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Hospice nurses perform many traditional nursing duties such as observing, assessing, and recording symptoms, and they still work closely with physicians, administer medications, and provide emotional support. Hospice nurses have a particularly tough job because, from the outset, they know that the patient for whom they are caring is terminally ill. The medications that hospice nurses administer and the symptoms they record aren’t intended to aid a patient in his or her recovery, but rather to make his or her remaining days as comfortable as possible. Most of the nurse’s duties involve minimizing pain. Although being a nurse of any kind is very difficult, dealing every day with a dying person requires an exceptional temperament, one that embodies great caring, patience, and resolve. Hospice care is what is known as comprehensive palliative medical care, i.e., treatment to reduce pain and other troubling symptoms as opposed to treatment to cure. The hospice doctrine states that terminally ill patients have the right to spend their last days in the comfort of their own homes, with their families, and hospice care provides professional medical care as well as supportive social, emotional, and spiritual services to accomplish this. The hospice nurse’s duties fall somewhere in between all of these ideals, with emphasis on medical care. Because they essentially act as home-care nurses and spend several hours a day with their patients in their homes, they become emotional caretakers as well. The majority of hospice patients have cancer, but others suffer from AIDS, Lou Gehrig’s disease, heart or lung disease, and other fatal conditions. Patients can be any age, race, or creed, and it can be especially trying on hospice nurses to attend patients who are as young, or younger, than they are. Hospice nurses coordinate the care of every hospice patient through an advising physician, provide direct patient care, evaluate the patients’ conditions, and serve as the liaison between families and physicians. A hospice nurse may also work with a patient’s social worker, home-care aide (who may do housework and provide hygienic care to a patient who is incapable of bathing and caring for him- or herself ), and physical, occupational, or speech therapist.
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The note by suethequilter reminds us all that we as caregivers should have lots of lists readily accessible at any time. Listing specifics (as many pertinent ones as possible) is very important, not only for continuity of care in a caregiver's expected OR unexpected absence; but also it is extremely important for the safety of the person being cared for. We need to be sure to include physicians' full names, phone numbers, insurance numbers, hospital system being utilized, all food, chemical (Latex, tape, cleaners, etc.), and medication allergies of the person you're caring for. Include lists of alternate caregivers and other contacts/family members, etc. Make sure everyone is aware of POA/Guardianship paperwork and list back-ups' contact numbers as well. And tell backups ahead of time if you know you are going to be unavailable for an extended period. Keep a copy of DNR papers (if applicable) visible. (It's often recommended in my area to keep DNR papers taped to the fridge.) Do not keep old meds and do not move meds from one bottle to another. Keep a medication record too noting when each medication is taken, or not. And note specifically whenever a med is started, stopped, if the dosage was changed, and if the person you're caring for had any side effects or adverse reactions to any meds. There's no need to be fancy. Many people just use an ordinary steno pad. Keep records current at all times though, including any necessary notes regarding vital signs, changes in behaviors, increasing forgetfulness, confusion, paranoia, and or hallucinations, signs or symptoms of any recent physical changes, congestion, swelling, drainage, pains, falls, skin changes, changes in ability to and/or hours of sleep, changes in intake and output including any emesis and bowel movements---yes, keep a running written note of all of this info. Call the doctor's office or 911 as necessary. And if everything's in order, you or anyone can grab it and go informed---to the hospital or wherever necessary at any time. I would recommend to any caregiver to also keep information readily accessible regarding signs of a heart attack, choking, or stroke, and what to do if/when you do think someone is showing those signs. Of course you should know ahead of time when you can and SHOULD CALL 911. The above described lists of information would be helpful to one's physician when being seen routinely as well. I hope you find this helpful.
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For anyone who is in a situation where you must have a caregiver coming into your home, there is something that is really important that you do for your loved one. Because they are in a situation where a stranger could suddenly show up, you need to leave something, in writing, to hep the caregiver know what is going on typically in your house. My mother has aphasia and is unable to communicate any info about herself to a caregivers, So I have written town her typical schedule. What she likes on TV and what she hates, What she typical eats, foods she hates. There is a page with essential medical info that will need to be handy to EMS worked if they need to call them. Directions to our house and our physical address....evn with E911 you never know. There'S a page about what she likes to do and is able to do for herself what she needs help with.

