How to Create a Compassionate Hospice Care Program

Compassionate hospice care is not for the faint of heart. It takes grit, deep empathy, and creative communication—but it brings immeasurable satisfaction. Your hospice care can imbue your patients’ end-of-life experience with dignity, joy, and meaning while comforting their family members and close friends.

We’ve compiled a compassionate hospice care guide with time-tested advice on delivering the physical, mental, and spiritual support your hospice patients and their loved ones need — whether from home care providers or nursing home inpatient care teams — to make the end-of-life transition peaceful and meaningful.

Creating a compassionate hospice care program

Because end-of-life care nurtures grieving families during a major transition, it requires all primary caregivers, hospice nurses, respite care providers, home health aides, and trained volunteers to become more patient-centered. Meaningful palliative care requires hospice providers to move beyond comfort care services, symptom management and medical equipment delivery. and nurture hospice patients’ spiritual needs.

Although hospice care traditionally treats patients with up to a 6-month life expectancy, palliative care providers who are also delivering end-of-life care can benefit from this advice as well.

As the National Hospice & Palliative Care Organization puts it, “hospice and palliative care are not ultimately about death, but how one chooses to live with serious illness or in their final days”. Here’s how your hospice team can enhance those final days.

Offer physical comfort

Many hospice patients have been fighting life-limiting illness for months or years, and spending a large portion of their days in bed, which induces extreme discomfort. Compassionate hospice care prioritizes pain management and comfort enhancement as outlined in the 8 Principles of Patient-Centered Care developed by the Pickard Institute and Harvard Medical School.

Pain management

Pain perception is as subjective as the meaning patients may give to their pain. Clinicians can offer patients codeine, morphine, and other strong medications to prevent and manage pain, as the potential negative effects of prescription drugs aren’t a concern. However, your patients may need more to experience complete relief.

Studies show that integrative palliative care and compassionate hospice care improve the quality of life for diverse populations, ensuring health justice for those who’ve previously lacked access.

The National Center for Biotechnology Information stresses the importance of cultural competence in pain management. Delivering compassionate hospice care in a culturally diverse society means understanding, respecting, and integrating your patients’ cultural beliefs and lifelong practices. The center maintains that: “Pharmacists and prescribers should collaborate to ensure the safety of alternative therapies, especially when combined with prescription medications.”

Bedsores

Bedsores are caused by constant pressure on sensitive skin and can often be prevented by adjusting the patient’s position from side to side, or from side to back every few hours. Ensuring good nutrition and some form of daily movement can also help prevent bedsores, but check daily for discolored patches of skin that become increasingly darker.

Digestive distress

Nausea, vomiting, and constipation are common issues hospice care providers address daily. Many people experience end-of-life appetite loss, and some choose to stop eating entirely. Don’t force patients to eat, as going without food and water is often less painful than chewing and swallowing.

Temperature sensitivity

Truly compassionate hospice care requires close observation of body language and facial expression. Your patients may not be able to tell you when they’re too hot or cold. Take note if a patient tries to remove a blanket or hunches and shivers—then adjust the temperature accordingly. Therapeutic massage can also stimulate circulation and warm up an immobile patient.

Address psychosocial and spiritual needs

End-of-life care goes well beyond physical bodily sensations. The only way to face or assuage fear, panic, or regret is to ensure your whole-person, compassionate hospice care plan addresses and integrates each patient’s psychosocial and spiritual needs.

Psychosocial needs

According to the National Council for Hospice and Specialist Palliative Care Services in the U.K., psychosocial care is “care concerned with the psychological and emotional well-being of the patient and their family/carers, including issues of self-esteem, insight into an adaptation to the illness and its consequences, communication, social functioning, and relationships.”

As a hospice care provider, your job is to ensure that the patient and their family members are able to process and express any emotions and practice any spiritual end-of-life rituals or traditions. This may include helping the patient come to terms with death and manage anxiety, fear, or depression. It can also mean addressing unresolved anger, resentment, or guilt. Each patient will accomplish this differently—your job is to facilitate these needs for them and their family members or friends.

Spiritual needs

While more difficult to define in clinical terms, spiritual care is equally critical for compassionate hospice care. Many people become more religious or spiritual as they approach the end of their lives—even if they never considered themselves religious or spiritual in their youth.

Set your own beliefs aside, and facilitate any spiritual experience your patient is craving. That may require inviting non-traditional practitioners into your facility—welcome them with the same enthusiasm as your patient does and watch trust grow.

You’ll want to get answers—either directly or through a spiritual advisor—to these questions:

• Would you like to meet with a religious or spiritual leader before passing?
• How would you like your body to be handled before and after passing?
• Where would you like to pass away and who would you like to be surrounded by?

Keeping these preferences top of mind will enable you to provide genuinely compassionate hospice care and inspire peace during the time your patients have left in the physical world.

Coordinate and integrate ancillary and support services

You may not be qualified to assist the patient with their psychosocial and spiritual needs—and that’s okay. Patient-centered care requires integrating a variety of certified professionals to help hospice patients navigate these complex needs and preferences—within or outside of your organization—you are still helping to offer your patient the best care possible. Using a next-generation Care Management platform will help your care team connect and communicate with all the integrative specialists that bring your patients comfort and peace.

