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Hospice in a Senior Care Environment

Everyone dies. There are no exceptions. But as an assisted living or skilled nursing facility, this happens more often. At these times, hospice can be a help. Here are some things that senior care professionals should know about hospice.

A Resident on Hospice Can Continue on in Your Facility

This especially pertains to memory care and assisted living facilities. If a resident, or more likely their family, chooses hospice, they, in all likelihood, can continue at your facility. Four states don’t allow hospice in an assisted living facility or community: Idaho, Mississippi, Montana, and North Dakota. The other states allow hospice in these facilities.

Hospice is not a place, however (although there are some hospice facilities). Hospice is best described as an approach to care, recognizing that the resident will pass within weeks or months.

It is likely that the resident has been with you for some time and considers your facility their home. Moving them in their final days only adds to their distress.

Most hospices come to your facility, assess the resident, and then set up a care schedule. If it is a hospice that you work with regularly, then they are likely at your facility daily, administering to more than one patient. The resident or their family can also indicate which hospice they would like to work with.

While your front-line staff still has responsibilities with the patient, the hospice staff is more concerned with treatments such as administering medications, sponge baths for patients who can’t get out of bed, preventing pressure ulcers, palliative care, and other duties. They can also help educate your staff on how to ease the patient’s final days.

If anything, hospice is a relief to most front-line staff. They have been taking care of the resident, often for years. They form relationships. It is distressing when they have to be with the patient in their final days. Hospice involves coordinating care and medications across all disciplines, including the resident’s doctors, hospice doctors, nurses, aides, chaplains, and facility staff.

Hospice personnel are trained specifically to work with patients approaching the end of life. This eliminates or minimizes readmissions to the hospital, an essential consideration for SNFs. Hospice staff are trained in areas such as administering high-flow oxygen, wound care, fluid management, detecting and treating urinary tract infections, and other challenges.

Hospice is Not Limited to Cancer Patients

Hospice care is available to any resident of an assisted living facility or memory care unit with a diagnosis of less than six months to live. This includes dementia patients, heart and liver disease, or other conditions. If the patient continues for longer than six months, that’s okay. Hospice can usually continue.

Medicare and Medicaid Pay for Hospice

After deciding to bring hospice in for the care of their loved one, families often inquire about the cost of the services. Medicare and Medicaid typically pay for hospice services. They don’t impact the family, and they don’t affect the payment your facility collects from those agencies, either.

Hospice often means hospital beds, oxygen, and new medications. All of those are covered by Medicare and Medicaid.

Hospice is Good for the Family, too

Hospice services include social workers that work with the family when obstacles are encountered, or things get tough. They are trained to help families make decisions and be part of the process, helping with care and other duties. These social workers also help families as they make final arrangements, try to negotiate through the maze of insurance and benefits, bereavement after death, and access to other resources.

Hospice Does not Hasten Death

There are concerns that hospice is giving up, that it accelerates death. Not true. In a study in the National Library of Medicine, of nearly 4,500 Medicare beneficiaries, hospice patients survived an average of 29 days longer than non-hospice patients. Remember, the goal of hospice is to maintain quality of life as much as possible and eliminate pain.

Having a Person with Hospice Experience on Your Staff Helps

In your ongoing effort to cultivate a staff at your facility with broad experience, look to include someone with a hospice background. Tell your HR department to pay particular attention to resumes that come in with hospice credentials. RNs, CNAs, and LPNs all have a role in the hospice environment. They are, by nature, compassionate people. More importantly, when a resident at one of your facilities, be it an AL, SNF, or memory care, gets to where they need hospice, someone with hospice experience on your staff can help guide the resident and more likely, their family, in their decision making.

“When my mother started to push away food and not want to get out of bed, I realized the end was getting near,” said one family member. “Still, I didn’t have the experience to make those decisions. When I learned that the health director had a hospice background, it was a great relief. She helped me figure out what to do.”

Working with Hospice

For many senior care professionals, this post doesn’t reveal anything you don’t already know about working with a hospice. For others, we hope that we’ve answered some questions. For the resident and family, it can be a difficult time. Still, if they are served by a senior care facility that knows how to work with hospice, the family may well remember their loved one’s passing as easier than they expected.

If you have a relationship with a hospice, cultivate it so you can provide your residents with the best care. If you are looking for an excellent hospice to work with, perhaps ask some you your colleagues in other facilities for their recommendation.


CareWork is dedicated to working with senior living and long-term care organizations to negotiate the many hurdles of doing business in today’s world. CareWork’s software platform pulls together all the data silos in your operations, whether you are an SNF or senior housing operator. CareWork allows leadership and management teams to see vital information and make the best decisions.

Whether it is how to work with hospice or how to collect and interpret the data from your facility, CareWork is here to help. Interested? Call us today or visit our website.

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