Hospice Care

Hospice care is specialized treatment that prioritizes physical, psychosocial and emotional comfort for individuals and their loved ones when curative therapies are no longer effective or wanted. Hospice is considered the model for quality care for people facing a life‐limiting illness.

Holistic Care Hospice provides expert medical care, pain management, personal care, and emotional and spiritual support individually tailored to the patient’s needs and wishes. We focus on quality of life by keeping a person comfortable in their home environment, promoting dignity and independence and providing support to both the person needing care and their loved ones.

You can rely on Holistic Care Hospice and Palliative Care to be experts at symptom management, patient-family communication, medical crisis prevention, urgent response and genuine coordination of care across medical settings to ensure continuous communication between providers during times of transition or changing needs.

•Holistic Care Hospice and Palliative Care delivers expert medical care with thoughtful consideration of each person's beliefs and values.

•Offices throughout Southern California to care for patients in Riverside, San Bernardino, Los Angeles, Orange and San Diego Counties.

•Member of the National Hospice and Palliative Care Organization (NHPCO) "We Honor Veterans" program. Our Veterans deserve extra care and special attention to their unique needs.

•More nursing visits than other providers.

•More Home Health Aid visits than other providers.

•Give Back Campaign - We are committed to supporting local non-profit organizations by choosing an organization each month that will receive a monetary donation. For more information about this program please see that Give Back Campaign section of our website.

•Disadvantaged Seniors' Assistance Program - Removal of caregiver burdens through a partnership with a local non-profit organization, RLOVE Seniors. For more information see www.rloveseniors.org

•To affirm life physically, mentally, emotionally, and spiritually.

•To empower our patients and families with the knowledge that their decisions and choices will be treated with the utmost respect.

•Delivering state-of-the-art medical care with thoughtful consideration of each person’s personal beliefs and values.

•The continued pursuit for excellence to provide the highest quality service.

•Honestly and integrity in each and every member of our team. Holistic Care as a Hospice Care provider?

It can be difficult to identify when it is the time to begin Hospice Care. There are many signs and symptoms that an individual could benefit from all the extra care hospice provides. These symptoms alone may not qualify a person for hospice, but could indicate that there is an underlying illness that should be considered:

•There is a terminal disease or a life-limiting illness

•A person is no longer seeking aggressive treatment

•Decreased mobility or there is a reduction of Activities of Daily Living. Activities of Daily Living include bathing, dressing, toileting, transferring, continence, and feeding.

•Recent or frequent hospitalizations or trips to the emergency room

•Progressive or unexplained weight loss or a reduced desire/ ability to eat Increasing weakness, fatigue, and somnolence

•Change in mental status or decreased cognitive and functional abilities

•Frequent or recurrent infections

•Wounds that aren’t healing

•Frequent falls

•Increased Edema or swelling

•Continuous use of Oxygen

•Difficulty swallowing

•Uncontrolled or increased pain

•Difficulty in breathing

•Progressive renal insufficiency

•Uncontrolled nausea or vomiting

•Emotional, social or spiritual distress

•Progressive decline in health despite therapy

•General decline

24/7 Hospice Care Hotline for nursing support anytime you have symptoms or questions.

Nurse Care Coordinator in our office assigned to each patient.

Regularly scheduled home visits from the Hospice Care Team.

After-hours nursing visits available for emergent needs.

Bereavement services

Medications related to Hospice Diagnosis and medications to provide comfort medical equipment such as:

Hospital Bed

Wheelchair

Walker

Commode

Bedside Table

Oxygen

Nebulizer

Suction Machine

CPAP / BiPAP

Hoyer Lift

Supplies such as:

Diapers

Wipes

Gloves

Barrier Cream

Under Pads

The healthcare professionals of the Holistic Care Hospice Care Team work together to ensure that each person’s unique needs are met. The responsibilities of each member of the team, also called an Interdisciplinary Team are:

PHYSICIAN

The patient’s primary care physician may be responsible for identifying when they may benefit from hospice care. Holistic Care Hospice encourages physicians to remain involved as a member of the patient care team. Each physician prefers a different level of involvement.

HOSPICE MEDICAL DIRECTOR

The Holistic Care Hospice Medical Director provides oversight of patient care and support to the hospice care team. The hospice medical director attends a weekly team conference to discuss the plan of care of each patient, establishes goal sand participates in all medical decisions.

REGISTERED NURSE (RN)

The RN coordinates the plan of care with the Hospice Medical Director through initial and ongoing nursing assessments. The RN supervises all care provided by the licensed practical nurse (LVN) and home health aide (CHHA), and coordinates care with the other members of the hospice care team to ensure patient and family spiritual and psychosocial needs are met.

LICENSED VOCATIONAL NURSE (LVN)

The LVN makes regularly scheduled and emergent visits to patients under the supervision of the RN and the Hospice Medical Director.

