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Hospices is great & they will work with you.

I am about at the point where I am looking in to hospice for myself & I am so glad I'll have it there when I make the transition..
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Actually Hospice does not "work" for you. It is a wonderful service that is paid for by Medicare. It only happens in the last days of someone's life.

Because there are so many people in the end stage of their lives, Hospice must fit all the visits into a certain schedule of work not of their making. They have no choice. So if your mom needs their service they must fit her into the schedule. Once that happens they will try to fit her in on your schedule but I say that with reservation.
Perhaps there is a neighbor or friend that can be present?
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A regularly scheduled visit by your Hospice nurse should be able to fit your schedule. An added unscheduled visit may not but if there's a problem I'm sure you're happy to compromise. When the regular nurse is on vacation or ill, it can be difficult. My partner is a home Hospice nurse and fills in for others. She gets a call in the morning with a list of patients to see, usually 4. She calls them and schedules time that are best for them, but with 4-6, often miles apart, she can't visit all in the afternoon which is often the preferred time. There are days when she has to drive 30-50 miles between patients and will put on over 100 miles driving besides seeing the 4 patients. I agree that giving your regular nurse your work schedule and asking her to work within the ties you are available is absolutely reasonable. If she won't honor that, then it's time to talk to the supervisor and if they don't find someone who will, move on to another provider. You don't need the hassles.
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I am having the same problem with our Hospice. We live in a very rural area, and I have repeatedly requested afternoon visits. My dad is terminally ill, and mornings are very tough on all of us. My mom is 81, with mild Alzheimer's with me being caretaker for both.
They have tried to work around the schedule and seem to always blame the office for the scheduling, but I get different answers to the same request.
For example, I called and requested the nurse who comes out once a week also, to come in the afternoon. She called 10 minutes before she was coming and arrived at 10:00am.
When she left I followed her outside and explained again, that afternoon's were better for us. Next time she came she called 2 hours before hand and came in the afternoon. So far so good. We live in a very rural area and there is only one Hospice in this area.
Good luck and just keep requesting and calling. They are pretty understanding, but I think the schedule making is actually in the field nurse's hands.
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Hospice works for you/mom, and your insurance company is paying for their services. The Hospice Agency should utilize a patient centered approach. My heart goes out to you, while you attempt to work a 30 hour position and be a caregiver to your mom, during this very difficult time. It is important that you and your family maintain a healthy life balance and minimize your stress levels. An excellent Hospice agency will recognize this. An excellent Hospice agency should hire staff (including social workers) that will provide good customer/patient services. It is not acceptable to make an appointment with a caregiver and not show up for a scheduled appointment without a phone call and explanation. Please understand that you do have choices. I recommend that you share your schedule needs/ expectations with the Hospice Director of nursing. Inform them that you are seeking a Hospice agency/center of excellence that can support the needs of you and your mom. If you have any available time, do some research, or assign this to a trusted friend. Find out if your hospice agency is the best choice for your mom/family. I checked with nurse and doctor friends, other clinicians, and online searches to find a center of excellence/hospice agency for my brother. The hospital planned to "assign" a Hospice Agency to my brother. Fortunately I knew that we were able to select our own hospice agency, and selected the one that was highly recommended by trusted professionals. My brother's hospice agency was excellent! If you are not getting the service that you are paying for, please know that you can request to change to a different Hospice agency. BEFORE you change, please check with your preferred new Hospice provider, to make sure that they can provide services to you/mom.
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If you live in a more metropolitan area there are many many many hospice providers. I would talk with a care manager or discharge planner the hospital, nursing home, or doctors office. They will be able to recommend another hospice agencies. It should be a collaborative propress
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Has to be a compromise. I would set down your working schedule for them and explain your situation. Tell them where, if at all, you can be flexible. It is hard, I can attest after doing home health for years, and having a big geographic area to work around. What I did was put folks who had defined schedules high on prioriity as much as possible and then add iin others. It does get tricky, I can tell you. Hopefully if you can meet them half way since they are not making daily visits and half a win win. Sometimes understanding they are stressed, trying to fit it in, in a work environment that involves lots of difficult situations, but also expressing your own needs in direct, matter of fact tone, can get you what you want. Good luck.
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I agree with Maggie....they are employed by YOU not the other way around!! Call the director and if you get nowhere call your Medicare rep and report the problem!!
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Stay calm and tell them that their surprise visit doesn't fit your schedule.

Is anyone at home with your mom during the day? Must YOU be there?
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Well done Maggie.......
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Take charge. They work for you. They are not doing you a favor. They are being paid well for their services.

Of COURSE you're going to try to be accommodating. But don't hesitate to offer alternatives for your convenience and sanity.

Perhaps you could give all of them an idea of what works for you Mon thru Fri. Like afternoons after 1 PM are the best.

You might also call the supervisor or director of the hospice program you're using and tell them the problem you're having...asking at the same time if he/she knows of ANOTHER hospice program that has more flexibility. Be ready to provide your best times because, believe me, she isn't going to refer you anywhere. She'll solve the problem.
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