Our clinical transformation consultant, Carleen Rogers, is a registered nurse with nearly 20 years of experience caring for hospice patients. In this Q&A, Carleen dispels some misconceptions about hospice care and gives us a more personal glance into a patient's final days.
A lot of people are confused about where hospice takes place. Is it in the hospital? Is it in a hospice facility? So, tell us. Where can hospice care happen?
Anywhere. I’ve taken care of patients in vans, under bridges and even in a nudist colony. Hospice is a time where you get to choose where you spend your final days. If that’s in a nudist colony, that’s where your hospice nurse will care for you.
While more times than not, hospice care happens where you live, it can be given in a hospital or any care setting with a hospice unit.
What types of care and services does hospice offer?
Many people are under the wrong impression that when hospice care comes in, care stops. That couldn’t be further from the truth. In hospice there are still nurses, physicians, physical therapists, occupational therapists, counselors and so much more. Here’s a diagram that helps answer the question.
Why do we need analytics to help understand which patients would most benefit from hospice care?
As a hospice nurse with years of experience, I can tell you who is going to die in three days, five days and maybe 10 days. I cannot tell you who is going to pass away in six months. It’s too difficult to decipher with experience, instinct and education alone. I need predictive analytics to help me see the future. Analytics, coupled with my and a physician’s experience, education and instinct will help ensure the right patients learn about their end of life care options at the right time.
Why is it important for patients to experience more days on hospice?
Nearly 50 percent of patients receive 14 or fewer days on hospice. In that short amount of time, a hospice nurse has managed a dying patient’s symptoms. There’s so much more hospice care can provide a patient after symptom control.
For example, if my patient, let’s call him Mr. Jones, wants to reconcile his relationship with his son before he leaves this world, hospice will help. We’ll get a counselor involved and help facilitate an effective meeting.
Or let’s say my patient Mrs. Smith has always wanted to go to Hawaii. We may not be able to send her to Hawaii, but we can throw a Hawaiian party complete with fire dancers and leis.
Another great thing many hospices will offer is a life review. The hospice team will interview the hospice patient about his or her life and record the session. This video is a treasure that can live on for posterity sake. It means a lot to the patient that his or her life is documented, and means even more to the family members the patient is leaving behind.
Why are we focusing so much on the end of life conversation?
Everyone deserves to have an open and honest conversation about his or her life expectancy. Its a tough day to tell someone that he may be dying, but if you don’t tell him, it’s not fair. That patient doesn’t get to make the best decision for himself and his family. He may not get to record his life interview. He may not get to reconcile with his son. We must equip patients with the best information about their final days.