“When you are there, be truly present, be into that moment, 100%, and that place, or person, or experience will forever become part of you” — Bodhi Smith
Living On The Clock
Hospice patients are living with an incurable, untreatable, terminal illness. They are living a life on the clock. Every tick and every tock is a countdown that can overwhelm a patient. They have little to no control over their life. They may be worried for their loved ones. They are often wracked with anxiety, fear, frustration and disappointment. Even worse, these emotions can be negatively heightened by the effects of medications leaving many patients feeling vulnerable and afraid.
Further, their may be a host of other particular scenarios, such as a language barrier, a history of poor interactions with the medical community, poverty, loneliness, and more all culminating in a desperate patient.
While providing medical care such as pain and symptom management is the primary objective of hospice, how the patient and their loved ones feel about their hospice care team has a great impact on the patient’s health & well-being as well as how the loved ones will remember your care long after the patient has passed.
5 Tips To Show Hospice Patients You’re There For Them
Tip #1. Start Fresh
You might be in a rush, running late from the last patient, documentation piling up, whatever it might be, when you feel rushed, stressed, or anxious, no matter how well you think you hide it those feelings come out.
Compare how you treat a relatively stable patient you’ve been treating for months to how you treat a patient the first time you meet. There is a natural level of casualness that is part of and comes with building a relationship. However, that familiarity can also lead to the patient feeling like they are being taken for granted.
Are your visits taking less time? Are you rushing through explanations? Are you still asking questions and listening with intent?
Try to visualize who and how you were with the patient the 1st few times you met and re-enter that space.
Tip #2. Inspire Trust
Patients need to feel that they can trust their healthcare provider. Our impressions our formed almost instantly upon sight. And a new or expanded impression is made every time with every interaction.
Be the professional that automatically inspires trust.
Wear a professional uniform that is clean and crisp. Don’t show up with messy, or torn, or dirty clothes. Be prepared to change your outfit between patients if need be. Make sure that your hair is neat, nails trimmed, minimal or no jewelry, and that your overall appearance reflects professionalism.
Remember that in hospice your care cannot be solely based on temporary outcomes of pain management and symptom. As opposed to traditional health care with a curative outlook on treatment, the outcome of this type of medical care is death. How professional you are, the trust you can inspire, is a key element of hospice care and the foundation of how the care you delivered will be remembered.
Tip #3. Be Honest
Honesty is more than simply ‘not lying’. Honesty also means sharing information directly and forthrightly, without fluff or skipping details.
The patient and their loved ones may be anywhere on the range of accepting the finality of the illness. Your job is to provide care that is honest & comforting. Don’t pretend or ignore that they’re suffering a terminal illness or minimize their pain or symptoms while over-promising what the medications will do for them. There is a fine line between having a comforting manner while acknowledging their difficulties and minimizing or sugarcoating issues in a manner that distorts from the reality.
However, honesty does not need to be harsh and cold. Empathy, listening, focus, and mindfulness go hand in hand with honesty & forthrightness. Honesty will allow patients and their loved ones to effectively participate in care the treatment decision-making process and prepare for what’s to come. And when patients feel informed and involved that can provide them a sense of control. Anything less than honesty undermines their ability to participate and plan.
Tip #4. Respect My Autonomy
Be respectful of people’s autonomy.
Regardless of how many times a loved one has been present during a conversation or treatment, ask your patient regularly if it is ok to proceed while others are present. Don’t assume that because previously it was ok, that your patient feels comfortable having a loved one present during this treatment or conversation. Remember, the patient may not have the emotional capacity, stamina, or wherewithal to express their desire for privacy on their own.
Make sure to create a private moment in order to ask your patient about their privacy needs for that visit and to express any other concerns they may have. It may be difficult for them to say no with their loved one in front of them.
Don’t rely on the patient to pro-actively verbalize their wants and needs.
The necessity of asking and directing questions to the patient, not just about privacy but about their pain, symptoms, and other issues, even when caregivers and loved ones are in the room, can not be emphasized enough. Many patients, whether it’s their personality, culture, or simply because they feel weak, will need to be pro-active in expressing themselves.
Ask open ended questions and listen with focus. Though caregivers and family may jump in with answers, if the patient is capable of responding, do not allow the responses from others to stand-in for the patient’s response. You can note the family member’s response and then ask the patient if they agree with that response, or if they have more to say, or simply that you’d like to hear from them.
Treating a hospice patient with the respect of autonomy, and empowering them to have some control over their situation simply by keeping a conversations focus on them, their responses, their wants, their needs, is a powerful way to show a hospice patient that you’re there for them.
Tip #5. Don’t Just Slip Out The Back Jack
Everyone knows that healthcare providers are stretched thin. That’s why it’s so important to put the previous patient and the next patient you have to see out of your mind while you’re with a patient.
When you’re visit is wrapping up, don’t just grab your stuff and things, say a quick goodbye and rush out the door to get to your next patient. Slow down. Take the time to close the visit with a recap of what was done or discussed during the visit. Make sure to ask questions such as “What do you think of our visit today?” or “Can you tell me if there is anything we discussed that you still have questions about.” As you leave it is a great opportunity to let them know that you recognize they may think of questions later and they should keep a pad where they can write down thoughts and questions to discuss at your next visit.
When you’re there for your patient, and they can feel it, you will create better results for your patients, their families, and clinicians. Practicing these skills will deliver positive returns for everything from referrals to testimonials, reviews, & your hospice CAHPS scores.
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