Hospice care is offered by a hospice center or service. The team at the hospice center works with the primary caregiver of the patients to provide care and support. However, not all hospice services provide support 24 hours a day.

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It depends on the hospice, the condition of the patient and a number of other factors. If any of your loved ones are terminally ill, it is important to understand what hospice care is. According to Medicare guidelines, there are four different levels of hospice care. One patient might be receiving all levels of cares after a week of getting in the hospice care. Another patient might just be receiving level one of the care during their time in hospice care.

Every certified hospice provider must offer these 4 levels of care:

Level 1: Routine Care 

It is the basic level of service provided by a hospice center. The patient receive- services such as nursing, social services, medications, home health aide services, counseling, medical equipment and supplies, lab and diagnostic studies, and therapy services. 

Level 2: Continuous Care

This type of care includes continuous home care. A nurse or a home health aid is needed with the patient 8 to 24 hours a day. Such care is a short term. The level of care is reevaluated every 24 hours.

The symptoms for which continuous care is required include nausea, vomiting, unrelieved pain, panic attacks, shortness of breath, anxiety.

Level 3: Inpatient Care 

The patients who have severe short-term symptoms and it is not adequate to treat them at home, are offered inpatient care. 

The symptoms that make a patient eligible for inpatient care are as the same as continuous care. Only the environment of care is different. Nurses are available around the clock to provide emotional support, medication and treat the patient to make them comfortable. 

Inpatient care might be offered in a freestanding facility operated by a hospice center, a hospice unit in a nursing home or an inpatient hospice care unit within a hospital. 

Level 4: Respite Care

It’s the type of care which is more for the family than the patient. Some patients don’t qualify for continuous or inpatient care. However, their family is going through a difficult time and they need emotional support. For such patients, respite care is offered. 

In some cases, the family of the patient is their primary source of care. Due to increased stress and other circumstances, sometimes, the family is unable to meet the needs of their loved ones. In such a scenario, the patient is temporarily admitted to an inpatient care so that the family takes a respite. 

The respite care is for 5 days only. Once the 5-day period expires, the patient is discharged from the care.

Only a Primary Care Giver Is Available 24 Hours

When a patient is admitted in the hospice program, they have to identify an individual as their primary caregiver. They are responsible for providing daily care to the patient with the assistance of the hospice team. 

The role of a primary caregiver is extremely important. Although it is a demanding role, it is highly rewarding. The primary caregiver is responsible for meeting the needs of their loved ones and add comfort and quality to their life.

They have to make sure the care is provided to the patient 24 hours a day or as needed. As one person cannot be available to provide care for continuous 24 hours, the responsibility is shared with other family members, friends and even the caregivers from the hospice. The hospice team cannot provide 24 hours care.

Who Is A Primary Caregiver?

The primary caregiver is usually a family member or a close friend. They work with the hospice team and the patient for developing a care plan depending on the preference of the patient. This caregiver continues to be the main member who makes important decisions for the patient throughout the length of the hospice care. 

When the patient is receiving hospice care at home, the primary caregiver provides physical care and keeps an eye on their symptoms. Even though the primary caregiver can share responsibilities related to physical care with another member, when it comes to communicating with the hospice team, it is their responsibility. They are responsible for administrating the symptoms as well. No other family member or friend can play these roles.

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What If There Is No Close Family Member Or Friend To Become A Primary Caregiver?

There are certain cases where the patient does not have a close friend or family member to play the role of a primary caregiver. The patient needs to work with the hospice team member who comes to talk about the services. 

It is important to check with your insurance company to be sure that the services of a primary caregiver are covered by the plan. 

24 Hours On-Call Availability 

The patients who are receiving in-home care are not just visited by nurses regularly, they are available on the phone 24 hours a day as well. Whether or not other members of the hospice team can visit the home of the patient depends on their insurance coverage. 

Special Cases of 24 Hours A Day Care 

If the patient is in crisis (their symptoms are uncontrolled or they are reaching death closer), hospice center might provide 24-hour care. The facility might send a nurse at the patient’s residence to assist them. 

Another instance when a patient might need 24-hour care is when they are in the inpatient unit. Although the stay of the patient is for a short-term, they receive 24 hours of care if their symptoms need to be addressed. 

Bottom Line 

The goal of hospice care is to provide the patient and their family members support at the right time. Normally, 24 hours care is not available. However, if the condition of the patient demands 24 hours of care, the hospice facility will make necessary adjustments.

24-hour on-call services are available too in case the caregiver of the patient wants assistance in treating the symptom or have a query.