crisis care

Had my first crisis care pt myself on Monday. Think it depends on the hospice but from the little I saw they are there to provide comfort/assist when needed. Although honestly I'm not sure what the ones who came for my pt did specifically. I know the CNA they sent for the day had tried to feed her, and the nurse for the night did help me hold her head up so I could give the pts medication. It didn't seem too involved. But not too much you can do for a DNR pt who is actively dying besides provide comfort and support.

I believe the real purpose is to have someone at the bedside more frequently than what you are capable of doing with multiple patient assignments.

Crisis care or continuous care usually means that a hospice staff member will be bedside around the clock. It means patient is in active death. One of the most important reasons hospice exists is so that nobody ever dies alone. Also that symptom relief can be immediate with 1:1 care. If in an LTC, the LTC staff have many, many other patients to care for, often this means many people die alone. If hospice is involved, decline is noticed often subtle changes, and the family can be alerted to come to visit, often flying in -- all that needs arranging and is a lot of work. If in the home, the same stuff goes on, and the family will want to gather, also, this is the time that the family needs hospice at bedside for questions and help the most. Some hospices use LPNs or RNs at this time, some use any staff, could be a CNA as well if in a LTC where meds can be passed by facility staff. The biggest reason is to have someone there, to gather family, for the patient not to go it alone.

Some hospices have changed the term "continuous" care to "crisis" care for greater clarity for the families as to what this service entails. Crisis care is clearer that this is a short term service with a specific goal; i.e. to control a specific problem or in the last (up to) 72 hours of life. Continuous care sometimes led the families to believe that this was an on-going service of 1:1 care until the patient died and families became angry when the symptom was managed and 1:1 service was discontinued. It just helps families to maintain realistic expectations of what services are available.