Blog - Page 21 - Compassion Crossing

Compassion Crossing, LLC

Guiding Life's Journey with Care

Compassion Crossing, LLC

Guiding Life's Journey with Care

What Does Hospice in a Home Setting Look Like?

About Hospice, Hospice

wife comforting her terminally ill husband

Caring for a terminally ill loved one can be challenging. Still, with the proper support and understanding, you can help ensure they experience a comfortable and dignified end of life. Hospice care offers specialized medical and emotional support during this time. This guide aims to empower families new to hospice services by providing essential information on what to expect from a hospice provider and how to manage the journey towards a good death.

Educating Facility Staff on What Matters for Terminally Ill Patients

Hospice, Nurse Skills, Tips and Tricks, Tips For Nurses

Educating nursing home staff on hospice care priorities like shifting focus from vital signs to comfort, managing symptoms like pain/breathlessness, providing psychosocial support, end-of-life planning, and bereavement care is crucial. Hospice emphasizes quality of life over curative treatments. Effective symptom management through medications and non-pharmacological approaches enhances patient comfort. Open communication, empathy, and respecting patient autonomy are essential. Hospice prepares families for the dying process and grief counseling.

The Life of Least Regrets

About Hospice, Caregiving Tips, Hospice, Terminal Illness, Tips and Tricks, Tips For Nurses

The longer I work in hospice, the more I'm reminded about two critical pieces of wisdom: 1) Hospice is about living, and 2) we should all do our best to live a life of least regrets.

While this article is geared towards family members with a terminally ill loved one, as well as my fellow workers in the fields of palliative and hospice care, I believe the thoughts that I will share apply to everyone alive near and far.

Review of the Hospice Documentation Master Bundle

Best Practice, Compliance, Documentation, Hospice, Hospice Care Team, Hospice Eligibility, Nurse Skills, Tips and Tricks, Tips For Nurses

Whether you are a new hospice nurse or an experienced one like me, I would hope that it is your desire to prove and support continued hospice eligibility for your patients and families. In my years as a hospice nurse, I've always felt the training on what words and phrases to use to support hospice eligibility was weak compared to the training received in other areas of nursing. Now, you have a means of getting the education you need in a very portable setup that you can take with you, use as you see fit, and bloom!

Tube Feeding on Hospice — Increased Risk of Your Loved One Suffering

Artificial Hydration, Artificial Nutrition, Death and Dying, End of Life, Hospice, Nutrition, Nutrition At End Of Life, Palliative Care, Terminal Illness, Tube Feeding

Considering tube feeding for a loved one in hospice? This intervention may not improve quality of life and can lead to discomfort, reduced mobility, and complications. Learn about the risks and make informed decisions for their end-of-life care.

The Ins and Outs of Hospice Patients Seeing Their Regular Doctor and Specialists

About Hospice, Caregiving Tips, Hospice, Tips and Tricks

A female doctor with their patient

When it comes to hospice care, one common question that arises is whether terminally ill patients should continue seeing their regular doctor or specialists. As an experienced hospice nurse, I have witnessed the benefits and challenges of maintaining these relationships. In this article, we’ll explore the pros and cons of hospice patients still visiting their general practitioners and specialists from the perspective of patients and their families.

A Day In The Life Of A Hospice Nurse

About Hospice, Admission, Assessment, Best Practice, Death and Dying, Documentation, End of Life, Hospice, Hospice Care Team, Nurse Skills, Post Admission

Day in the life of a hospice nurse

What does a typical day, a typical week look like for a visiting hospice registered nurse case manager look like?

My name is Peter, yet the patient called me “Jack”

Death and Dying, Dementia, End of Life, Hospice, Terminal Illness

As a hospice registered nurse, I have encountered numerous heartwarming and challenging experiences throughout my career. One of the most memorable encounters was with a dementia patient, Miss Norma Jean Smith, who affectionately called me "Jack." This endearing nickname, born out of her unique perception, became a symbol of the special bond we shared. In the following account, I will share the poignant journey of building trust, providing compassionate care, and embracing the unexpected moments of joy and sorrow in the life of Miss Norma. This story is a testament to the profound impact of person-centered care and the invaluable lessons learned from the patients we are privileged to serve.

Understanding HIS Requirements for Medicare in Hospice Care

Admission, Best Practice, Compliance, Documentation, Hospice, Hospice Care Team, Hospice Eligibility, Nurse Skills, Recertification

One crucial aspect for new hospice nurses to grasp is the Hospice Item Set (HIS) requirements. In this article, I’ll explain the HIS requirements for Medicare, providing you with a comprehensive understanding to ensure compliance and quality care delivery.

