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Heartfelt Reflections A CHMC Blog

Writer's pictureSam Williams, MDiv., BCC

Hospice Qualifications - For the Healthcare Referrer, MD, NP, RN, MSW, LCSW



Hospice - Rest of Life Care

Many times, when people think of hospice disruptive emotions surface. Many professionals become uncomfortable when broaching the subject of hospice referral/placement to families and patients. This happens typically because the professional has not been given the tools and processes necessary to assist in making the conversation smooth. This post will provide guidance to the Clinician in identifying hospice candidates as well as broaching subject with healthcare decision maker.


Criteria for Hospice Qualification

Identify if patient meets general guidelines. If patient's condition is listed below, use drop down to see qualifying conditions.

General Guidelines

  • >10% weight loss over last 6 months

  • Decrease cognitive ability

  • Decreased tolerance to physical activity

  • Dependence in 3 of 6 ADL's

  • Life limiting illness with a prognosis of less than 6 months

  • Multiple hospitalizations or ER visits

  • Other comorbid conditions

  • Palliative Performance Scale of <60%

Alzheimer's and Dementia

Amyotrophic Lateral Sclerosis (ALS)

Cancer

Cardiac Diseases

Cerebrovascular Accident (CVA)

HIV/AIDS

Liver Disease

Pulmonary Disease - COPD

Renal Disease




Initiating Conversation with Decision Maker


When preparing to have conversation with decision maker regarding hospice enrollment there are several things to keep in mind.

  • The decision maker has a vested interest in their relationship with the patient

  • The decision maker has fears related to patient's health decline and death

  • The decision maker trusts the medical professional-initially giving benefit of the doubt until trust is lost

  • The decision maker is vulnerable to their own emotions which at times complicate reception of information and providing medical directives to clinicians.

The survivor/decision maker wants the best for the patient however there may be other factors weighing on the decision maker's mind. See Stages of Grief Blog Series for more information.


While the decision maker has their own challenges to face in this conversation, so does the medical professional. When sharing information about hospice the provider prepares for a difficult and potentially emotional conversation. The provider may feel a mix of emotions regarding the care of the patient and feeling uncomfortable with the intense sadness being shown by the decision maker/family. Strengthen your bedside manner with Connecting Humans Corporate Package Service Line and learn how to have conversations with decision makers that end in an accepted referral.


Typically Offered Hospice Service Lines


Routine Home Care

This is the most common type of hospice care. Routine Home Care allows the patient to remain in the comfort of their own home where they belong.


Respite Care

This level of care is utilized as a way to give families and patient's care givers time to handle personal necessities while patient is moved to an inpatient setting - typically a hospice house.


Continuous Home Care

Continuous Care is a service line that activates when the patient is having uncontrolled symptoms or is beginning to decline rapidly. More clinical resources are allocated to that patient to ensure their comfort.


General Inpatient Care

Inpatient care is reserved for when patient symptoms are too aggressive to be monitored in their home environment. The patient is admitted to a facility where clinicians and the medical team can support through symptom management.





Local Tampa Metro Hospices


Accent Care

Specialized Services Offered:


Inpatient Care

Around-the-Clock Care in a Facility Until Symptoms Subside

  • Typically, patients stay for a short period of time

  • Families may stay too while the at-home caregiver takes time to recharge


Open Access

A Program Allowing Those Receiving Treatment to Access Hospice Support Earlier

  • Some patients with a six-month prognosis still receiving treatment may be eligible to begin hospice services

  • Can act as a bridge between curative therapies and the comfort the hospice provides


Around the Clock Care

The Accentcare team visits you or your loved one at scheduled times and frequencies. When something happens outside of those scheduled visits – we have a National Call Center that you can call 24/7.


Nutritional Support

As you or your loved one’s condition changes, AccentCare’s registered dietitians can help answer any of the questions or concerns you may have about nutrition.


Music Therapy

The Accentcare team visits you or your loved one at scheduled times and frequencies. When something happens outside of those scheduled visits – we have a National Call Center that you can call 24/7.

Live Music That’s Scientifically Proven to Soothe and Comfort

  • Our board-certified music therapists play and sing songs by request

  • Can include relaxation techniques, stress relief for family and caregivers, and creative self-expression


Namaste Care

Sensory Activities to Stimulate the Senses and Promote Serenity

  • Activities include bathing, dressing, grooming, hand and neck massage, hydration, aromatherapy and spiritual readings

  • Namaste is often particularly meaning for patients with dementia

We Honor Veterans Program

A program designed to show respect and thanks to our nation’s veterans and to honor their wishes at end of life.

  • Developed as a collaboration between National Hospice & Palliative Care

  • Organization and the Department of Veterans Affairs.

  • Our sites are certified under the 5 levels of We Honor Veterans


Helpful Links:


Address | Phone Number

AccentCare Hospice & Palliative Care - Hillsborough County

1408 N Westshore Blvd #260

Tampa, FL 33607

(855) 216-7197


Empath Health

Specialized Services Offered:


COPD Program

Patients in Empath - Tidewell’s COPD program receive individualized care plans including:

  • Regular visits from a specially - trained nurse. The nurse will work with you and your hospice care team to control COPD at home

  • Medications prescribed to control symptoms and keep you at home

  • Addressing symptom crises 24/7 a day with RN and medical director

  • Monitoring of weight, vital signs, monitoring of oxygen levels and symptom management


Advanced Cardiac Care

Empath - Tidewell’s Advanced Cardiac Care provides individualized care plans including:

  • Regular visits from a specially-trained nurse. The nurse will work with you and your hospice care team to control cardiac symptoms at home

  • Specially-designed cardiac education

  • Oversight from a hospice and palliative care physician

  • Medications prescribed to control symptoms

  • Additional support from Tidewell’s social workers, nursing assistants, chaplains, grief counselors, and, if requested, a volunteer


Pediatric Care and Family Support

  • Pain and symptom management

  • Integrative medical treatment and palliative arts services

  • Emotional, spiritual and bereavement counseling

  • Volunteer support

  • Guidance with living wills and other healthcare planning

  • Caregiver support

  • Hands-on care education and training

  • Siblings workshops and counseling

  • Access to hospice information and resources

  • Assistance coordinating community and financial resources


Veteran Support

When veterans are living with an illness and approaching the end of life, we are here to serve them with expert care, understanding and compassion. Our Empath Honors program supports veterans’ personal goals and needs, including any type of suffering from their time in the military or service-connected conditions. The focus is to achieve comfort and resolution for veterans so they can live and pass on peacefully. Families of veterans also receive support, guidance with healthcare decision making and connection to beneficial resources. Services include trained veteran volunteers, military service recognition ceremonies and a Recruit Level of the We Honor Veterans program.



Helpful Links:












Sam Williams, MDiv, BCC | President/CEO

Professional Crisis Support Chaplain

Connecting Humans Mobile Chaplaincy

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