Home Visits in Hospice: Quality and Comfort Toward End of Life

1. What Does Quality Hospice Care Look Like?

The Medicare hospice regulations define hospice care and the Centers for Medicare and Medicaid updated the regulations in 2008 to ensure that regulatory guidance for hospice care was patient centered and focused on quality outcomes. This chapter discusses the characteristics of quality palliative nursing care at the end of life and other Medicare quality measures in place that demonstrate the quality of hospice care provided to patients and their families.

2. Hospice Nurse Case Management

The hospice nurse is the manager of the patient and family plan of care and also serves as a coordinator for the hospice interdisciplinary team. This chapter will discuss the nurse case manager process and the responsibilities of the nurse to ensure that the hospice team delivers individualized holistic care.

3. Providing Hospice Care in the Home

The cornerstone of hospice care is that it is delivered in whatever environment the patient and family call home. Provision of nursing care in a home environment can be rewarding for a nurse but it also has unique challenges. This chapter will look at provision of nursing care in a patient’s home and the specific areas of focus for a nurse in this environment of care.

4. Team Development of the Hospice Plan of Care

The hospice nurse is usually the first member of the hospice team to visit a patient and their family when hospice care is implemented. The nurse will continue to visit the patient and family with the goal of assessing and meeting ongoing needs. This chapter will describe the types of home visits a hospice nurse completes with a patient and their family including admission, follow up, and death visits.