When a loved one is terminally ill, finding the right amount of care for them can be difficult. Family caregivers try their best to be there for their loved ones, but they may not have the skills or time to provide necessary care, particularly during times of increased need or crisis. Continuous hospice care, or 24-hour hospice care, is provided in a patient’s home for the short-term management of severe symptoms.
The levels of hospice care
Hospice care is prescribed when your loved one's doctor certifies they have an estimated life expectancy of six months or less. Hospice's primary goal is to ensure your loved one’s comfort and maintain their quality of life instead of curing their illness.
There are four levels of hospice care that can be used to support a patient at all steps of their end-of-life journey.
- Routine care is the most common level of hospice care. At this level, members of the hospice team visit the patient's home regularly to help manage symptoms and are on-call 24/7 to advise and assist as needed.
- General inpatient care can be provided in a hospital, skilled nursing facility, or specialized hospice house.
- Respite care is temporary care provided in a nursing home or other inpatient environment to allow family caregivers time off from caregiving duties.
- Continuous home care also takes place in the patient’s home, but it involves consistent support for eight to 24 hours a day to help during periods of crisis. This care becomes necessary when symptoms increase in severity.
Who needs 24-hour hospice care at home?
A person may need continuous hospice care if they’re experiencing acute symptoms but want to avoid a hospital stay. Patients may need 24-hour support from hospice professionals to manage end-of-life symptoms such as the following:
- Breathing difficulties
- Agitation and anxiety
- Uncontrolled pain
- Change in consciousness
- Nausea and vomiting
Continuous care services predominantly address medical needs and are provided by medical professionals, including nurses. Families can also receive help with decision making and bereavement counseling.
How can in-home care supplement hospice care?
Family caregivers who use hospice and in-home care services together receive extra hands-on assistance while their loved ones receive the medical and personal care they need to be as comfortable and supported as possible.
Nonmedical in-home care services can help people living with a terminal illness and their families through lifestyle support. In-home care professionals handle household tasks that hospice care professionals do not, including light housekeeping, transportation, and assistance with activities of daily living. Even with hospice services, the bulk of a loved one’s daily care falls to family caregivers. Home care services can be beneficial because they alleviate caregiver stress and minimize daily responsibilities.
With this extra help, family caregivers can spend more meaningful time with their loved ones doing things they enjoy rather than having to dedicate a large amount of time to care tasks.
When hospice care at home is not enough
While continuous hospice services are important for end-of-life care, hospice organizations can’t provide 24-hour care at home for the full hospice term. As a patient nears the end of life, they can experience more discomfort and may need round-the-clock care in an institutional setting. If this happens, your loved one’s hospice team or primary care doctor might recommend alternative end-of-life care options like inpatient hospice care.
Providing adequate end-of-life care for a loved one can be physically and emotionally difficult. The AgingCare Caregiver Forum offers family caregivers a space to ask questions, discuss options, and seek advice and support from others navigating similar circumstances.
Reviewed by Todd Austin, President and COO of Home Care Pulse.
Sources:
Hospice levels of care (https://www.medicare.gov/care-compare/resources/hospice/levels-of-care)
Hospice FAQs (https://www.nhpco.org/hospice-care-overview/hospice-faqs/)