The hospice physician oversees the care and treatment of hospice patients to ensure quality and continuity of care. Physician collaboration with nurses, home health aides, medical social workers, counselors, dieticians, pharmacists, nurses, chaplains, volunteers, and other health care professionals is a critical component of hospice care.
Role of a Hospice Physician
The hospice physician has the following duties and responsibilities:
- Collaborate with the patient’s primary care physician
- Support the patient’s care team to maximize patient comfort
- Help patients and families identify and meet goals across symptom relief, pain management, and spiritual comfort
- Conflict resolution
- Ethical problem-solving
- Oversee supportive care, symptom management, or comfort care
Hospice Physician Collaboration
Hospice care teams provide interdisciplinary care to seriously-ill and terminally-ill patients and support to patients’ families. Care teams are composed of medical and non-medical practitioners and are led by hospice physicians.
Every individual on the team communicates with the physician who oversees the overall treatment plan. The physician tracks patient progress and makes adjustments to the care plan as necessary. All changes are communicated to the right person.
Who Needs a Hospice Physician?
Patients diagnosed with the following conditions may need the care of a hospice physician:
- Advanced End Stage Senescence or Debility
- Amyotrophic Lateral Sclerosis (ALS)
- Liver Disease
- HIV
- Cancer
- Pulmonary Disease
- Alzheimer’s Disease or Dementia
- Stroke and Coma
- Parkinson’s Disease
- Heart Disease
- Multiple Sclerosis
Levels of Hospice Care
The role of the physician will change depending on the level of hospice care being provided:
1. Routine Home Care
Routine home care encompasses a range of services provided in the patient’s place of residence. This care is for patients not currently experiencing a medical crisis. Members of the hospice care team visit the patient in their home to provide the necessary services. Routine home care services can include:
- Services of a doctor, physician’s assistant, or nurse practitioner
- Nutrition counseling
- Nursing services
- Social services
- Occupational therapy
- Speech-language pathology services
- Hospice aide services
- Physical therapy
- Spiritual support
- Medical supplies
- Medications for pain and other symptoms
- Durable medical equipment
2. Continuous Home Care
Continuous home care is provided for patients in crisis who need a higher level of nursing care. Patients are under the care of a nurse for at least eight hours in a 24-hour period. Patients may also receive help from other hospice team members. Patients experiencing the following symptoms may need continuous hospice care:
- Pain that isn’t going away
- Severe nausea and vomiting
- Severe breathing problems
- Anxiety or panic attacks
A breakdown in the patient’s family or caregiver support system may also necessitate continuous hospice care.
3. General Inpatient Care
Patients experiencing short-term symptoms so severe they can’t be treated at home may need to be treated at an inpatient facility. Inpatient care is provided by nurses who administer medication, implement treatment, and look after the patient around the clock.
4. Respite Care
Family members active as caregivers may need professional assistance from time to time to reduce stress and give them a short break. Respite care services are designed to support the caregiver, rather than the patient. Patients who don’t qualify for continuous or inpatient care, but are becoming too much for a family caregiver to handle, may benefit from respite care.
