I just read an article that due to the nursing shortage many hospices are unable to accept new referrals and are putting people on a waiting list. Really? A waiting list? I appreciate if there isn’t staff, then there isn’t staff, but a waiting list seems incongruous with end of life. Particularly since most people wait until a person is literally on death’s door before reaching out to hospice.
What to do, you ask? Here are some of my thoughts:
Give written literature as to signs of approaching death and what to do as it approaches for the family. Yes, give Gone From My Sight and The Eleventh Hour as a “I’m sorry we can’t bring you on service right now but these will help you” gift. Giving these learning tools is at least not leaving these families unguided (it's also good PR).
Offer a one-time meeting with the hospice social worker to offer guidance in community resources and support. Write it off as part of your community service, even marketing. The family will either remember you as a hospice that had no room in the inn or a hospice that offered guidance even though there was no room.
Can you discharge some of the patients with dementia that are not declining, that are probably many months from death, to accept those patients who are closer to death?
As during the lockdown times of covid when you used the telephone more as your means of contact, begin using the phone for visit assessments. Have a nurse in the office make calls to patient’s families, touching base when nurses are in short supply.
Use your volunteers more. Create a telephone check in where a volunteer checks in each day with a family to see how the patient is progressing and that report is given to the primary care nurse. This can decrease the need for a home visit and provide continued support and assessments of the patient and family.
What you can’t do is decrease the necessary visits to your existing patients to take on more patients, then nobody is helped. BUT you can use social work and volunteer visits to supplement the number of nurse visits which supports the families and provides eyes on the ground.
These are trying, unusual times. We really don’t know what the next weeks will bring, let alone any kind of a future. We need to adapt. Adapting to changing times is being able to think outside the box, to be innovative. We just can’t be putting dying people on a waiting list!!!
Something more about... A Hospice Waiting List?
If your agency has a quiet room where families who are "in the queue" for services can come and watch your copy of NEW RULES for End of Life Care with a social worker or volunteer, this will be most helpful. I know that all hospices cannot afford to provide each family with their own copy of the film. This resource has a profound affect on the fear that families have about narcotics, problems with food and hydration at end of life, withdrawing from family members, increased sleep...