Consistently every caregiver who comes to the house has thanked me profusely for doing this for them.
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We have had numerous caregivers through two different agencies. I despise the whole caregiving system. We only have a caregiver in 4 hours a week. It is obvious we are at the bottom, then, of the caregiver agencies priority list. Which means you are likely to basically get the live body they have available in an emergency whether they are a fit with your loved one or not. You are getting people who are working for minimum wage and aren't necessarily the sharpest tack in the box.

I f you go through an agency to find care it is important that you understand that some of their workers will only stay for a week at a time. Others only work weekends, some only work nights, some only days. If you think about it you will quickly realize this can cause you to have a stream of people changing over care over the course of several days if you aren't routinely having one caregiver for several days at a time.

At the same time I realize that is just the way it works. There is a HUGE advantage to having a caregiver associated with an agency....there is always going to be someone available in an emergency situation. And we have had to draw on that twice. One year when we were on vacation I had a backup person lined up for my backup person for the person who was staying with mom. All those were trusted friends and not through an agency. Each one had an emergency situation come up after they showed up to take over for the person before who had had an emergency! Incredible! Our final backup was for our son to call the care agency who immediately sent in a total stranger to wake mom up and stay with her for a week. That time it turned out great.

Another time my husband was having surgery in another town, which required that we be away for 3 days. However as we were literally ready to leave the hospital room to go home, another problem was discovered that required him to go back to surgery the next day and an additional 2 day stay in hospital. Thankfuly all that was needed was a call to the agency and they cleared that particular caregivers schedule to let her continue to stay with mom.

I mention all of this to say that even if you hire a person privately to stay with you loved one, you need to have a back up plan or two in place in case something happens. Life throws everyone curve balls. That includes the faithful reliable cagiver....illness and family deaths can happen to them while they are with your loved one,
Dell
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What luvmydad said. Before I was in charge of Mother's care, she and her husband had caregivers from Home Instead. Great companions and attention. High end:)
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I was a special ed teacher for many years and was able to meet so many parents, aunts, and family members who were natural caregivers. Many of my students indicated that they would grow to share the same skills. When/if my mother needs a caregiver, I have a list of people to contact. I would suggest that you talk to teachers in your community who know of substitute teachers, parents, or adult students who can help you.Of course, there are more formal methods of obtaining a caregiver, and if I did not live in a small town I would probably use one of those methods.
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Check out your county's website for seniors. A social worker gave me a catalog of senior services for my county. I also googled in home health care. I chose Home Instead which I believe is a national company. All workers are drug tested, a criminal & background check is done & they are licensed & bonded. Today was the first day. We actually stayed home for about an hour to make sure we were comfortable that this person. My dad loved her! He talked & talked & Dawn play card games with him. Dad has Alzheimer's & dementia. Meanwhile my husband & I went out for coffee & did some shopping. It was heaven. We are all looking forward to next week. The agency gave me a list of all the things the caregiver could do. God luck to you!
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Correction to above post: I misspoke. My Mother IS in the care home again.
So, actually, the three caregivers I had came from 3 different sources and they were all excellent, caring, professional. Good Luck, again.
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It depends on how much you want to pay. There are online services where caregivers register. You can email them then meet them to interview them and ask for references, then USE the references. I found our best care giver in the Penny Saver, although I would not recommend that source as #1 in general. I found 2 great , If you are looking to place your Mother there are free services as a place for mom, but they charge a fee and only show you the places that are contracted with them. That can be good, or not. I used that service 4 years ago to find a good residential care home. After a year and a half, I thought I could do a better job in my home, which is when I hired the caregivers I mentioned. Mother is not back in same care home, as her condition ( and MINE) progressed to a place where I could not do it myself, even with help. Additionally, I prayed a lot and trusted God.
Know what you want, ask the right questions, supervise everyone like a hawk, which is easier to do in your own home. All the Best.
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I have never gone through a company and so far, I've been blessed with compassionate and conscientious caregivers. I contacted our local Aging office for referrals; contacted the Nursing Department at our local university; hired someone found on Care.com. I think it's important to look in the places that people will be found who have a willingness to help the elderly. For instance, I'd never advertise in our local newspaper because all kinds of people would apply that would not be a fit.
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