The Hospice Interview Process: Key Questions To Ask Before Selecting Your Hospice Provider
With so many options available, finding the best hospice provider for your loved one can be overwhelming. On the one hand, all hospices are required to offer a base level of care and services to their patients. On the other, every hospice approaches these services differently and while some providers go above and beyond for their patients, others do only what is required.
To help those who are seeking the right fit, two members of the Crossroads Hospice team Terri Doughty, Vice President of Inpatient Services, and Megan Henson, Assistant Executive Director in Kansas City offer key questions everyone should ask before selecting a provider.
How often will your staff visit?
Every hospice patient has a unique set of needs and every hospice will approach direct patient care and caregiver support in its own way. Ask questions to understand specifically how the provider will deliver care.
With any hospice provider, Id want to know how often my loved one is going to be seen, says Doughty. Someone should be checking on them regularly to make sure theyre ok and that they have everything they need.
Its important for people to know that as a patient declines, they will be seen more often to ensure comfort is maintained and the necessary support is given to caregivers, says Henson.
What support do you offer in the case of an emergency?
How do you provide end-of-life care?
What makes you different from other hospices?
Questions About Hospice Services For Family Members
1. What kind of respite care is available and under what circumstances? If the family is exhausted and needs a break from caregiving, is respite care available?
Ask if there are requirements that need to be met first, what type of care is offered, and who provides the care.
For example, some hospices will move your older adult to an in-patient facility for up to 5 days or provide continuous nursing care at home for short periods of time.
2. What is the expectation about the familys role in caregiving?Clarify what the hospice company expects family members to do versus what they will do to care for the older adult.
Make sure the responsibilities the family is expected to take on is realistic for your situation.
3. Will the hospice company provide training to family caregivers?Family members may not have caregiving skills or experience. But if the hospice company provides training, people might feel more confident and be more willing to help.
4. What help do hospice volunteers provide and how can we request their help?Hospice volunteers may be available to help with a wide variety of tasks. Find out more to see if they could help you.
5. What kind of grief counseling or support is offered?Grief counseling services are often available at any time for seniors and families while hospice services are being provided.
What Makes A Good Hospice
Lots of hospices might provide the above services, but how do you know youre choosing high-quality hospice care for you? Here are pros and cons of hospice, as well as some things you want to look out for. Combining this with the next section on interviewing for hospice will help you choose exceptional service.
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Interview Questions For Hospice Nurses
Being a nurse can be pretty challenging and takes a lot of hard work before youre really really considered to get a job especially as a hospice nurse.
There are so many things that go into their careers and can they perform different functions than the other people in the hospital.
When hiring someone, an employer needs to be confident that this person is going to be able to perform for them in the long term.
Most of the nurses are great picks for your hospital, but you need to be able to ask them serious questions so that you can be confident in your pick.
Its best to let the conversation flow naturally, but these questions are going o serve as a guide so that youre not lost in the interview.
In this article, weve listed the 12 best interview questions for hospice nurses with examples to help you out.
This is a hard job to get, but its also a great job.
You should ask questions that are going to make the hospital a more positive experience to be in for their shifts.
Knowing how many hours the nurse is going to work is also important for getting hired.
Some can only work the day shift, while others are more comfortable during the night shift.
Its good to maintain authority as an employer, but also give the nurse to ask questions if they have any concerns.
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How Often Will The Nurse Come
Managing pain and other symptoms is a big part of what hospice does. A hospice nurse is responsible for assessing pain and making recommendations for medication changes based on what they observe.
Ask the nurse how often you can expect them to come each week, and also how to contact them outside those regular hours. A nurse should be available on call 24-hours a day.
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Can You Choose Your Own Hospice
Even if youve been diagnosed with a serious illness that has robbed you of your independence, youll still want to make decisions about your own life if you can. Is a senior allowed to choose the hospice care they receive, or will this important decision be made for them?
Rest assured, its certainly your choice!
Although your doctor might offer hospice care options, that doesnt mean you have to take them up on their recommendation. If you live at a nursing home or an assisted living facility, you also dont have to choose the hospice care they suggest.
Read our article on How To Communicate With Your Parents Doctors.
When my mom was put under hospice care, we had no idea you could choose a hospice company, so we just accepted the hospitals assignment. Fortunately, Mom received wonderful home care via aregistered nurse who made Moms final days much more comfortable.
Your adult children or caretakers could also have opinions about hospice care. Its ultimately your choice whether you listen to them.
