The hospice care team comprises a full complement of professionals who attend to the physical, emotional, and spiritual wellbeing of the patient and their family. The hospice team works with the patient and family to create a plan of care that outlines the actions and goals of the patient’s individualized care. For most patients and their caregivers, a huge bonus is that members of this team visit the patient rather than the patient having to go to a doctor’s office or clinic.
Visits by team members are based on the patient and their family’s needs as outlined in the care plan and medical situations that arise during the course of the illness. The frequency of volunteer and spiritual care visits is often dependent upon the availability of these services. Travel requirements and other factors may cause some variation in how many individuals each hospice staff serves.
Members of the hospice care team and their duties are:
The hospice doctor works with the patient’s personal physician to develop a treatment and care plan.
Registered Nurse or Nurse Practitioner
A hospice nurse (RN) or nurse practitioner is assigned to the patient to assist with pain and symptom control and to monitor the patient’s changing needs. For those receiving hospice care at home or in a care facility, the hospice nurse visits at least once a week and more often if needed. A hospice nurse is on call 24 hours a day, seven days a week, to give the patient and their family support and assistance whenever needed.
Home Health Aide
A certified home health aide or licensed vocational nurse (LVN) visits the patient two or three times a week to take vital signs (blood pressure, temperature) and assist with bathing and personal care.
A hospice social worker provides emotional support and counseling for patients and families as well as providing information about other community resources.
Many hospices have a dietitian on staff to provide patients and families with nutritional counseling, as needed.
Physical and Occupational Therapists
If ordered by the patient’s physician, physical and occupational therapy services to manage symptoms related to the terminal illness are provided through arrangements with contracted agencies or individuals.
Speech-language pathology is a specialty focusing on the evaluation and treatment of communication disorders, voice disorders, and swallowing disorders, which often occur following stroke or are the result of neurological or other diseases. Speech-language pathology therapy services are provided through arrangements with contracted agencies or individuals to manage symptoms related to the terminal illness if ordered by a physician.
The hospice chaplain can be a minister of any faith, and his or her goal is to provide spiritual consolation and guidance to the patient, their families, caregivers, community, and to the hospice team, as requested. The hospice chaplain typically visits the patient within a week of the initiation of hospice care to complete a spiritual assessment and respond to spiritual requests from the patient. The chaplain also meets with family and caregivers to assess their needs and concerns. The participation of a chaplain in the treatment plan is entirely up to the patient and caregiver(s).
Grief and Bereavement Counselor
Hospice grief and bereavement counselors provide support and counseling to patients, families, and caregivers, as needed. Support groups and classes are also offered for adults, teens, and children. Families have access to grief counseling and bereavement support for 13 months following a patient’s death.
The types of support provided to patients and their loved ones by hospice volunteers include running errands, preparing light meals, sitting with the hospice patient when caretakers need or want to take time for themselves, and lending emotional support and companionship to patients and their loved ones. Volunteer schedules are arranged as requested by patient and family.
Every hospice program has some type of application and interview process to assure the volunteer is right for this type of work. In addition, hospice programs have an organized training program for volunteers. Topics covered by these training programs include a description of the purpose and function of hospice, the need for confidentiality, working with families, listening skills, recognizing signs and symptoms of approaching death, and loss, grief, and bereavement support.