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Differences Between Hospice and
Other Care Alternatives
In the years since the development of
hospice care in the United States, some health care providers have
questioned how hospice differs from that which has traditionally been
available to terminally ill patients, i.e., hospitalization, long term
care, and/or home care. This question has been particularly
relevant within the home health industry. The major differences
can be summarized as follows:
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Hospice provides central case
management and continuity across both home and inpatient care
settings.
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Hospice utilizes an interdisciplinary
team model of care with physician direction of the team and
regular meetings and participation of all providers involved in the
care, including volunteers. This team is involved in all aspects
of care planning and revisions, direct care, and monitoring.
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Hospice offers additional services not
traditionally offered. These include the utilization of
volunteers in both direct services and support capacities, bereavement
follow-up, additional social services such as support groups and
family counseling, spiritual care, more integral involvement with the
patient's personal physician, medical direction and consultation for
the attending physician, as well as offering broader services in the
more traditional categories (e.g., longer nursing visits, continuous
care capability, respite care, etc.).
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Hospice focuses on both the family and
the patient as the unit of care.
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Hospice makes its services available on
a 24-hour, 7-day-a-week basis. These include, at a minimum,
nursing and physician contacts with visit capability; prescription
drugs and biologicals; medical supplies and equipment; and inpatient
admission capability. In addition, off-hours on-call staff are
familiar with the patients and care plans, can coordinate closely with
other members of the hospice interdisciplinary team, and can establish
procedures for communication and reporting.
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Hospice offers inpatient care
components in which care is directed, managed, and coordinated by
hospice personnel.
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Hospice medical records are
comprehensive and reflective of the full range of problems, services,
level of care, and care planning across care settings.
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Hospice interdisciplinary team members
are specially trained in palliative care techniques and intervention
with terminally ill patients and their families. Hospice
team members also generally receive special supervision and internal
support programs geared towards alleviating the unique stresses
inherent in work with the dying.
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Hospice offers unique programs for
volunteers who in turn are carefully screened, selected, trained,
and supervised to perform a wide variety of direct service and
supportive functions for hospice patient, families, and the program in
general.
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Care plans are comprehensive and
reflect the combined physical, sociological, emotional, educational,
and spiritual needs of the patient and family.
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