Hospice care is the term used for the special care that a dying person needs. Hospice care may be provided in a hospital, at a special care facility, or in the home. A hospice can be any location where a person who is dying is treated with dignity by caregivers who provide for their physical, emotional, social, and spiritual needs.
Any caregiver may provide hospice care, but often specially trained nurses, social workers, and volunteers provide hospice care. The hospice team may include doctors, nurses, social workers, counselors, home health aides, therapists, clergy, dietitians, and volunteers.
In home care, goals include a focus on the client’s recovery, or on the client’s ability to care for him- or herself as much as possible. In hospice care, however, the goals of care are the comfort and dignity of the client. This is an important difference. You will need to adjust your mind-set when caring for hospice clients. Focus on relieving their pain and making them comfortable, rather than on teaching them to care for themselves. Clients who are dying also need to feel some independence for as long as possible. Caregivers should allow clients to retain as much control over their lives as possible. Eventually, caregivers may have to meet all of the client’s basic needs.
Family members or friends who are caregivers for the dying person will appreciate your help. You are providing them with a break. This kind of care is sometimes referred to as respite care. You must be aware of the feelings of family caregivers. Encourage them to take breaks and take care of themselves. However, do not insist that they do so. Many want to do all they can for their loved one during his or her last days. Do observe family caregivers for signs of excessive stress. Report any signs to your supervisor. Your agency may be able to refer them to local support services.
The most important attitude for hospice work is the focus on providing comfort for the dying client, rather than on promoting wellness or recovery. Other attitudes and skills useful when providing hospice care include the following:
- Be a good listener. It is hard to know what to say to someone who is dying or to his or her relatives and friends. Most often, people need someone to listen to them. A good listener can be a great comfort. Recognize that some people will not want to confide in you. Never push someone to talk.
- Respect privacy and independence. Relatives, friends, clergy, or others may visit a dying client. Make it easy for these difficult visits to take place. Stay out of the way when you can. Do not join in the conversation unless you are asked to do so. Dying clients can hold on to some independence even when they need total care. Let the client make choices when possible, such as whether to bathe now or later, or what to eat or drink.
- Be sensitive to individual needs. Different clients and families will have different needs. The more you know what is needed from you, the more helpful you will be. Some clients need a quiet and calm atmosphere. Others appreciate a cheery presence and might like you to make small talk or stay close by. If you are not sure what you can do to help, ask someone.
- Be aware of your own feelings. Caring for people who are dying can be draining. Know your limits and respect them. Discuss your feelings of frustration or grief with your supervisor or another care team member. Request a change of assignment when you need a break.
- Be sure to follow the plan of care. Know whom to call and when to call them.