With a focus on providing comfort and compassion, home health and hospice care gives patients a chance to control their quality of life. To learn more, we spoke with Dr. John Berges, medical director of home health for Gold Coast Home Health &
Hospice in Fort Lauderdale.
What type of patient should consider home health care? Any patient who is discharged from the hospital should consider some sort of care at home. It allows for continued recovery in a familiar environment, led by a medical professional who can spot issues or potential complications a lay-person may not.
How does one begin the search for a caretaker? Even though searching on the Internet is an option, it can be overwhelming. There are 285 Medicare-certified agencies in Broward County, so it could be a daunting task to start the search that way. It’s always good to ask physicians about whom they have worked with in the past and who they would recommend.
What are some common mistakes made with home health care?
Patients and caregivers not carefully listening to the instructions given during home visits and not applying the advice given to their situations.
In most home health care cases, the skilled staff member is visiting only for a few hours, so that means family members and friends need to be there for the rest of the time. It could be as simple—yet important—as paying attention when being taught how to change IV bags. It’s also wise to have two other people learn along with you so they can be your backups.
What suggestions can improve a patient’s quality of life? There are a lot of little things family members can do. For example, make sure the patient’s bed is located in an area where he can participate in family life, rather than feel secluded. Family members can also make efforts to accommodate what their loved ones enjoy eating and how they’re feeling at any given moment, since this can change from day to day.
When is the right time to begin the discussion for hospice care? This is an extremely difficult and sensitive conversation for any family to have. We recommend that it happens in conjunction with the patient’s physician and healthcare team. There needs to be an understanding amongst family members that various outcomes are possible, including death. It sometimes takes multiple conversations before all are able to reach that understanding.
What types of medical professionals comprise a hospice care staff?
It’s an interdisciplinary team headed by a physician who specializes in pain management. Next there are skilled nurses who assess a patient’s changes and provide medical care. At Gold Coast, we also have volunteers who monitor the patients in their care and interact with family members—they get to know them on a deeply personal level and try to help lift spirits and communicate what is exactly going on with the patient.
With our experience, we know there’s a lot of fear and apprehension during any transition, so we try to give some organization and direction to these feelings of confusion. The highly skilled Gold Coast volunteers guide family members, letting them know that they can hold the patient’s hand and it’s not a problem if they want to sit on the bed and be close to the patient as he or she is transitioning. The volunteers also give the caregivers some independence, specifically to relieve them for a few hours and allow them a chance to clear their minds.
What should patients expect with hospice care? Whenever possible, hospice referrals should happen early on in the terminal diagnosis phase to prevent a “crisis intervention” type of response. In cases where the Gold Coast nurse, personal care aid, religious figure (if requested) and volunteer does arrive, however, they bring much compassion and sensitivity to each case. It’s an extremely personal experience, so when we know what the patient’s wishes are and involve the friends and families in those wishes, it makes this very difficult situation a more healing experience for all involved.