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Level Two Hospice: Continual Home Care

The second of four levels of hospice care is called Continual Home Care. It is often referred to as Crisis Care since it is implemented during times of medical crises of hospice patients already enrolled in the first level of hospice care called Routine Home Care.   

In Routine Home Care a friend or family member volunteers to act as caregiver to the terminally ill patient. This caregiver provides care and companionship by helping with daily routines and schedules. They feed, bathe, clothe, and engage the patient throughout the hospice experience. The hospice patient has the support of their caregiver as well as the support of the hospice nurse, hospice volunteers, other family members, and various friends and counselors. 

When a medical emergency arises in the home—the patient falls, symptoms of the illness become acute, pain levels rise beyond control— the caregiver contacts the hospice medical team. They explain the nature of the emergency and describe the symptoms. If the situation meets the criteria for an emergency as stipulated by Medicare, the team sends a skilled nursing staff to stay with the patient in the home on a continual basis until the crisis subsides.

Unlike Routine Home Care where a hospice nurse visits the patient one to three times a week, Continual Home Care offers skilled nursing care eight to twenty-four hours each day for up to five consecutive days in the patient’s place of residence. The nursing staff is usually comprised of a Registered Nurse [RN] and may include a Licensed Practical Nurse [LPN], a Licensed Vocational Nurse [LVN], or a Certified Nursing Assistant [CNA].  

The caregiver can step back from their official role during the crisis and be involved with their loved one as part of the support group of family and friends.  They can receive advice from the hospice medical social worker about community resources. They can also seek comfort and guidance from hospice and spiritual counselors who are available to the group at this time. 

The goal of Continual Home Care is to keep the patient in their home and out of the hospital when possible. This is accomplished by aggressively managing the acute medical symptoms and regaining control over the patient’s pain. As the skilled nurses work diligently to abate the crisis, they stay in close communication with the hospice Medical Director who collaborates with the patient’s primary physician.  

In order to receive this Medicare Hospice Benefit, a terminally ill patient must be enrolled in a hospice program that provides all levels of hospice care. Once the crisis is over, Routine Home Care resumes and the hospice patient is in the loving hands of their caregiver once again.

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.”