Home Health - the Levels of Care – Nursing Homes Example

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"Home Health - the Levels of Care" is an engrossing example of a paper on nursing homes. Hospice care is a philosophy of care that puts emphasis on the palliation of the terminally or chronically ill patient’ s symptoms as well as pain, in addition to attending to their sexual, emotional, and spiritual requirements (Connor, 2009). Since hospice is often delivered at home, the treatment of the patient of a terminal illness can be carried out to address the cause of suffering. The terminally ill patients suffer from pain along with painful symptoms.

In most cases, the physicians treat pain with pain medications including acetaminophen, ibuprofen, aspirin or others. Next is maintaining patient comfort by eliminating terminal agitation. Other ways include back rubs, analgesics, position changes, giving off oxygen, tranquilizers, antidepressants, and music, giving massage and maintaining a silent atmosphere, creating conversation, and lastly companionship (Peden, 2011). The team usually comprises of the following (Saltz & Schaefer, 2010): Nurses, hospice physician, clergy or other counselors, hospice aides, social workers, trained volunteers, therapists such as speech, physical, and occupational therapists, a personal physician of the patient may also be included, all staff, and bereavement care staff. A Medicare patient elects to receive hospice care when they elect the Hospice Benefit such as being eligible for Medicare Part A or hospital insurance (Peden, 2011).

Moreover, they may also choose to receive hospice if the hospice doctor certifies that one is terminally ill and have six months or less to live if the disease runs its normal course. Lastly, one may sign a statement electing hospice care in place of other Medicare-covered benefits to treat the terminal disease. The time of mourning after a loss of someone is known as bereavement.

The hospice care team is tasked with assisting the survived loved ones through the time of grief. A clergy member, trained volunteers, or professional counselor gives support to the survivors via letter contact, physical visits, phone calls, and support groups. More to the point, the hospice team can refer the family members as well as other care-giving friends to other professional caregivers if necessary. The bereavement services can be offered for up to one year after the death of the patient. The four levels of care consist of the following: routine care is where a patient receives routine care in the place of residence; general inpatient care is an inpatient facility that controls pain or manages chronic symptoms which cannot be managed in other settings; continuous care entails hospice care is provided on a continuous basis at home, and it should not be less than 8 hours; lastly, inpatient respite is when a patient receives care in an approved facility in a short run (Peden, 2011). Hospice is accountable for proper allocation and use of resources so as to give optimal care that is consistent with patient and family needs.

It monitors as well as evaluates its regular allocation of resources to establish and provide solutions to problems by using its facilities, services, and personnel (Peden, 2011). Monitoring includes specific treatment modalities, reviewing the patient regularly, and suitability of the interdisciplinary team Some of the data collected by hospices consist of cancer registry, Medicare total budget, a medicine used to treat the patient, pain measure that gives the percentage of patients who report being uncomfortable as a result of pain at the initial assessment, patient care-related quality indicators such as symptom management and medical errors, pain assessment, dyspnea treatment, and dyspnea screening. Quality Assessment Performance Improvement (QAPI) program ensures that high-quality care is offered in addition to available resources being suitably used.

Evaluation results are reported to appropriate persons for action. QAPI also ensures that bodies responsible for reviewing and interpreting data are specified in the quality plan. It drives organizations towards excellence in patient care delivery.


Connor, S. (2009). Hospice and Palliative Care: The Essential Guide. New York: CRC Press.

Peden, A. (2011). Comparative Health Information Management. New York: Cengage Learning.

Saltz, C., & Schaefer, T. (2010). Interdisciplinary teams in health care: Integration of family caregivers. Social Work in Health Care. 22:59-69.

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