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What Are the Four Levels of Hospice Care?

Many people are familiar with the concept of hospice care for terminally ill patients and family caregivers. It offers a holistic approach to health with a goal of enhancing your loved one’s quality of life as they approach their final days.

Hospice emphasizes comfort rather than trying to cure an illness, and it may include skilled nursing, medication management, emotional support and other services. All services must follow an individualized plan of care tailored to the specific needs of each patient and their family. 

Patients with Medicare Part A become eligible for hospice benefits when a physician certifies that they have a life expectancy of 6 months or less. Benefits may cover four different levels of care based on patient needs, as determined by a doctor.

The four levels of hospice care are as follows:

  1. Routine home care
  2. Continuous care
  3. Inpatient hospice care
  4. Respite care

An individual patient may receive just one level of hospice care or all four levels at different times, depending on their needs.

Level 1: Routine Home Care

This is the most common type of hospice care, as most patients receive services at home. For the purposes of hospice care, “home” is considered to be wherever the patient has their permanent residence. For some people, this may be a single family home or apartment. For others it may be an assisted living community or skilled nursing home. 

Patients receive a basic level of care with a focus on physical, emotional and spiritual support, along with social services. Hospice services are provided by a care team that includes nurses, personal care aides, chaplains and volunteers. In addition to medical care, patients may receive help with homemaking tasks and errands. 

Hospice care includes medications for symptom control, along with medical supplies and equipment such as wheelchairs and bedside commodes. Depending on the patient’s needs, they may also receive physical therapy, occupational therapy and speech therapy. 

Level 2: Continuous Care

Continuous home care is available during times of crisis, when higher-level care is needed for at least 8 hours in a 24-hour window. Patients become eligible when they experience severe, acute symptoms that can only be treated by a nurse or other medical professional. Like routine home care, it takes place in a residential setting. 

Symptoms that may require continuous care may include: 

  • Unrelieved pain that fails to respond to pain medications
  • Nausea and vomiting 
  • Severe shortness of breath
  • Anxiety or panic attacks
  • Breakdown in the patient’s primary caregiver support system

Level 3: General Inpatient Care

There may be some circumstances when a patient’s symptom needs cannot be met in their home. When this occurs, they may qualify for care in an approved inpatient setting. 

Symptoms treated are often similar to those that qualify for continuous care. Nurses and other health professionals are on hand around the clock to provide ongoing medications, specialized treatments and emotional support. 

Inpatient hospice care may be provided in a free-standing hospice center, a hospice unit within a traditional hospital or a skilled nursing home. 

Level 4: Respite Care

It’s easy to feel overwhelmed when you’re a caregiver. Between tending to your loved one’s care and handling cooking and cleaning, you may struggle to meet your own needs.

Respite care is intended to relieve caregiver stress by providing for your loved one’s needs while you take a break. In most cases the patient may be temporarily admitted to an inpatient setting (such as a long term care facility) for up to 5 days. At other times, a hospice employee or volunteer may be scheduled to provide companionship and care while a family caregiver runs errands or takes some personal time to relax.

Respite Care ensures that your loved one remains comfortable and stays up-to-date on their medications while you’re away. Assistance may also include help with, personal care and simply providing much-needed companionship. 

 

At Crown Hospice, we understand that every patient, and every family, is unique. That’s why we’re dedicated to increasing quality of life for patients and caregivers alike during this difficult time. 

If you need information about hospice care for yourself or a loved one, please reach out to us at 573-335-4800 or contact us online at any time. 

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