Hospice vs. In-home. What's the difference?

[nurse_wannabe]

Hi. I am an in-home LPN & have a question about hospice nursing. What care do hospice nurses provide that cannot be provided by an in-home nurse?

The reason I am asking is that I currently have a client & am considering referring her to hospice care, but I don't know if she would benefit from it.

She has been given approx. 6 months to live due to renal failure & CHF.

My main duty & the reason that I'm there is to set up her meds weekly. I can only go once per week. However, I find it impossible to perform my duties b/c she is constantly in & out of the hospital. Every time she goes in the hospital, she gives them incorrect meds. They then base her care in the hospital on those incorrect meds, & d/c her with instructions for the meds that weren't right in the first place.

She has 4 different pharmacies & has no clue what she's supposed to be on. Every time I think I have her orders straightened out, she goes into the hospital & gives them the wrong meds & everything is all screwed up again. At this point, I honestly have no idea what she is supposed to be on b/c she's been d/c'd from the hospital 4 or 5 times in the past 2 months & the meds keep getting changed around based on incorrect info that she has given them.

This client is really stressing me out. I'm spending hours at her house every week trying to get things straightened out & organized & only make $18 b/c it's a flat rate no matter how long it takes.

Do you think a hospice nurse would be better suited to care for her?

Thank you all for reading.

[caliotter3]

Yes. Continuity of care. The hospice nurse supposedly would be able to have longer or more frequent visits, and just plain would have an easier time keeping up with the situation. Maybe she could communicate with the hospital whenever this person goes in, fax them a med profile, etc. That is what you should do. Make a med profile if there isn't already one done. Fax or hand carry the document to the hospital or admitting doctor or whoever whenever she goes in. I can't see why the hospital would not accept this info from you in your official capacity. Good luck with this.

[Hospice Nurse LPN, BSN, RN]

I'm wondering why she's is the hospital so much? Symptom control, pain, or whatever a hospice would be able (usually) to handle at home. The hospice nurse could visit more often than 1x/week plus the CNA visits, MSW, Chaplain, and volunteers. Is her doc open to a hospice consult?

The med profile is a good idea. All of our home pts have one which is updated PRN. Sounds like you have your hands full with this pt. Good luck!