Home Hospice

End of Life Online Curriculum - Modules

Overview of Palliative Care	Dyspnea	Home Hospice
Opioid Conversion	Prognostication	Transition to Death
Palliative Sedation	Communication	Bereavement

Home Hospice : Home Care of the Dying Patient

Introduction & Learning Objectives

Where do Americans die?

Admission Criteria for Home Hospice

Establishing Prognosis

Patient and Family Goals

Caregiver at Home

Patient and Family Interview

Home Hospice Components

Home Hospice Logistics

Home death of hospice patient

Home death of non-hospice patient

Where it can go wrong

Medical Criteria for Hospice Eligibility

Common Terminal Diagnoses

Advanced Senescence

Pulmonary Disease

Adult Failure to Thrive

Stroke and Coma

Home Hospice Components

Team Approach	Comprehensive care related to the terminal illness by an interdisciplinary team	This team consists of: Nurses Aides Social workers Spiritual care advisors Volunteers Home health aides Dietitians Physical and occupational therapy A medical director Typically, a nurse will visit the home two to three times per week. Aides may similarly be sent two to three times per week.
Diagnosis, Therapy, and Monitoring	Medications, procedures and durable equipment	Procedures may include: Lab draws X-rays Radiation therapy Etc. Durable equipment may include: Oxygen Hospital bed Commode Must be related to the terminal illness to be covered under the benefit. All such medications and procedures must be approved by the hospice prior to their being ordered or performed. Other medications unrelated to the terminal illness are not covered on the benefit and must be paid for separately.
Family Support	Families of patients must be offered up to one year of bereavement support by the hospice.	Counseling from: Social workers Spiritual care advisors
Responsibility	Back-up support by the hospice medical director.	On-call help
Death	When the patient dies, pronouncement and disposition of the body is much easier and less traumatic for the family if the patient is on hospice than if not.	Including: Death pronouncement Death certificate Etc
Adapted from Palliative Care Perspectives, Hallenbeck J, Oxford Publications

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©End of Life Curriculum Project, a joint project of the US Veterans Administration and SUMMIT, Stanford University Medical School.
Funded by a grant to the Veterans Administration Nationwide Palliative Care Network by the National Library of Medicine. VJ Periyakoil, MD, Director.