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Level One Hospice: Routine Home Care

The first of four levels of hospice care is called Routine Home Care.  As the name implies, during this level of care a hospice patient is cared for in whatever place they call home—nursing home, assisted living facility, personal residence—by their loved ones who have taken on the role of caregiver.

In the comfort of their own home, hospice patients can peacefully face the challenges of terminal illness.  Those in Routine Home Care have personal options not available to hospital patients.  They can choose to continue living each day to the fullest their condition allows including entertaining guests and attending special events when physical limitations are at a minimum.  They can choose to be treated with dignity as individuals with incomparable value and uniqueness.  They can enjoy the company of dear friends without constant interruptions from hospital staff and medical treatments.  They can appreciate the pleasure of homecooked meals for as long as their appetite permits.  They can select and wear their own apparel instead of impersonal hospital gowns. 

Hospice patients in Routine Home Care receive specialized attention from their caregivers, hospice volunteers, the hospice nurse, and the hospice medical director. 

A typical day for a caregiver in Routine Home Care may consist of normal activities such as preparing and sharing meals, doing light housework, assisting with personal hygiene, and planning simple activities.  The caregiver is responsible for helping the patient follow the regimen prescribed by the hospice medical team: taking medications, adhering to a nutrition plan, doing physical therapy exercises, etc.  They assist the patient with daily tasks including bathing, dressing, grooming and eating.  They are also responsible for obtaining critical information regarding end-of-life imperatives such as legal documents and personal preferences of the patient for their passing.  The hospice caregiver serves as a companion to the patient and loved one, and as an advocate for them. 

A welcome member of the Routine Home Care team is the hospice volunteer.  This team member is vital to the smooth operations of successful home care.  The volunteer is available for driving patients to appointments and running necessary errands.  They offer moments of respite for the caregiver as they cheerfully spend time with the patient.  During a visit the patient and the volunteer may participate in games and creative activities or watch tv together.  They may choose to engage in friendly conversation over a snack or light meal.  They may even enjoy some quiet time together.  The hospice volunteer serves as a support to the caregiver while sharing their time with the hospice patient. 

Routine Home Care includes visits from the hospice nurse who monitors the patient and communicates the vital information with the hospice medical director.  If medicines need adjusting, the hospice nurse makes those adjustments and explains the changes to the caregiver, instructing them on how to administer the changes.  If new exercises need to be introduced to enhance physical therapy, the nurse demonstrates them and carefully explains to the caregiver and the patient why and how to do them properly.  The nurse is responsible for stocking and maintaining home medical supplies.  They also listen to the patient and caregiver in order to address any specific concerns they may have.  The hospice nurse serves as a medical professional in the home. 

The hospice medical director develops the care plan for each hospice patient in Routine Home Care.  They first must certify that a patient is eligible for hospice by determining that their medical condition is terminal with six months or less life expectancy.  Once a patient is deemed eligible for hospice the medical director collaborates with the primary physician and lays out a plan of care that includes palliative care directives for pain control and comfort, physical therapy recommendations for better quality of life, and oversight of drugs prescribed by their primary physician.  The hospice medical director is available to the rest of the hospice team to continually evaluate and revise each patient’s care plan as changes need to be made.  They also support and help educate the families and caregivers for the duration of Routine Home Care and assures that the wishes of the patient are honored by the staff.  If the time of eligibility expires and the patient needs recertification, the medical director is the one who must reevaluate their case and certify their new eligibility.  The hospice medical director serves as an overseer of individual cases and as a collaborator with hospice staff and primary physicians. 

As the first of four levels of hospice, Routine Home Care offers beautiful opportunities for the terminally ill and their families and loved ones.  With care and support from their caregiver, volunteers, hospice nurse, and medical director a hospice patient can live through the first stage of their illness with dignity and positivity.  Choosing hospice early in a terminal diagnosis gives the patient and all involved the ability to take advantage of the benefits of Routine Home Care.

Gifted Hearts Hospice and Palliative Care in Seguin, TX, is a fully staffed facility available to patients who call South Central Texas their home.  It is nestled in the beautiful New Braunfels area as the best hospice near San Antonio, Texas.  It offers palliative care for patients of any age in any stage of illness.  It also offers all four levels of hospice care and maintains its motto: “Live until you Leave.”