Tuesday, January 24, 2012

Explanation of a "Hospice House"


When I was first told that there was a hospice house in Pratt I let out a skeptical humph. Surely this was misinformation. The reason for my skepticism was that only four stand alone inpatient hospice homes exist in the state of Kansas.

Luckily, I was wrong. Although it may seem improbable, there is an inpatient hospice facility in this part of Kansas.

Realizing that the rarity of such places would naturally lead to some confusion on what they are, this gem is today’s topic.

First a little background. When most people talk about hospice they are referring to residential care. This is when hospice comes to where a person in living, whether in a home or a nursing home. The nurses may come as often as once a day, to as little as once a week. This is considered routine care because the actual needs are easily taken care of in that location.

Residential care is the most common because generally people prefer to be in their home, surrounded by family when they die. Unfortunately, though, this isn’t always possible.

This brings us to another type of hospice care called acute care. Acute care is rarely needed, for it is a high level of care specifically for someone with a symptom that is out of control. When the family is ready to hit the panic button, think acute care.

In the past, such a situation may have led to an admission to the hospital or worse, suffering without proper care in the home. This is why we are so fortunate to have an inpatient hospice. In a crisis, someone can come for acute management to the “house”. They get the aggressive symptom control a hospital would offer, with the comfort of being in a home setting. This benefit is covered by hospice, so once again free to the patient.

Acute care is exactly what Mr. M needed. Although able to have hospice at home for months with liver failure, when he began to transition into the dying process things got chaotic. Mr. M began to get restless; hallucinating, trying to get out of bed, and shouting “Help me” continually throughout the night. His wife was exhausted and at her wits end. Mr. M was brought to the hospice house for acute care. Medications were changed and Mr. M settled peacefully into the dying process as family gathered for the next several days at his bedside.

Some may say, “But I knew someone living out there for months!” The hospice house in Pratt has room for 9 patients, but because the need for acute patients is rare, rooms are used occasionally for residential care. Such a person doesn’t have needs at a hospital level of complexity, but still needs the 24/7 support. Because they choose the house to be their home, just like someone’s mortgage or room and board rate in a nursing home, there is a charge for residential care.

The secret is out now; doctors from across the state have sent patients to the hospice house. It’s time we realize what a treasure we’ve got. 


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