Hospice: The Medical Home for End of Life Care

Mahveen Hussain | posted September 09, 2009 |

By now you may have heard about a healthcare model called the “patient-centered medical home.”  It’s a concept that goes beyond just a physical place, but defines the people who provide healthcare and how it’s carried out. In a medical home the patient has an ongoing relationship with their primary physician who manages a team of healthcare professionals. This team is responsible for managing and coordinating all aspects of each patient’s care including preventative, acute and chronic care management, lifestyle and nutritional modifications and referrals to specialists.  Care is coordinated by the team whether the patient is at home, a hospital or nursing home. The care provided is accessible, continuous and coordinated unlike the current system of healthcare provider networks in the U.S.

The term, medical home, was originated in the 1960s by the American Academy of Pediatrics (AAP), and then officially defined in the early 1990s. It began catching on in 2002, when the AAP adopted it as its standard of care, and continues to gain momentum in the medical community. What I find interesting is the concept and principles behind the medical home model are what hospice care has been about since its inception.

Like the medical home model, hospice care is a patient-centered and whole-person approach. Each hospice patient has a team of caregivers that include a doctor, nurses, home health aides, a nutritionist, social worker, spiritual counselor, bereavement counselor and volunteers.  Because each team member has their own unique and valuable insight into the patient, patient care decisions are based on input from the entire hospice team, not just the physician. Coordination of care is achieved through a high level of communication and collaboration between our staff members. This includes weekly interdisciplinary meetings and daily contacts and updates throughout the day on the condition of our patients. We coordinate services with the primary care provider, medical equipment providers, and respite and nursing home care providers. We arrange for services with outside providers for consults when needed. And lastly we help arrange funeral services and actively participate in memorial services and bereavement counseling.

Other similarities between the medical home concept and hospice care are their goals to provide patients with around-the-clock access to medical consultation, and respect for a patient's cultural and religious beliefs. At each AseraCare Hospice facility we have a registered nurse on staff 24 hours a day, 7 days a week to answer questions, make patient visits, and to just be a comforting presence when the need arises.  Additionally, at AseraCare Hospice, our staff is trained to listen carefully, ask questions, and respect beliefs, rituals or ideas that may be different from their own. We also utilize translation services when needed to provide the best quality care to our patients and families.

Hospice care epitomizes the concept of “the medical home” for end of life care, and additionally provides the caring “family” of staff members and providers which truly embody the spirit of any home.