NURSE CARE COORDINATOR

Holistic Care Hospice added this role to enhance the experience of our patients and families. The Nurse Care Coordinator is a Nurse that works in our office and is assigned to each patient. The role of this Nurse is to be an extra layer of support and an added resource when patients or families call our office and to assist the care of our field nurses.

MEDICAL SOCIAL WORKERS

The Medical Social Worker provides initial and ongoing psycho-social assessments (mental, emotional, social, and spiritual dimensions of the patient) and establishes a psycho-social plan of care. The Medical Social Worker typically sees each patient once or twice a month to provide emotional support and ensure patient and family psychosocial needs are being met. The patient/family or any member of the hospice care team can request additional psychosocial visits as needed. The social worker can provide assistance with finding community resources, help with Advance Care Planning, assist with placement and much more. The hospice social worker can also provide counseling to the patient or family, if needed.

CHAPLIN

The Hospice Chaplain, also sometimes referred to as a Spiritual Care Counselor, provides nondenominational spiritual support to the patient and family as needed. The Chaplain visits once or twice per month or more often, if requested. The care provided by the Hospice Chaplain can address religious issues, however the focus of care is more spiritual, in nature, than religious.

CERTIFIED HOME HEALTH AIDE (CHHA)

The Hospice Volunteer can provide companionship and social support to a patient. All Hospice Volunteers are required to attend training prior to being assigned to patients. Hospice Volunteers do not provide any hands-on care and may be available for a few hours per month.

HOSPICE VOLUNTEERS

The CHHA assists the patient and family with personal care needs such as bathing and grooming. The CHHA can assist with light housekeeping such as changing bed sheets, but the care is not for other housekeeping or meal prep.

BEREAVEMENT COORDINATOR

The Bereavement Counselor can help a patient deal with the grief associated with declining health and guide the family through bereavement before and after the loss of a loved one. The Bereavement Counselor can provide bereavement services to the family up to a year, or longer, after a loved one passes.

Private residence

Assisted Living Facility

Board and Care

Independent Living Facility

Skilled Nursing Facility

○A person must be done with rehab

○The person must pay privately or have a Medi-Cal insurance that will pay for room and board while on Hospice.

Hospital - some Hospitals allows Hospice Care under special circumstances

Hospice patients may require differing intensities of care during the course of their disease. The Medicare Hospice Benefit affords patients four levels of care to meet their clinical needs: Routine Home Care, General Inpatient Care, Continuous Home Care, Inpatient Respite Care. The insurance benefit for hospice typically covers all aspects of the patient’s care related to the terminal illness, including all services delivered by the Interdisciplinary team, medication, medical equipment and supplies.

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Routine Hospice Care is the most common level of hospice care. With this type of care, an individual has elected to receive hospice care at their residence, which can include a private residence, assisted living facility or nursing facility. Nearly ninety- seven percent of hospice care is provided at the routine home care level.

General Inpatient Care is provided for pain control or other acute symptom management that cannot feasibly be provided in any other setting. General Inpatient Care has very specific Medicare criteria and begins when other efforts to manage symptoms have been ineffective. General Inpatient Care can be provided in a Medicare certified hospital, hospice inpatient facility, or nursing facility that has a registered nursing available 24 hours a day to provide direct patient care.

Continuous Home Care is care provided for between 8 and 24 hours a day to manage pain and other acute medical symptoms. Continuous home care services must be predominately nursing care, supplemented with caregiver and hospice aide services and are intended to maintain the terminally ill patient at home during a pain or symptom crisis.

Inpatient Respite Care is available to provide temporary relief to the patient’s primary caregiver. Respite Care can be provided in a long-term care facility that has sufficient 24-hour nursing personnel present on all shifts to guarantee that patient’s needs are met. Respite care is provided for a maximum of 5 consecutive days.

Holistic Care Hospice is accredited by the Accreditation Commission for Health Care (ACHC) and is Medi-Care and Medi-Cal certified. Our Hospice Care is 100% covered by Medicare, MediCal and many private insurance plans. Electing Hospice Care can help alleviate the heavy financial burden that the cost healthcare can have on patients and families. While under the care of Holistic Care Hospice, a patient retains full coverage for healthcare not related to their hospice diagnosis. An individual should continue to pay applicable deductible and coinsurance amount for those unrelated services. Additionally, a person’s social security benefits are not affected when receiving Hospice Care.

There is no limit to how long a person can receive hospice care, as long as they continue to meet eligibility criteria required by their insurance. At times, a terminally ill person’s health may improve, stabilize, or their illness goes into remission. If the Hospice Medical Director and Hospice Care Team no longer believe a person can be certified as terminally ill, that person would no longer be eligible for the Hospice Benefit. A person can return to Hospice Care when there is a time that their condition worsens, and they again meet eligibility criteria. A person receiving Hospice Care also has the right to choose to stop services at any time, for any reason.