Hospice Care 101: Dealing with Death, Patients, and Family

For patients nearing the end of their lives, hospice care provides the comfort and medical care they need for their final days. Although the health care professionals who work in hospice care may find their work to be emotionally and mentally taxing, it’s an important job that helps provide peace and comfort to dying patients and their family members.

If you’re interested in pursuing this career path and curious what it’s like, look no further. Here’s everything you should know about working in hospice care.

How Does Hospice Work?

Hospice care can be provided at an in-patient facility or in a patient’s home. Patients of all ages have access to hospice services if they have a prognosis of six months or less to live due to a terminal illness, life-limiting injury/trauma, or old age.

Health care professionals that provide hospice care don’t just provide medical care to the patient. They also offer emotional, psychological, and spiritual care to both the patient and their family members. 

Coping with the idea of death can be extremely overwhelming, so hospice workers are especially equipped to provide support during such a difficult time. As part of their duties, they ensure the patient is comfortable and not suffering in their last moments.

Who Is Part of a Hospice Care Team?

There are many professionals involved in a hospice care team to provide the necessary services for patients and their families. Here are their titles and responsibilities:

  • Primary care physician (PCP): A PCP is typically the referring physician who determines the patient’s need for hospice care. They are the point of contact for all related medical issues/concerns.
  • Hospice medical director: A hospice medical director creates and coordinates a plan of care for the patient to ensure all of their needs are met by the rest of the team.
  • Registered nurse case manager: An RN case manager typically visits the patient at least two to three times per week to check in on them. Case managers also ensure other specialists work as a team to provide the best care for the patient. 
  • Social worker: A social worker takes care of the patient’s and their families’ psychological needs by providing emotional support, assisting with paperwork and financial tasks, and offering counseling. They can also help them find resources as needed.
  • Chaplain: A chaplain offers spiritual support to help the patient and loved ones move through the end-of-life journey.
  • Bereavement counselor: A bereavement counselor helps individuals process and cope with the grief that inevitably surfaces when a loved one passes.
  • Home health aide/certified nursing assistant: A home health aide or certified nursing assistant is generally responsible for household tasks and activities of daily living based on their scope of practice. They also educate family members on how best to support the patient.
  • Hospice volunteer: A hospice volunteer can help the caregiver with household tasks like running errands, cooking meals, and providing companionship.
  • Caregiver: A caregiver is typically a loved one of the patient who offers support in all aspects of the journey and can also be the one responsible for legal and financial decisions involving the patient.

Each person involved in a hospice care team plays a vital role and should share the goal of providing the best comfort and care to the patient.

The Challenges of Working in Hospice

Given the nature of hospice care, health care professionals in this setting face the difficult task of dealing with terminally ill patients and emotional families as their loved ones reach the end of their life. 

If you’re planning on working in hospice care, you’ll need to be prepared for these challenges to successfully navigate difficult situations in your day-to-day work.

  • Comforting patients as they face death: Everyone copes with death differently. Some patients are accepting of their situation while others grow defensive or depressed, lashing out at health care professionals. Additionally, as many diseases progress, patients may become confused or agitated. 
  • Managing expectations of patients and families as their condition progresses: It’s important to be completely upfront with patients and their loved ones about what to expect. Managing their expectations is a complicated feat. If something inevitably goes wrong and the patient or their family members weren’t emotionally prepared, they might lash out due to their own pain.
  • Communicating difficult news to family members: It’s never easy to be honest with your patients and their loved ones when you know it will hurt them, but it’s part of the job in making sure they have all the information they need to make decisions and be prepared for outcomes.
  • Getting attached to patients only to lose them: There will be many times when you grow attached to your patients. Losing them after forming a bond or connecting with them on an emotional level can be very painful.
  •  Confronting your own mortality and beliefs about death: When you’re faced with death on a regular basis, you might start to question your own beliefs about death or fear the end of life for you and your own loved ones.

Despite these challenges, many professionals who work in hospice care find it rewarding to make a meaningful difference for patients and their families. 

Additionally, your responsibilities will vary as you work with new patients and as part of a greater team. You’ll get the chance to make a true impact on each individual you care for, including their loved ones.

How to Get a Job in Hospice Care

Interested in working in hospice care? While there are many challenges of working in hospice care, it’s a great opportunity for health care professionals who want to make a difference and touch the lives of their patients.

Registered Nurse

In order to start working in hospice care as a registered nurse, here are some steps to take get the job:

  1. Get the proper education: You’ll need to earn your Associate Degree in Nursing or a Bachelor of Nursing degree and be a licensed registered nurse.
  2. Earn the necessary certifications/credentials: Pass the standardized Certified Hospice and Palliative Nurse exam to get certified in hospice and palliative care. 
  3. Gain the right amount of experience: You should plan on getting at least two years of experience working as a nurse in a relevant job, like home health care.

Nursing Assistant and Other Positions

Of course, these are just the steps required for RNs who want to go into hospice care. You can choose to become a nursing assistant or licensed nurse without having to meet the same requirements as an RN, or further your career by becoming an advanced certified hospice and palliative nurse with additional education, credentials, and experience.

In some states, you may have the option to become a home health aide or work as a hospice volunteer to get a feel for what it’s like to work in this speciality. 

Although hospice care can be physically and emotionally challenging for those who choose this career path, it’s an incredible experience to be able to work and provide support to patients at the end of their lives and their families. 

Looking to pick up per diem shifts? Sign up for Clipboard Health to browse opportunities at facilities of your choice, including inpatient facilities that provide hospice care.