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End of Life

The 4 Levels Of Hospice Care

Reviewed by: MySeniorCare Staff
Last Updated: 4/15/2011 1:29:34 PM

When a loved one is ill or near the end of life the best place a family can think of for them to spend the remainder of their days is in the comfort and familiarity of his their home. But what happens when the loved one's care becomes more than a regular person can handle alone?

Hospice, or specialized, care focusing on providing support to people who are in the final stages of terminal illness or natural end of life, is a great option for those who want to offer a loved one the most comfortable environment possible during their last days while still ensuring they receive the proper medical care family members aren't able to provide on their own. While researching an appropriate hospice provider, family members should also be sure they understand what sort of hospice their loved one needs as it will help to narrow down their search.

Generally, there are four levels of hospice care. A person may move from one level to another throughout their care depending on her needs, the progression of her illness and individual circumstances.

Routine Home Care

Routine home care allows the patient to remain at home with the hospice providers coming to them. At this level the person's symptoms are not too severe to require the constant monitoring of a physician. Patients at this level can receive services such as nurse, social worker or religious representative visits; home health aide services; certain types of equipment and medications and counseling for the patient and family. The amount of visits received at this level depend on the loved one's needs. Usually a plan is created between the hospice provider and the patient's family to determine all of those needs so the loved one gets the best care possible. Another great benefit is that the patient is eligible for 24-hour on-call respite nurse services at this level, which can be a tremendous comfort to family members.

Inpatient Care

At this level the patient has what is termed "uncontrolled symptoms" and is residing in a health care facility away from home. All this means is that the loved one's symptoms have become too difficult for family members to handle on their own, requiring additional assistance to get their loved one the extra attention needed. The loved one will receive a more moment-by-moment attention and assessment of symptoms in order to ensure more comfort during the illness. At this level the hospice team works hand-in-hand with the patient's physician in order to get the symptoms back under control so the loved one can, hopefully, go back home or to a less closely monitored form of hospice.

Respite Care

Here the loved one will receive basically the same sort of care as they would receive in the home except the patient stays in a respite facility. Usually this is an option for family members who need a break from caring for their loved one on their own as it can be extremely exhausting task doing it alone every day. The patient is provided with 24-hour monitoring and care and is able to stay up to five days before being transferred back home.

Continuing Nursing Care

At this level the loved one would be in the home but receiving constant nursing care. Usually this is the option chosen for patients whose symptoms are uncontrolled and need more around the clock attention and care. This form of care is similar to that offered at the Inpatient Care level except that the care is provided in the home. According to the Hospice Patients Alliance, the only time such a service can't be offered is: (a) if the hospice provider has fewer than seven employees; (b) the hospice is in a rural or non-metropolitan area; and (c) the hospice doesn't have the staff to provide continuous nursing care in the home.

Hospice is a fantastic option for family members who want to provide the most comfortable care possible to a loved one in the final stages of life. Understanding the various levels of such care helps to determine the right care at the right times.

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