This may sound dumb, but a hospice is the last place a patient goes...

[Spikey9001, BSN, RN]

Right?

Like when they're too sick to be in LTC, they go to a hospice to pass away right? How are the similar and different from LTC facilities?

[LPN_2005/RN_10]

Some LTC facilities have hospice residents that stay there until they pass away. There were a few residents I've taken care of that was followed by a hospice agency. There will be a nursing assistant that will come to the LTC facility to do bathe the resident every morning, and the nurse will come do an assessment on certain days. We will also contact the on-call nurse who comes to the LTC facility to pronounce the resident's death.

So, I guess it depends on the LTC facility--> if they are able to take care of end of life residents. But some residents will need aggressive pain control as well as control of other symptoms such as nausea/vomiting, itching, constipation, ect-->so the resident may transfer to a hospice facility to aggressively control those above symptoms.

[patsysparksrnchpn]

Hospice is not necessarily a place, hospice is wherever the patient resides, be it home, LTC or ALF. For symptom management, a patient can go to a hospice house or have continuous care at their place of residence.

[Leda1st]

Hospice is not (necessarily) a PLACE, but rather a type of nursing / service. To qualify for hospice, a patient must have a life expectancy of less than 6 months (there are specific guidelines/ways to determine this, but I won't get into that). The difference between "regular" nursing and hospice nursing is, in my opinion, the ultimate GOAL for the patient. In most areas of nursing, the goal is to "cure" the patient. In hospice, the goal is instead to make sure the patient is comfortable and is able to have the best QUALITY of life they can for the last part of their life. So, instead of attempting to "cure" the person by treating the "disease", the hospice team treats/manages the SYMPTOMS caused by the disease.

Hospice care can be provided wherever a person lives - be it at home, assisted living, a nursing home, or wherever. A "hospice house" usually provides care to patients on hospice whose symtoms (for whatever reason) can't be effectively managed where they live, or to patients who are dying and don't want to die at home (but don't want to die in a hospital "hooked up to machines" either).

This is a very basic explanation, and doesn't begin to describe all the things hospice does to help patients at the end of life have good quality of life. But, I hope it helps clear things up a bit.

[UFEDRN]

I've had patients on Hospice who have actually been discharged from our services because they've gotten better...or no longer meet our criteria (life expectancy of 6 months or less.)

[nursel56]

Hospice is not necessarily a place, hospice is wherever the patient resides, be it home, LTC or ALF. For symptom management, a patient can go to a hospice house or have continuous care at their place of residence.

You can even have hospice care while you are still at the acute-care hospital. My mom did. Not sure how that worked out administratively as I wasn't concerned too much with it at the time for obvious reasons -but the hospice nurse checked vital signs and assessed need for atropine or the like. I'm pretty sure it was the hospital-employed nurse who managed the morphine drip, though.

Rules for hospice are less restrictive than they used to be. Some people think you wouldn't treat anything that cropped up during the weeks there, such as pneumonia, but they do.

[hugadoggieRN]

Okay, here's the way the medicare hospice benifit (gold standard which hospice must obay) works:

their are nurses, social workers, CNA's, MD's, Chaplins, volunteers and others who form this team that works on behalf of the pt and their families.

the team goes to

1. a patient's home (hospice provides: some medicines, a hospital bed, oxygen etc... and a lot of TLC)

2. a nursing home (a version of the patient's home where the family/medicaid pay the room and board like in a home or a place where the patient goes so the family can get rest (respite) benefit for a few days where the hospice pays the bill)

4. a hospice inpatient center -- "goes to hospice place" (hospice picks up the cost at the center for helping with out of controll pain or other simptom)

5. a hospital (where the hospice picks up the cost and the pt. is managed to get them comfortable not for life saving endeavors)

does that help anyone?

[tewdles, RN]

You can even have hospice care while you are still at the acute-care hospital. My mom did. Not sure how that worked out administratively as I wasn't concerned too much with it at the time for obvious reasons -but the hospice nurse checked vital signs and assessed need for atropine or the like. I'm pretty sure it was the hospital-employed nurse who managed the morphine drip, though.

Rules for hospice are less restrictive than they used to be. Some people think you wouldn't treat anything that cropped up during the weeks there, such as pneumonia, but they do.

It is very likely that the hospice case nurse was coordinating all of the plan of care in the hospital, and the floor/unit nurses were facilitating the orders of the hospice team. If we are cleared to practice nursing in that health system we can do everything except get meds out of the pyxis in most cases. I often had multiple patients on different floors in the same hospital...I had pyxis clearance on none. I often thought that I should have the same clearance as a "float" RN but my management was narrow minded and really didn't understand what I did...

[evolvingrn, BSN, RN]

If your talking about a hospice inpatient unit...........we are very different from LTC. Everyone there is having acute symptoms managed, some are actively dying but many leave our facility to go back home or to a long term facility. We are acute care. Its a common misconception that you 'can stay there until you die" a lot of hospitals make that promise before transferring pts to our facility thinking their pts only have a few days, but once pain is properly controlled people can rebound and then family are shocked when we have to transfer them to ltc once we get their symptoms mananaged. We are basically a hospital. the main issues we deal with are pain, dyspnea, nausea but we see almost everything.