Hospice care can be a difficult job, but its importance is paramount. Giving people who are approaching the end of their life a comfortable, dignified way to pass is worthwhile work that is appreciated by both the patient and their loved ones. When every day could be your patient’s last, it’s crucial that your team is providing exemplary care at all times.
We are going to teach you some of the best ways to create a compassionate care environment for hospice patients that addresses their—and their loved ones’—physical, mental, and spiritual needs.
Provide hospice care services with compassion
End-of-life care can be a difficult time—both physically and mentally—for patients and their families. As healthcare providers, we have to prioritize treating the patient holistically and supporting their families as they deal with their emotions and grief. Fortunately, there are many ways that clinicians can treat patients with compassion throughout their time in hospice.
It’s worth noting that while a hospice program is traditionally just for treating patients who have a prognosis that gives them six months or less to live, palliative care providers can apply many of the tips outlined here for their patients, as well. While palliative care provides a bit more hope for patients and families than hospice care, the outcome of their diagnoses sometimes aligns with that of hospice care.
Offer physical comfort
Many hospice patients are facing death due to terminal illnesses and spending a large portion of their days in bed, which means they are likely experiencing a fair amount of discomfort. Experts believe that pain management and comfort should be a top priority for hospice care providers.
Clinicians can offer patients codeine, morphine, and other heavy-duty medications to prevent and manage pain and other symptoms, as the potential long-term negative effects of using serious prescription drugs is not a concern in this case.
Bedsores are caused by constant pressure on sensitive skin and can often be avoided by adjusting the patient’s position from one side to the other, or from their side to their back, every few hours. Keep a lookout for discolored patches of skin, as bed sores become darker as they form.
Doctors can prescribe different medications to manage nausea, vomiting, and constipation. Many people experience loss of appetite as they approach the end of their life, and some choose to stop eating entirely. You do not have to force patients to eat, as going without food and water is often less painful than the act of eating.
Some hospice patients may not be able to tell you when they are too hot or cold. Take note if a patient tries to remove their blanket or hunches their shoulders and starts to shiver—then adjust the temperature accordingly.
Address psychosocial and spiritual needs
When providing end-of-life treatment to a patient with your hospice services, there are many aspects of healing to consider that go well beyond physical bodily sensations. There can be fear of the unknown that follows death, thus a large portion of your whole-person, compassionate hospice care plan should include addressing a patient’s psychosocial and spiritual 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.” Essentially, psychosocial care is ensuring that all of the patient’s emotional and mental health needs are met rather than just physical.
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 they are going through as the patient reaches the end of their life. This may include helping the patient come to terms with their death; managing any anxiety, fear, or depressed thoughts that they are dealing with during their last few months; and addressing unresolved anger, resentment, or guilt between family members or friends.
It’s important to recognize that you may not be qualified to assist the patient through these psychosocial issues, and that’s okay. If you develop a database of trusted professionals who are certified to help hospice patients navigate these sometimes complex emotions—within or outside of your organization—you are still helping to offer your patient the best care possible.
While spiritual care can be more difficult to define, it refers to an equally important variety of compassionate care that should be offered to hospice patients. Many people become more religious or spiritual as they approach the end of their life—but whether or not a hospice patient considers themselves religious or spiritual does not alter the need for spiritual care.
Some questions that clinicians and caretakers can ask the patient include:
- Would you like to meet with a religious leader before your death?
- How would you like your body to be handled before and after death?
- Where would you like to pass away?
- Who would you like to have around you when you die?
These questions can help hospice care providers tailor their spiritual care to the patient’s specific needs and desires, ultimately bringing them peace and comfort during their final moments in the physical world.
Help the families of hospice patients
When you are providing end-of-life care, you’re not just treating the patient—you’re treating their family members, too. Families of hospice patients often feel helpless and might not be quite sure of how to help their loved one or each other. As a hospice care provider, you have the ability to support family members in their own psychosocial and bereavement care, as well.
Whether the hospice patient is being cared for in a hospital, hospice care center, assisted living facility, or at home, it’s important that family members learn how to make their loved one feel comfortable and dignified. This helps the patient feel loved and cared for at the end of their life, but it is also extremely therapeutic for the family member to feel needed and useful in a situation that can otherwise make them feel quite helpless.
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 their loved one is uncomfortable in any way and promptly let a care provider know.
- Assure the patient that all of their 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, or funeral plans. Caretakers can reassure their loved one that they have nothing to worry about.
- Make the space as comfortable as possible. If the patient has chosen to spend their time left at home, this can mean the home health aide helps arrange for a hospital bed to be set up in their bedroom, rearranging things to prevent them from falling, and adding extra lighting—such as night-lights. If the patient is receiving hospice care in a space other than their home, family members can bring nostalgic and comforting items from home, such as a blanket, photos, or essential oils of their favorite scents.
- Check on other family members—especially the primary caretaker. It’s important to make sure the people who are caring for the hospice patient are also finding time to care for themselves. Encourage the main care person to alternate shifts with other family members.
Most importantly, family members should make sure they are giving themselves time to process their emotions and grieve. A good hospice care plan should include a bereavement care program for grieving family members following the loss of a hospice patient.
Provide support for your employees
Hospice care is a very important job, but it’s also a very emotionally exhausting one. It’s crucial that care teams receive extensive training to properly care for patients and to work well with each other, too. Streamlined, efficient communication is key for effectiveness.
Educate hospice care team members
Proper training is key to an educated hospice care team—health aides and nurses need to know how to handle the intense, everyday situations they will encounter when caring for patients. Build your team’s competency through training programs to educate them with the optimal resources and techniques to integrate into their patients’ hospice care plans. Make sure that they know how to hyper-communicate to ensure that every team member is up-to-speed on any given patient at any given time in order to provide consistently exemplary care.
Learn how to identify and treat compassion fatigue
It’s important that care supervisors are taking care of their staff so they can do their job well. This includes being able to identify and treat compassion fatigue.
Compassion fatigue is work burnout commonly experienced by healthcare workers and is especially prevalent in hospice care teams. Having prolonged exposure to other people’s 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 the symptoms of compassion fatigue and intervene when necessary.
Symptoms of compassion fatigue
- Empathy imbalance: having too much or too little empathy, to the point where role confusion or a poor connection between caretaker and patient occurs.
- Diminished performance: the care provider has difficulty concentrating or providing the same quality of care they did before.
- Increased complaints: experiencing physical exhaustion to the point where they describe feelings of being “sucked in” or “wrung out.”
- Inability to share about suffering: having difficulty enjoying life outside of work or sharing their emotions and struggles at work with loved ones.
Utilize integrated technology to improve hospice care
Great communication is crucial to a hospice care team’s success. With a Patient Relationship Management software program, team members can streamline communication and store patient information in one place to make sure everyone is up-to-date.
This continuity eliminates bottlenecks and mistakes and ensures that the patient and their family are getting the best care possible—no matter who is working with them directly on any given day.
Discover how a PRM like Welkin Health can help support your hospice care team so you can deliver the best quality of life to patients and their loved ones.