Hospice Care is defined as a type of health care that focuses on the palliation of a terminally ill patient’s pain and symptoms and attending to their emotional and spiritual needs at the end of life. In this article, however, we want to throw out sterile definitions and take a closer look at what it means to care for patients that are terminally ill, and the most important aspect of what a great caregiver should have: Compassion.

The Need for Hospice Care

Hospice care is focused attention on caring for the dying with serious illnesses. These are patients that doctors think have only a short time to live, often less than 6 months. Believing that this physical and spiritual treatment will make a huge difference in the patient’s life, physicians, nurses and family members often opt to make this process as comfortable as possible. Hospice involves caring for dying patients by helping them be as free from pain as possible, providing them with assistance to complete wills and other arrangements for their survivors, giving them social support through the psychological stages of loss, and helping family members cope with the dying process, grief, and bereavement. In addition, the process of hospice care will prioritize comfort, quality of life, and individual wishes freely; far away from any stress or restrictions.

National Hospice resource

Levels of Hospice Care

Patients differ in needs and required care according to their health case; as a result, there are four different stages/ levels of hospice care that meets each patient’s needs.

The four levels of hospice care are available for anyone who is eligible for Medicare:

• Routine Home Care

Routine home care is the basic level of hospice care provided in your home, assisted living, or nursing home. This level of care offers a team approach by hospice staff and your physician to provide comfort at the end of life.

• Continuous Home Care

This is when a nurse stays in your home for an extended period of time because the patient is experiencing a medical crisis or having a severe symptoms such as unrelieved pain.

• General Inpatient Care

Once the patients’ severe symptom requires an advanced level of hospice, they should be moved to specialized places called “General Inpatient Care”. The goal of inpatient hospice care is to control severe pain and symptoms, so the patient can receive the care that is consistent with their wishes.

• Respite Care

The respite level of hospice care is provided on an occasional basis and offers a planned, short-term break for caregivers who face the challenges of assisting patients with an advanced illness. The patient should receive a plan of care require 24-hour care.

Who are the caregivers? 

Caregivers are the people who have unique features that reflect compassion, love, mercy and hope to give the patient a secure and comfortable space to live. They can be a member of the patient’s family or loved ones; otherwise, it can be people that are specialized to provide such care for the sake of a happy and satisfied final moment/ ending.

Caregivers do not only provide a perfect sensible space, but they also provide help that makes the patient’s life easier when it comes to their daily routine. I would describe the caregivers as “adaptors”, according to the way they adopt their feelings, ideas, and time to fit their patients needs.

In most cases the disciplinary teams include: the nurse, nurses aide, medical assistant, homehealth aide, social worker and the physician.

Hospice Caregivers Challenges 

Caregivers are responsible for taking care of the basic needs of patients and giving hope to the patients for their remaining time. However, there are hidden challenges that caregivers face while performing hospice care. Some of those challenges will be outlined below.

According to caregivers’ continuous care routine, they may face many challenges that affect their daily lives, such as being exhausted exhausted from long hours of work. In addition, caregivers may also have fears about losing their loved one/ patient at any time or making a mistake that could compromise their quality of life. Caregivers may also have a difficult time when it comes to making decisions that may jeopardize the patients comfort level, such as removing a favorite pillow for a new one, or a favorite chair for a newer model, as some patients can become very emotionally attached to these things. High levels of caregiver stress may drive those working in hospice care to feel angry with themselves and/or guilty about decisions they have had to make, often taking that stress home with them.

A Reason to care

Individuals taking care of patients in hospice settings aim to help patients feel mercy, compassion and love, with the goal of providing a peaceful and relaxing end. Often, the greatest challenge is helping the patient feel the will to continue on, as the will to live can often help patients in hospice care hold on for a few more precious moments with family and or loved ones. Giving compassionate care should always be emphasized in any health care setting, especially when caring for those in their final stages of life. This is where the field of medicine truly becomes a calling, not a job description.

1. Prep Your Supplies

One of the most important points to keep in mind is that a safe and effective blood draw begins before the phlebotomist approaches a patient.

Nowhere is this more evident than in the World Health Organization’s (WHO) blood draw guidelines — much of which discusses preparation and supplies more so than the blood draw itself.

Supplies you’ll need include needles for collecting the blood and tubes for collecting it, gloves and hand sanitizer, a tourniquet, and gauze. Many healthcare institutions have kits containing the required equipment. Otherwise, you’ll need to collect the supplies listed above and others.

Blood can be very toxic. You must exercise great care during its collection; having proper supplies on hand will help ensure this.

2. Interact with the Patient

More than an opportunity to display a pleasant bedside manner, interacting with the patient is vital. This is your opportunity to confirm the patient’s identity using the information you have on hand and by asking the patient for his or her name. You’ll also want to address with the patient any allergens listed on the information you have.

Interacting with the patient is also a good way to gauge their level of anxiety, if any. If the patient expresses concern, it might be best to have him or her lie down. Otherwise, you may be able to alleviate their anxiety and the potential of them fainting by explaining the procedure (even talking through it) or suggesting the patient look away, close their eyes, and breath slowly.

3. Find the Right Vein
Next, identify the vein from which you’ll draw blood. Your top choices will likely be:

1. The median cubital vein
2. The basilic vein
3. The cephalic vein

What qualifies the median cubital vein as a good first option? It is prominent on the arm and becomes even more noticeable when pressure is applied. (It’s equally important to avoid certain areas when drawing blood. Those include hematomas and wounds.)

4. Draw the Blood

Whether the patient is seated or standing, ensure their arm is positioned and prepped effectively. That means it’ll need to be hyperextended, with a clenched fist and tourniquet placed approximately three inches above the draw site. (The site will have been cleaned with an alcohol wipe by now.)

Gently pull the patient’s skin tighter by grabbing the arm. Then insert the blood draw needle. Blood should flow into the collection tube.

5. Stressing Safety, Conclude the Draw

Possible exposure to bloodborne pathogens introduces risk to the drawing and handling of blood. Viruses such as Hepatitis B, Hepatitis C, and HIV merit your utmost care.

The blood may be out of the patient’s arm, but that doesn’t mean the blood draw process is done. Now, you must remove the tourniquet from the patient’s arm. Then, remove the needle and apply gauze on the spot where the needle penetrated the skin. Once this is done, all contaminated items must be disposed of in their proper toxic material containers.

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