At the end of the day, you need hospice care that you feel comfortable with. Its also ideal if your health insurance provider has a covered hospice benefit in place, such as those under Medicaid or a Medicare Advantage Plan.
Read our article, Does Hospice Take Your Assets.
How Do You Work With Others On A Team
The hospice director will work with others on the interdisciplinary team. Members include physicians, nurses, nursing assistants, chaplains, social workers, counselors, therapists and volunteers. Hospice directors must have good communication skills and teamwork capabilities in order to provide the best care for their hospice patient. Qualified candidates may share examples of previous interdisciplinary teamwork experiences.
References
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How Long Has The Hospice Provider Been Around
One of the questions to ask during a hospice interview is how long the hospice provider has been serving hospice patients. The more established the provider is, the surer you can be that the hospice staff is well trained and experienced. Hospice volunteers and staff who work with organizations that have been around for a long time have probably received their training from others who have a wealth of knowledge to share.
Interviewing A Hospice: Questions To Ask
Once youve found a hospice you are interested in,call or have a family member call and ask to speak toan intake person. Make sure to have paper and pento take notes. Explain your current medical situation,tell them where you live, and ask questions from thelist below that are important to you. Listen for concern, kindness and thoughtful responses.Remember, its important to choose a hospicethat is a good fit for you based on yourend-of-life priorities.
General Patient Care:
- What is the role of my physician once hospicecare begins? Can I still see my doctor if Iwant to?
- How will the hospice physician oversee my careand work with my doctor?
- How are my family and caregivers given theinformation and training they need to care forme at home?
- What happens if my care cannot be managedat home?
- How does the hospice provide services forpeople in different settings such as nursinghomes or other residential care?
- How will the hospice staff work with me, myfamily and caregivers, and honor my wishes?Are there volunteer services offered?
Pain Management and Comfort Care:
My End-of-Life Options:
After-Hours Care
- What is the hospice staff weekend and nightcoverage?
- How quickly do hospice staff respond to after-hour calls and emergencies?
- Are other services, such as a chaplain or socialworker, available after hours?How are calls and visits handled whendeath occurs?
Paying for Hospice Care:
Additional Information
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Q Do State And Federal Reviewers Inspect And Evaluate Hospices
A. Yes. There are state licensure requirements that must be met by hospice programs in order for them to deliver care. In addition, hospices must comply with federal regulations in order to be approved for reimbursement under Medicare. Hospices must periodically undergo inspection to be sure they are meeting regulatory standards in order to maintain their license to operate and the certification that permits Medicare reimbursement.
Operational And Situational Questions
- One of the patients under your care starts complaining constantly. How do you deal with this?
- Imagine a patient dies suddenly when their family isnt around. What do you do about the patient and how do you inform their relatives?
- Envisage that a DNR patient just died and a panicked caregiver tries to perform CPR on them. What would you do?
- How would you deal with a family member who tried to convince the patient to continue treatment that stopped at the patients request?
- What would you do if you suspected that a family member was stealing from the patients medication?
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Can You Help With Family Conflict
Death and dying are not only about grief, letting go, and acceptance. There can also be a great deal of conflict among family members about hospice. It is not unusual for some family members to object to hospice and advocate for curative treatments.
Once hospice starts, anger and resentment can sour what should be a time of connection and love. Ask the social worker if they can help with conflict by talking individually with frustrated family members or getting the entire family together to talk things out and reach a resolution.
Questions About Hospice Services For Seniors
1. Are hospice-certified nurses and doctors on staff and available 24 hours a day, including weekends and holidays?If you call with an urgent need, how fast could they respond? Are qualified staff available to answer the phone 24/7?
For example, if theres an issue and you need a certified nurse to come to the house at 3am on Sunday, how long would it take for them to arrive?
2. Can they meet your older adults specific needs?If your older adult has special or specific needs, ask the hospice provider how they would handle those.
3. How quickly will a care plan be developed by the hospice?The care plan will make sure your older adults needs and care are documented. This makes expectations clear and keeps everyone on the same page.
Ask when you can expect their care plan to be completed.
4. How quickly will pain and symptoms be managed?Once hospice takes over, how quickly will your older adult get the medications and treatments they need to stay as comfortable as possible?
When the hospice orders medication, is it delivered by the hospice or do you need to pick it up? Will there be any delays in treatment as the transition is made?
5. If medications arent managing pain or symptoms well enough, how long will it take to make changes?At any time, if the medications arent managing the pain or symptoms, how quickly can changes be made? How long will it take to make your older adult comfortable again?