Supporting families of hospice patients

When you’re providing end-of-life care, you’re not just treating your patient—you’re caring for their family members and closest friends, who often feel helpless and unsure of how to help their loved one or each other. They also need psychosocial and bereavement care that helps them build resilience and a deeper connection with their loved ones.

Whether in a hospital, hospice care center, assisted living facility, or at home, it’s important that family members help make their loved one feel comfortable, dignified, heard, and loved. Feeling needed and useful is therapeutic, so providing tasks and roles for each family member can prevent them from feeling helpless and provide compassionate hospice care for all.

Here are some things that family members can do to help:

• Advocate for the hospice patient. Family members can learn to pay attention to body language that might indicate discomfort and promptly alert a care provider. They can inform the entire care team about their loved one’s lifelong comforts and preferences, bringing in items or sharing rituals or comforting habits.
• Assure the patient’s affairs are in order. Many people worry about what will happen to the people and things that are left behind when they pass away—including pets, plants, and prized possessions. Others are more concerned with funeral plans. Compassionate hospice care takes all wishes and visions of life celebrations into account and communicates them to all necessary parties (which is sometimes difficult or awkward for the patient to do).
• Make the space as comfortable as possible. Whether at home or in a facility, family members can help set up a hospital bed, rearrange the room to make more space or bring in more light, and place comforting photos and mementos, blankets, teas, or essential oils in view and accessible.
• Check on all family members. It’s critical for the primary caretaker of the hospice patient to practice self-care. Other family members and friends can facilitate this by alternating shifts, providing meals, and offering stress relief in any form the caretaker prefers.

Most importantly, family members need time to process their emotions and grieve in whatever way works for them. Compassionate hospice care plans also include bereavement care for grieving family members following the loss of a hospice patient.

Providing support for your employees

Hospice care is physically and emotionally exhausting. It’s crucial that care teams receive extensive training on patient care as well as team collaboration. Streamlined, efficient communication is key to effective, compassionate hospice care.

Educate hospice care team members

Every health aide and nurse needs to be trained to handle the intense situations they’ll encounter when caring for hospice patients. Build your team’s competency through training programs, resources, and techniques. Share case studies. Teach them how to discover and integrate their patients’ preferences into compassionate hospice care plans. Make sure they’re using a next-generation Care Management platform to hyper-communicate and keep every team member up-to-speed at all times.

Learn how to identify and treat compassion fatigue

To get the best care delivery care team, supervisors must take care of their staff—and be able to identify and treat compassion fatigue.

Compassion fatigue is burnout common among healthcare workers, but especially prevalent in hospice care teams. Prolonged exposure to trauma can cause care providers to suffer from acute symptoms that may put their physical and mental health at risk.

Compassion fatigue can impact job satisfaction and patient outcomes, and in some cases, can even lead to caretakers leaving healthcare permanently. Care supervisors should know how to identify compassion fatigue symptoms and intervene when necessary.

Symptoms of compassion fatigue

• Empathy imbalance: having too much or too little empathy can cause role confusion and disrupt the healthy connection between caretaker and patient.
• Diminished performance: occurs when the care provider has difficulty concentrating and can no longer provide the standard quality of care.
• Increased complaints: caretakers reporting physical exhaustion to the point they feel “sucked in” or “wrung out.”
• Inability to share emotions: difficulty enjoying life outside of work or sharing emotions and struggles at work with loved ones.

Improving hospice care with integrated technology

Every hospice patient is unique—so you should make sure their experience with you is, too. Welkin Health helps your team build, iterate, and perfect your Patient Relationship Management to make your team’s day run more smoothly by helping you:

Improve communication with centralized conversations

Welkin’s software redefines how patients and care teams interact by simplifying communication—which saves time and energy better spent building trust and delivering impeccable, compassionate hospice care.

Leverage team-first care delivery

To achieve a healthcare experience as unique as your care team, you need to deliver the right care at the right time — as hospice care is especially time-sensitive. Welkin knows it takes a village, so we enable you to curate a custom experience for every patient.

Enjoy intelligent workflows

Welkin allows you to create smoother processes for your team and to empower your clinicians to do more for patients by asking them to do less. Your clinicians will be able to build a workflow that pivots with the rapidly changing needs of hospice patients.

Create integrations

Welkin allows you to customize your platform to support your growth plans and build your own system that works with your existing and future systems. With leading integrated applications already built-in, as well as APIs, you can create programs that work as well for you now as they will when you grow — and nurture even more hospice patients and families.

Design without coding

Welkin’s single connected platform enables your team to build and fine-tune workflows to make your day run more smoothly. Our codeless program editor allows you to easily customize your program with no code or hassle — so you can spend more precious minutes with the patients who need your attention most.

Ensure platform security

Welkin takes security as seriously as hospice patients’ families do. With the help of leading third-party security organizations, we’ve implemented these technical, administrative, and physical safeguards to protect your data: SOC 2 Type 2 certification, HIPAA compliance, audit trail and security logs, flexible role-based, attribute-based, and geography/territory-based security permissions, and multi-factor authentication (MFA) or single sign-on (SSO) for added security.

Discover how a PRM like Welkin Health can help support your care team so you can deliver the most compassionate hospice care possible for your patients and their loved ones.