The 4 Levels of Hospice Care
The four levels of hospice care were designed to treat patients across a variety of scenarios and needs. While Routine and Respite Care help create a stable environment that serves both patients and caregivers, Continuous and General Inpatient Care treat spikes in symptom severity that require more intensive medical assistance.
Routine Home Care
Routine Care is what most people think of when they think of hospice. It consists of several professionals regularly tending to the patient’s needs within their home or residence. The goal of Routine Care is to make the patient as comfortable as possible, so the patient and family can get the most out of their time together.
What’s included?
At this level of care, the family still handles the bulk of daily caregiving. The experts listed below can attend to the patient regularly and as needed, but Routine Care does not include round-the-clock nursing aid.
- Physician care
- Nursing care
- Medical social services
- Spiritual counseling
- Medical equipment and supplies
- Medication to manage symptoms and pain
- Hospice aide and homemaker services
- Physical therapy
- Occupational therapy
- Speech therapy
- Dietary counseling
- Bereavement counseling for the family before and after the patient’s death
What if home care becomes overwhelming?
At some point, your loved one may require more care than you’re capable of giving — and that’s OK. In fact, it’s expected. The other three levels of hospice care were designed to meet periods of burnout and crisis-level symptoms to bring the patient back to a state of stability.
Continuous Home Care
Continuous Care is designed as crisis intervention for managing uncontrolled symptoms like severe pain or bleeding, respiratory distress, seizures, nausea and vomiting, terminal agitation and delirium, and others. This care is not intended for end-of-life care, caregiver burnout, or when caregiving becomes difficult.
What’s included?
Note that Continuous Care is not intended to treat a patient who is generally declining, but rather whose symptoms are out of control. Continuous Care gives the patient temporary, round-the-clock medical attention at home with the intention of stabilizing the patient and returning them to Routine Care.
- Management of acute medical symptoms at home
- Palliative care for symptoms caused by chronic conditions like cancer
- Care directed by a physician
- Medical equipment and supplies
- Up to 24-hour, 1:1 care from a Registered Nurse, Licensed Vocational Nurse, and Certified Home Health Aide
- Assistance with the activities of daily living
- Spiritual and emotional support from counselors, social workers, and chaplains
How long does Continuous Home Care last?
A patient can receive Continuous Care as long as crisis-level symptoms persist.
General Inpatient Care
General Inpatient Care (GIP) is appropriate for intense periods of uncontrolled crisis symptoms that can’t be feasibly managed in the home. This type of care treats those symptoms in a contracted, certified inpatient facility, and addresses scenarios that need frequent, prolonged attention from medical professionals. The goal is to stabilize crisis symptoms so that the patient can return home.
What’s included?
General Inpatient Care takes place in a Medicare-certified hospice inpatient facility, hospital, or skilled nursing facility. The hospice team works alongside the inpatient medical team to coordinate care and treat symptoms.
- Treatments and interventions needed to address crisis symptoms
- Evaluations by doctors and nurses
- Delivery of medication including IV-administered drugs for pain and symptom management
- Round-the-clock care by facility staff
- Patient care planning meetings conducted with the facility’s staff
- Personal daily care by a certified nursing assistant
- Regular visits from the nursing case manager, hospice chaplain, social worker, volunteer coordinator, and others
- Family bereavement services
- Medical equipment and supplies
How long can General Inpatient Care last?
General Inpatient Care is intended to be short-term, but there’s no firm limit on how long it can last. However, each day the team must document and justify why GIP is necessary, what treatments have been done, what progress the patient has made, and why interventions can’t be provided at home.
Inpatient Respite Care
Respite Care offers temporary care if you need a break to take a trip, meet a conflicting obligation, or simply recharge. The goal is to give caregivers the break they need to be in the best condition to care for their loved one. Respite Care pays for the patient’s temporary transfer to a Medicare-approved inpatient facility for up to five days.
What’s included?
For the patient, the normal duties of caregiving are handled by the facility staff. This care is overseen by the patient’s regular hospice team.
- Bathing and other daily care performed by a certified nursing assistant
- Attention from the hospice chaplain, social worker, and others
- Support from trained volunteers
- Family bereavement services
- Medication management and delivery
- Medical equipment and supplies
- Patient care planning meetings conducted with the facility’s staff
How do I tell if I am experiencing burnout?
If you’re wondering whether you’re burned out, you probably are. If you are physically and emotionally exhausted or overwhelmed with caregiving, it’s time to arrange for Respite Care. Sometimes your hospice team will recommend Respite Care if they see signs of burnout in caregivers, but if you’re feeling burned out, you should let your hospice team know and they can help arrange a Respite Care period.
Let us help.
We know the healthcare and hospice system can be overwhelming and difficult to navigate. Our team wants to help you create the best possible environment for your family or loved one. Please don’t hesitate to give us a call to talk through your particular situation, so that you can make the most informed decision regarding the care of yourself or your loved one.
For more information about general hospice services, what’s covered, visit our services page.
Why In the Arms of Grace Hospice?
IAGH is a family-owned and operated boutique hospice serving the communities of Los Angeles and its surrounding counties. We believe that while hospice may be a difficult time in one’s life, it certainly doesn’t have to be the worst. Our team goes above and beyond to help patients and families gain dignity, peace, and resolution in the face of loss.
Schedule a complimentary nursing evaluation.
We’ll contact your physician, walk you through the process, and discuss the nuances of hospice care and all that it entails.