A hospice case manager nurse is a registered nurse (RN) who is responsible for overseeing the care of hospice patients. Hospice case managers have been specially trained in evaluating and caring for the terminally ill patient and their family or caregivers. The hospice case manager nurse is an expert at recognizing and evaluating symptoms. They work closely with the hospice physician to treat distressing symptoms and improve patient comfort.
A hospice case manager nurse educates families and/or caregivers on recognizing symptoms and providing safe and competent care for the patient. They offer emotional and practical support for both the patient and their family/caregivers. The case manager nurse must have excellent communication and time management skills and be comfortable around dying patients. They should be compassionate and patient and respect the unique differences of their patients.
The hospice case manager nurse works as a part of the palliative care team. They supervise the care of Certified Nursing Assistant (CNA). They work closely with the hospice social worker, chaplain, and volunteers to coordinate physical, emotional, and spiritual care of the patient and family.
LPNs are compassionate and patient, and excellent caregivers. LVNs and LPNs perform a variety of patient care tasks including feeding and bathing, giving injections, collecting samples for lab tests, monitoring patients and medical equipment, and dressing wounds. They also gather information from patients and record it, such as vital signs, and any symptoms described by the patient.
Certified Nursing Assistant
A Certified Nurse Assistant, or CNA, is also known as a nursing aide, nurse’s aide, or orderly. CNAs typically work under the supervision of a nurse or other licensed healthcare provider. Some CNAs also work as home health aides. CNAs usually work in nursing homes or hospitals, to help with daily living tasks such as bathing, eating, and dressing.
Certified Nursing Assistants also help with cleaning, moving the patient, and in some cases, taking vital signs such as temperature, pulse rate, and blood pressure.
A nursing aide, or nursing assistant may also be known as a home health aide when working in a patient’s home instead of in a nursing home or hospital. Not all home health aides are certified nursing assistants, however.
The hospice chaplain is a non-denominational spiritual support person who is available to council and support hospice patients and their families. The hospice chaplain may visit with patients and their families to discuss any spiritual or religious concerns they have. They may offer prayer, communion, inspirational readings, or emotional support.
The hospice chaplain is first and foremost concerned with the emotional well-being of the patient and their family and secondly with their relationship to God. The chaplain is prepared to meet patients and families wherever they are on their spiritual journey. They understand many faiths and honor their differences.
A hospice chaplain is well connected within the local religious community. Chaplains are able to request the assistance of secular professionals, such as priests, shamans, pastors, rabbis, and mullahs to meet the unique needs of the patient and family.
Hospice chaplains are part of the palliative care team and work closely with hospice physicians, nurses, social workers, and home health aides.
The hospice social worker is a certified medical social worker (MSW) who has had specialized training in end-of-life care. Social workers have in-depth knowledge and expertise in working with ethnic, cultural, and economic diversity; family and support networks; multidimensional symptom management; bereavement; interdisciplinary practice; interventions across the life cycle; and navigating health care systems. They are concerned with enhancing quality of life and promoting well-being for patients, families, and caregivers.
In the hospice and palliative care setting, the social worker may help with any number of the following:
- Assisting patients and families in making health care decisions based on personal goals of care.
- Ensuring the patient's end-of-life wishes are documented and known by assisting with advance directives, do not resuscitate (DNR) orders, or POLST forms.
- Contacting local agencies and/or community resources that may be of help to patients and families (i.e. hospice agencies, Meals-on-Wheels, Life Alert, etc.).
- Assistance with insurance, Medicare, and Medicaid paperwork.
- Assistance with funeral planning.
- Identifying emotional and spiritual needs of the patient and their loved ones and finding appropriate support as needed.
- Assistance with bridging family gaps to bring loved ones together whenever possible (for example, help obtaining temporary Visa's for out-of-country family members).
- Assisting survivors with necessary arrangements and paperwork after death occurs.
- Assisting survivors in obtaining appropriate grief counseling. Identifying other needs of the patient and their support circle and assisting as needed.
Typically, one social worker is assigned to a patient to provide continuity of care. The social worker will build a relationship with the hospice patient and their support system and assist in areas of need they identify together. Most hospice agencies have a social worker on-call for urgent patient and family needs after-hours as well.
Check our current job listings at Serenity Hospice & Palliative Care.