Clues for terminal restlessness often missed for facility patients

Assessment, Death and Dying, Dying Process, End of Life, Hospice, Nurse Skills, Symptom Management, Terminal Illness, Tips and Tricks, Tips For Nurses

One of the hardest portions of the job of a hospice nurse is to identify when a patient has two weeks of life left to live; this can be especially difficult at facilities going through staffing shortages leading to inconsistent caregivers with little to verbally report on a patient’s change of condition. Since being aware of the velocity of declines is extremely important, let’s cover an area that we in hospice (nurses, families, and caregivers alike) can keep an eye on in terms of identifying terminal restlessness which is often a key indicator for one week or less of life.

Effectiveness of topicals for pain and anxiety management

Hospice, Nurse Skills, Symptom Management

I have seen firsthand the benefits and drawbacks of different medications for managing pain and anxiety in terminally ill patients. Fentanyl patches and Ativan gel are two commonly used medications, but their effectiveness can vary depending on a patient’s build and weight, particularly for very thin or cachexic individuals.

Two days…. until…

Cancer, Death and Dying, Dying Process, End of Life, Ethics, Faith, Hospice, Near Death Experience, Terminal Illness

There is a spiritual connection in hospice, dealing with death and dying forty-plus hours per week. We who are in the field see it often, but there are times when we hear it firmly from the patients and families whom we serve. Let me share the most recent event on Memorial Day, 5/29/2023, week.

How Hospice RN Case Managers Can Reduce After-Hour Calls

Best Practice, Hospice, Hospice Care Team, Tips and Tricks, Tips For Nurses

I understand the challenges that patients and families face when receiving hospice services. One common issue that arises is the need for after-hour calls, which can add stress to an already demanding situation. However, with proactive care and effective communication, dayshift hospice RN case managers can play a crucial role in reducing after-hour calls and providing better support to patients and their families. Here’s how:

Detecting Infections in Terminally Ill Geriatric Patients with Dementia

Assessment, Dementia, Hospice, Non-Pharmacological, Nurse Skills, Symptom Management, Terminal Illness

One of the most important roles is detecting and managing infections in terminally ill geriatric patients with dementia. These patients are often at higher risk for infections due to their weakened immune systems, underlying health conditions, and limited mobility. Detecting infections in these patients can be challenging due to their limited communication abilities and other cognitive and physical impairments. However, early detection and management of infections can significantly improve the patient’s quality of life and potentially prolong their life.

What Hospice Nurses should assess every visit

Assessment, Best Practice, Hospice, Hospice Care Team, Nurse Skills, Tips and Tricks, Tips For Nurses

assessment sheet top

Hospice nurses play a vital role in providing quality care and comfort to terminally ill patients and their families. They must make accurate and timely assessments of the patient’s condition, needs, and preferences every visit. This article will outline the key aspects that hospice nurses should assess every visit, in addition to the standard physical assessment.

Ethical Dilemmas in Hospice

Case Studies, Ethical Dilemma, Ethics, Hospice

As a hospice RN case manager, I have seen many ethical dilemmas arise in end-of-life situations. Hospice care is unique because it focuses on providing comfort care to patients no longer seeking curative treatment for their illnesses. As a result, the ethical concerns in hospice care differ from those in other healthcare settings. This article will explore some ethical dilemmas that can arise in hospice care and how they can be addressed.

Before I review several case studies gathered from the sources in the resource section below, please allow me to share a current one of mine that is ongoing as this article is being published.

Should dying patients be on oxygen?

Caregiving Tips, Death and Dying, Dying Process, End of Life, Hospice, Nurse Skills, Palliative Care, Symptom Management, Terminal Illness, Tips and Tricks, Tips For Nurses

I have cared for many terminally ill patients over the years. One question that comes up frequently is should the dying patient be on oxygen at the end of life?

I see it from both sides, from hospice intake personnel as well as the admitting nurse — all had it drilled into them over the years that low oxygen saturation must be treated — to families who see how hospital and nursing home staff rush to put someone on oxygen because of low oxygen saturation.

Contrary to widespread belief, most dying patients do not need oxygen. Here’s why:

Frequency of Changes in Condition as an Indicator of Approaching Death

Assessment, Death and Dying, Dying Process, End of Life, Hospice, How Much Longer, Nurse Skills, Prognostication, Terminal Illness, Tips and Tricks, Tips For Nurses

Recognizing the velocity of changes in a patient's condition is crucial for hospice nurses. By understanding the pace of changes in vital signs, symptoms, functionality, and more, nurses can anticipate needs, adjust care plans, and communicate the prognosis effectively with patients and families. The article provides guidelines on interpreting the velocity to estimate the time a patient has left.

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