Hospice in LTC

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Quick question, folks. Do you Hospice nurses have many LTC residents? I had done a paper in school for HealthCare Policy, where research showed an underuse of Hospice in LTC. Can anyone shed some light on the subject (if you can)?

Suebird :p

Hi Suebird, In the LTC that I work we average 4 Hospice pts at a time. My Administator thinks that we don't need Hospice because we do the same care. I think that Hospice care in LTC is a benefit for all. Although I find that often we call Hospice in to late in the game.

hi suebird, in the ltc that i work we average 4 hospice pts at a time. my administator thinks that we don't need hospice because we do the same care. i think that hospice care in ltc is a benefit for all. although i find that often we call hospice in to late in the game.

dang, fellow bird! i have found that family is often resistant to hospice care... i do believe that hospice gives "a little extra". mind you, i am sure you and i try to do our best, but we can't always do it. any ideas?

suebird :p

dang, fellow bird! i have found that family is often resistant to hospice care... i do believe that hospice gives "a little extra". mind you, i am sure you and i try to do our best, but we can't always do it. any ideas?

suebird :p

i believe that hospice in ltc is a great opportunity for us. the facility should be treated like part of thefamily and our team should be an extenuation of their team (and visa versa.) if we get to a place in a facility where the team has a good relationship with their staff then it works really well and we provide them with a great deal more than they would have alone. the point is to offer them support and to make their jobs easier. we offer inservices in our facilities on how to talk to families about hospice and this seems to help get the families on board....but definitely there is an underuse of hospice in this setting. i think that i read a study that stated about 10% of residents in facilities are appropriate for hospice. it is very rare to see that many patients in a facility, but it does happpen.

Since we are both believers in Hospice care might I suggest that you request from management that Hospice come in and in-service your nurses on what they offer. This would at least be a good beginning.

bird....our admin and don are all for hospice. there was one family whose loved one could reeaallly have used hospice, but the family was reisitant, etc. not sure what happened, but all hospice referrals/suggestions have to come from "top brass" because of this particular rezzie.

we do have a yearly "rememberance" program from one of the 2 hospices we have. is very nice.

sueb :p

While we have quite a few patients in the area's long term care facilities, this continues to be an underserved population. There are many barriers, ranging from misconceptions about duplication of service to a financial disincentive for those who also can qualify for Medicare skilled days. Usage varies widely between facilities. A DON and Administrator who are knowledgable and appreciative of hospice go a long way toward creating productive working relationships. Hospice utilization falls when administration is turning over more than once a year.

I think the usual statistics are that approximately 25% of nursing home residents die each year...so you could extrapolate that about 12.5% would have 6 months left to live. Therefore the 10% number sounds like a reasonable estimate. I am sure we have never come close to that percentage anywhere.

Specializes in Hospice, ER, Telemetry.

Actually, only 3% of ALL patients (including those in LTCF) that are hospice eligible, ever utilize hospice services!! Sad statistic huh?? Sounds like we need more education all the way around.

Specializes in Geriatrics.
Actually, only 3% of ALL patients (including those in LTCF) that are hospice eligible, ever utilize hospice services!! Sad statistic huh?? Sounds like we need more education all the way around.

I couldn't agree more! I don't think that people realize all that hospice offers. I never knew until we had a hospice nurse come in to speak to our class that they will take you even if you can't pay for their services. i also agree though that we (in the LTCF) often wait too long to call hospice in. I think there should be more hospice education all around...for the public as well as health care workers!!

I couldn't agree more! I don't think that people realize all that hospice offers. I never knew until we had a hospice nurse come in to speak to our class that they will take you even if you can't pay for their services. i also agree though that we (in the LTCF) often wait too long to call hospice in. I think there should be more hospice education all around...for the public as well as health care workers!!

Just out of curiosity, was this a non profit or for profit agency that came in? I realize that both will see unfunded patients but it would surprise me if a for profit announced it.

Specializes in Hospice, ER, Telemetry.

What's funny about the for-profit vs not-for-profit hospice debate is that all hospices, regardles of their profit status, are paid the same reimbursement rate by medicare; therefore, it stands to reason that ALL hospices potentially make a profit. I have worked for both types of agencies and I have to say in all honesty that my patients at the for profit hospice receive better care because we can provide more for them. We also accept indigent patients because it is the morally correct thing to do. I'm not saying all for-profit agencies do so, I'm simply stating that the one I'm currently employeed by does.

I couldn't agree more! I don't think that people realize all that hospice offers. I never knew until we had a hospice nurse come in to speak to our class that they will take you even if you can't pay for their services. i also agree though that we (in the LTCF) often wait too long to call hospice in. I think there should be more hospice education all around...for the public as well as health care workers!!

Yes, Yes Yes! The biggest barrier I have is getting the family and docs on board for this. A lot of them feel that hospice is only good for when death is really soon. Ugh, bang head on wall.

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