Inpatient hospice care is provided to patients in their final stages of life when hospitalization is unnecessary and care at home or in a nursing home is not practicable.
The primary goals of inpatient hospice care are to relieve symptoms, ensure the highest possible quality of life until death, and provide grief care¹.
In many countries, an inpatient hospice serves a similar purpose to a palliative care unit (PCU), whereas a clear differentiation can be made in others. Patients may be admitted to a PCU for crisis intervention and an inpatient hospice for end-of-life care in various countries.
Requirements
An inpatient hospice requires a multidisciplinary staff to provide holistic care to patients and their relatives. Nursing staff should have a minimum of one, and preferably two, nurses per bed. A physician with palliative care training should be on call 24 hours daily. Psychosocial and spiritual care professionals, as well as volunteers, should make significant contributions.
An inpatient hospice’s core staff comprises nurses and requires immediate access to a skilled physician. The extended team comprises social workers, psychologists, spiritual caregivers, physiotherapists, nutritionists, speech and language therapists, occupational therapists, and volunteers.
Inpatient hospices must provide a home-like ambiance, accessible to people with disabilities, single or double patient rooms, and a minimum bed capacity of eight. Rooms for social and therapeutic activities should be provided at the hospice. Each patient room should have a bathroom. It should be possible for the family to remain overnight.
When Symptoms Are Uncontrollable at Home
Hospice care is typically provided in the patient’s home, as this is where most very sick individuals prefer to be: in familiar settings with familiar routines and familiar faces.
Additionally, all hospices must provide inpatient care to assist with assessing and managing acute, complex, or uncontrollable symptoms such as pain or shortness of breath that cannot be managed at home or in other settings.
What Qualifies for Hospice Inpatient Care?
The following are possible indications of the need for inpatient hospice care:
- Rapid decline necessitating intense nursing care
- Intractable pain
- Nausea and vomiting that is out of control
- Pathological fractures
- Uncontrollable respiratory distress
- Symptomatic alleviation by the use of intravenous medicines that necessitate close monitoring
- Complex and frequent dressing changes are required for wound care that cannot be performed at the patient’s house.
- Agitation or restlessness that is uncontrollable and requires serious intervention
- Uncontrolled seizures
- Minor operations to improve the patient’s comfort, such as draining fluid from the abdomen (paracentesis) or implanting a permanent drain or tube.
Where Can I Receive Inpatient Hospice Care?
Inpatient care is provided in a facility—typically a hospital², nursing homes, and free-standing hospice houses—capable of providing clinical care around the clock.
The mood in an inpatient hospice setting is quite unlike an acute-care institution. The inpatient hospice unit is more tranquil and comfortable. Staff personnel move at a leisurely pace, frequently pausing to speak with patients, interact with family members, and answer questions. Day or night, family members and friends of all ages are welcome, and overnight accommodations can be arranged.
However, make no mistake: intensive pain and symptom treatment are underway, intending to stabilize the patient and allow them to return home to receive routine hospice care.
The inpatient hospice care team consists of the following individuals:
- Assesses symptoms
- Intensive symptom management is available.
- Provides round-the-clock care and visits regularly
- As a result, the team can typically manage and control the patient’s symptoms within a few days, allowing the patient to return home.
Hospice care is classified into four distinct categories or levels:
- Regular in-home care. The majority of hospice care begins with routine in-home care. When you get routine home care, hospice staff will visit your house to provide nursing, psychological, spiritual, and other types of care. Your hospice staff will work with you and your family to organize this timetable.
- Constant in-home care. If you experience a medical emergency or require 24/7 care, your hospice team will provide continuous in-home care. For instance, if you were suffering from significant pain that was not alleviated by your current meds, a nurse may stay with you for a longer amount of time to fix the issue.
- Inpatient care in general. Certain symptoms cannot be addressed at home. In this scenario, the hospice physician may propose an inpatient hospital or inpatient hospice stay. Your symptoms will be addressed during your inpatient stay so that you can resume getting routine hospice care at home.
- Care in the interim. Respite care is short-term care that gives family caregivers a break. When you receive respite care, you will spend a specified amount of time in an inpatient hospice, a skilled nursing facility, or a hospital. Respite care can benefit family members who must travel, are experiencing personal health issues, or simply require a break from full-time caregiving.
- The degree of hospice care you receive will not affect the quality of care. While your environment may change briefly, your plan of care will not. All hospice caregivers who are Medicare-certified are obligated to provide all four levels of care.
Conclusion
Both inpatient institutions and hospice care organizations strive to provide your loved one with the highest possible level of care. Currently, Medicare does not cover room and board, but Medicaid does. As indicated previously, if you are not eligible for Medicaid, you may be asked to pay for your room and board. Additionally, we provide placement services, which enable us to select the most appropriate inpatient institution for your unique needs and circumstances. Our staff at Melodia Care works relentlessly to alleviate any stress you may face. Whether you’re looking for financing or conducting research on inpatient facilities, we’ve got you covered so you can focus on the things that matter most to you, such as family, health, and time.
