a hospice agency and provide a wonderful service to patients, families, and staff.
(To see all 5 considerations that are important when choosing a hospice, please read this article Tips for Choosing a Hospice)