Find out how who will visit , how frequently , and for how long .
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What Bereavement Services Are Available
Hospice care isnt merely for the person suffering from a life-limiting illness but also to help the family with their emotional suffering. One of the important questions to ask during a hospice interview is what types of counseling services and support are available to assist you through the process of caring for your loved one and to help you once theyve passed.
What Are The Average Caseload And Coverage Area
This question may seem like a direct question to ask during the hospice nurse interview, its meant to be. If this is too direct for you then you could also try asking What does a typical day look like?
This question is to find out how much you will be traveling and how many patients you will be expected to visit each week.
Many hospices cover a variety of counties and towns which means that you could be traveling a lot.
You might easily travel more than 100 miles per day to see your patients.
This can be difficult mentally when others on your team are covering nursing homes and only driving to a couple of places per day.
This also equals wear and tear on your car so you will want to be clear on this point.
How you plan your day will depend on how many patients you are responsible for.
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Hospice Nurse Interview Questions
Hospice nurses provide end-of-life support to terminally ill patients, either at the patients home or other facility. Theyre registered nurses so they possess all the typical qualities of those healthcare professionals. But, since theyre dealing exclusively with a patients inevitable demise, their compassion and mental resilience should be even greater.
Not every RN is cut out to be a hospice nurse. You need someone who believes in the hospice philosophy and can persuade you they can handle the burden. If youre interviewing candidates who are inexperienced in hospice care, make sure they have the motivation and emotional stability to do the job.
Focus the greater part of the interview on asking about their past experience and their responses to hypothetical scenarios. You can ask basic nursing questions to verify their knowledge of procedures and patient care. A certification in palliative care can be an asset.
How Often Will Aides Come
Aides assist with bathing, dressing, re-positioning, hygiene, and toileting your loved one. When an aide is not there, a family member or another professional caregiver will need to assume these duties.
Knowing the exact schedule will help you put together a caregiving schedule. In most cases an aide will come only three days a week for an hour or so, leaving many of these responsibilities to family members.
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How Long Can My Loved One Stay
It is also important to note that a common misunderstanding about hospice is that it provides 24-hour care. It does not, which means that someone has to attend to your loved ones medical and comfort needs when hospice staff is not there.
Furthermore, with hospice at home or a senior living facility, it is possible to be recertified if the Medicare criteria are still met. Does the same hold true to a hospice facility? What are the conditions where a hospice resident would be discharged? Even though hospice rules are the same regardless of where the service is administered, ask to verify that information.
How Does Hospice Benefit People With Advanced Dementia
Most people with advanced dementia cannot communicate clearly, which means they may not be able to share their concerns with their caregivers. Caregivers may find it difficult to provide adequate care at the end of life because of this and other concerns. Hospice care can help with this situation. Hospice whether used at home or in a medical facility can provide caregivers and the person with dementia the support they may need near the end of life. Studies show that family members of people with dementia who received hospice report better quality of care and having more of their needs met at the end of life.
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Does The Hospice Offer Extra Services And How Are They Charged
Some services are not required by Medicare but may improve a patients comfort, such as radiation and/or chemotherapy to shrink a tumor and ease a cancer patients pain. How are those services paid for? Does the hospice work with volunteers to offer services like massage, reiki, or group therapy? Sometimes these premium services can help you decide if the hospice is right for your loved one and ensuring their comfort.
What Is Hospice Care Like During An Emergency
You need to know how quickly you can get in touch with a hospice team member when you require urgent care. Since this could happen at any time, its important that the hospice care provider you select has staff able to respond and arrive when you need them. It also gives you an expectation of when the hospice staff member will arrive once youve called and asked for help.
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What Questions To Ask Hospice
Determining when its time for someone with a terminal illness to go into hospice is its own agonizing decision. Next, you have to find good end-of-life care, which can be just as difficult if not more so. How do you choose a hospice care provider?
Here are some important questions to ask when scouting a hospice program:
- Do you provide extra services?
- What role do family caregivers play during this difficult time?
- Are the hospice services certified by Medicare?
- Does hospice offer bereavement services?
- Is respite care available?
In this article, well help you navigate the difficult questions you might have about hospice care. Well cover everything from whether you can choose your own hospice agency to tips on interviewing social workers, a potential hospice nurse or the doctors.
Whether youre a senior going into hospice care or an adult child with an elderly parent or loved one, this article is for you.