Archive for Home Health Aides

Please Say “Yes!” to a Home Health Aide!

Why would hospice patients say no to a home health aide?

At our weekly hospice team meetings, we review every patient’s current situation. This includes the various staff assigned to a patient’s care. It goes something like this:

What about Juan Lopez?

  • Nurse . . . two to three times a week
  • Social Worker . . . one to two times a month
  • Chaplain . . . phone contact only
  • Home Health Aide . . . declined
  • Volunteer . . . one to two times a month

What about Mary Jones?

  • Nurse . . . one time a week
  • Social Worker . . . two to three times a month
  • Chaplain . . . two to three times a month
  • Home Health Aide . . . declined
  • Volunteer . . . declined

Of course, the above names are fictional. In a typical meeting, the hospice where I work will talk in detail about scores of patients. We discuss the recent deaths and new admissions, along with all of the ongoing patients served in their homes or facilities. Every patient has a choice about which of their “team” provides direct support to them. However, every patient must be seen by a nurse, from as little as several times a month to (though rare) every day. It depends on the needs. Read More →

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How Much Time is Left?

One of the hospice home health aides (HHA) went to a patient’s home. Among other things, she gave him a bath. Let’s call our HHA by the name of Jane.

“About how much longer will this take?” the patient—let’s call him Arturo—asked.

I don’t know if this was the first bath for Arturo, or if Jane had given him a number of baths over the prior weeks. In hospice, the aides are a critical part of a patient’s care. They do the grunt work of supporting the patient when he or she is most vulnerable: showering or bathing, brushing teeth, commode duties, and helping ensure there is safe movement from a wheelchair to a bed.

Maybe a patient is incontinent with bowel or bladder. Some patients complain often, others make every visit a delight. In certain homes, the caregiver—perhaps the patient’s spouse or daughter—fears making a mistake and the HHA will teach—a literal show and tell—some of the better ways to help with the “simple” tasks for a loved one.

When a patient takes a bath, naked as a newborn, he is vulnerable. When a patient begins to trust the HHA with her failing, fragile body, she’ll reveal fears about living or dying. He might share childhood tales or family memories. She might talk about an ancient guilt or a recent regret.

And many times, patients will ask questions . . . Read More →

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Hospice and the Last Days

hospiceBelow is an overview of what it’s like when someone agrees to hospice care for her or his life-threatening illness. Spoiler alert: my description is intentionally optimistic.

This scenario assumes a patient will be supported by a hospice over several months. Maybe more. As I’ve written elsewhere, nearly a third of all hospice patients die within the first week. Though I understand why, I believe some wait longer than necessary to consider hospice. My hope is that a few find this “optimistic” sketch about the first (and last) days with hospice and make the hard, but equally likely good choice of seeking comfort care when a terminal illness forces you to ask . . .

How can I have the best quality of life in the last days of life?

Meeting the hospice team that will care for you and your family will be overwhelming . . .

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It’s bad enough you’re sick. But not just sick, since you have a terminal illness and your physician—maybe your friendly family doctor or a guy in a starched white lab coat who didn’t know your name without glancing at the chart—told you there are no more options for a cure.

Simply put, you are dying. Read More →

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