Medical Director: The experience and leadership of a seasonsed medical doctor on our Interdisciplinary Team is extremely important. At Harrison's Hope, this is of paramount concern in the care of our patients. Dr. Jonathan Chu is the only full-time Medical Director at any hospice in Southwest Idaho, exclusively focused on the needs of our hospice patients only. This gives him the unparalleled ability to consult directly with Nurse Case Managers and Medical Social Workers on a daily basis, and meet face to face with patients regularly. This has risen the bar for hospice services in our area, and gives a more traditional approach to our care. Our doctor knows the patients and families we serve intimately, and they have the opportunity to interact directly with Dr. Chu, enabling the patients to more controlled pain and symptom management and greater comfort at end-of-life.
Nurse Case Manager: Each of our patients is assigned a nurse case manager who serves as a bridge back to the primary care physician. Day-to-day patient care in the home is provided by the Primary Care Giver (PCG) who is typically a member of the family. However, the PCG could also be the nursing home or assisted living staff, or sitter services. The nurse case manager teaches the PCG all they need to know to competently and confidently care for the patient. Education is key. The nurse is an expert on end of life diseases, situations, and problems. They will be able to anticipate and plan ahead for what may come next in the declining process and get treatment and medications in place needed to navigate such situations before they happen. The nurse case managers make regularly scheduled visits to the home or facility throughout the week. They are on-call and available by phone for any potential emergencies or questions that may come up 24/7. Nursing visits may begin care at 1-2 times per week and as the patient's symptoms worsen increase to daily visits 7 days per week. The visits consist of a medical assessment, communication with patient and family or staff, and education about disease process, and current status. Medication management and changes to medications or treatment may also be part of the regular visits as the patient's condition changes.
Certified Nursing Assistants: CNA's provide bathing and personal care services to patients and are available typically 2-3 times per week. Hospice CNA's possess a number of skills, especially for patients at end of life. Our aids have extensive experience with skin breakdown, wounds, bed baths, dry skin, sore muscles, aches and pains from inactivity, and behaviors. Most importantly hospice CNA's know how to handle a dying person and keep them comfortable even in their final hours. CNA's give massages if necessary, lotion skin, help dress patients, fix their hair, provide much needed routine nail care, and report directly to the nurse case manager.
Medical Social Worker and Bereavement Counselor: Social workers are trained professionals who specialize in helping patients and families work through changes that occur during a patients decline and eventually death. Hospice social workers are focused on respecting the wishes of patients and families as a unit. They may assist you in accessing community resources, legal assistance, education about the dying process, and provide support and counseling during this incredibly difficult time. The social worker can provide grief and bereavement counseling to those experiencing anticipatory grief and need emotional support. The social worker will be present at the start of care and will complete an extensive psychosocial assessment to determine the patient and families needs for ongoing services or future visits. Social workers may visit patients 1-4 times per month depending on the need.
Chaplain and Spiritual Counselor: The chaplain is available to provide spiritual support as requested or desired. The Chaplain can also act as a liaison between the dying patient and their spiritual community. The Chaplain can provide services such as communion, read the Bible and scriptures, pray with patients and families, spiritual education, and music. For patients that are not particularly religious the chaplain is simply a friendly visitor or support person in conjunction with the other hospice team. It is also very common for the hospice chaplain to provide funeral services since the patient may not have been able to attend church for several years and is not connected with any church in the community. Patients are assessed by the chaplain and will visit the patient as desired by patient and family. Typically the Chaplain visits 1-4 times per month.
Volunteer Coordinator: Attends IDT to determine if any patients and families could benefit from volunteer services. The volunteer coordinator recruits and trains volunteers for specific tasks in hospice. These specially trained volunteers are available to provide respite care, companionship, and patient care services as needed or assessed. Each volunteer is back ground checked, finger printed, drug tested and certified as a hospice volunteer.
The IDT meets every other week and reviews each and every patient. Other IDT members include the following:
- Medical Director
- Pharmacists
- Therapists
- Medical Records
- Billing department
- Administrator
*Dietary, Occupation, Physical, and Speech therapy is available and possible for hospice patient's on a case by case basis as assessed by the interdisciplinary team.
*Hospice is paid for by Medicare, Medicaid, and most private insurances. Agency fund raising and private donations allow Harrison's Hope to provide hospice care to individuals with no hospice insurance benefit. Medicare and Medicaid pay for hospice services. Private insurance may have a copayment attached or require a deductible be met first. The hospice billing department will contact the insurance company to find out the benefit and its coverage.
*The Hospice Medicare benefit includes medications, medical supplies, durable medical equipment, and lab fees as related to the terminal diagnosis.