Hospice Is a Care Solution for Residents in Assisted Living Facilities
When residents of assisted living facilities (ALF) require skilled nursing care, hospice is a beneficial healthcare solution for the facility and residents alike.
Hospice is a particularly helpful option if state or ALF policies require residents who have an advanced illness or who are nearing the end of life to be discharged to higher levels of care, either within or outside of the ALF.
Hospice care in the ALF:
- Maintains the facility’s reimbursement/payment stream for non-hospice services
- Supports aging in place by bringing a range of hospice services—medical, emotional, and spiritual—directly to the resident in the ALF
- Avoids relocation or disruptive, potentially harmful care transitions near the end of life, easing emotional and financial burdens for the resident and family
Seamless Transitions to Hospice Support ALF Residents, Families, and Staff
A referral to hospice keeps residents in the ALF for end-of-life care, with skilled medical/psychosocial care and supplemental personal care provided by the hospice team. Residents remain in familiar surroundings, with VITAS providing comfort-focused care, equipment, and supplies to address the hospice diagnosis, while the ALF continues to provide non-hospice-related services.
During an evaluation with the ALF resident, family, and staff, a hospice admissions nurse will identify which services are already provided by the ALF and which additional services or supplies are needed to keep the resident comfortable in the facility. ALF services (sometimes available at extra cost) might include housekeeping, an aide’s support, or medication administration.
ALF Residents Benefit From Hospice Expertise, Equipment, Supplies and 24/7 Care
The hospice team provides extra levels of support related to the resident’s diagnosis, including:
- Care in the ALF via regularly scheduled visits from members of an interdisciplinary hospice team: nurse, aide, physician, social worker, chaplain, and volunteer
- In collaboration with the attending physician, the hospice nurse and physician oversee medical care and update the resident’s care plan as needed
- The hospice aide, social worker, chaplain, and volunteer address the resident’s personal hygiene, emotional, and spiritual needs.
- Timely delivery of medical equipment to the resident, such as a hospital bed, wheelchair, walker, bedside commode, medications, or other supplies.
- Once a hospice referral has been made, VITAS typically supports the care transition within 24 hours.
- Assistance from a hospice social worker, who can help with insurance benefits or connections to other community resources
- VITAS offers expert symptom management to improve residents’ experience. Modalities can include high-flow oxygen, wound care, fluid management and other integrative services.
- Ongoing support for goals-of-care conversations, advance care planning, and advance directives to explore what residents understand about their diagnosis, symptoms, and prognosis, and to help them identify their goals, values, and wishes for end-of-life care as their health declines
- Support at the time of death, including contacting the physician and transferring the body to the funeral home
- Assistance for the family with funeral arrangements
- Timely physician’s signature on the death certificate
- Spiritual support and pastoral care from a hospice chaplain
- Bereavement support for the patient, family, and ALF staff leading up to and for up to 13 months after a death
Hospice care is a feasible solution for end-of-life care in the ALF setting, one that benefits ALFs in a noncompetitive manner and gives residents the assurance that they can remain at home (where they prefer to be) for end-of-life care.
Frequently Asked Questions
How can VITAS help curb ED utilization and high-risk rehospitalizations?
By transitioning your ALF's high- and rising-risk residents to VITAS, we can provide expert, high-acuity care that minimizes the risk of return visits to the hospital or emergency department. We bring hospice care to your resident.
With hospice services, your resident doesn’t leave home. They continue to age in place. Since the resident elects to receive palliative care and a physician has certified the resident has a prognosis of six months or less, the need for a higher level of care is diminished.
The goal is to keep the resident comfortably at home, in their assisted living community, surrounded by the faces and routines they know.
Our staff is always looking for new ideas, and they require professional education. Can VITAS help?
VITAS provides nearly 70 continuing education presentations at no cost.
VITAS staff understands the needs of residents and their families who are coping with end-of-life concerns. Ask a VITAS staff member about educational opportunities.
When we see a resident declining, we want to discuss options with their family. How do we begin?
As your partner in care, VITAS can provide conversation starters that families can share.
Ultimately, having the conversation in an appropriate, sensitive way can become one of the most profoundly satisfying experiences of a healthcare professional’s career.
Broaching end-of-life discussions with residents is a skill that can be learned, much like history-taking or physical examination. When performed skillfully, these conversations can strengthen physician-resident relationships and increase the likelihood that residents will choose appropriate treatment options, such as hospice.
Even before hospice is considered, a VITAS physician is available for a consultation. Our physicians have the time to listen to the concerns of the resident and family, describe the progression of the advanced disease, explain care options and outline a realistic plan of care. You are informed of the outcome, and we maintain communication with resident and family.
Numerous printed materials, online resources and how-to documents can help professionals handle the “it’s-time-for-hospice” conversation. Start by downloading the family discussion guide at HospiceCanHelp.com.
Sickness and death are hard on our staff. We get to know and love our residents. How can hospice help?
We offer grief and bereavement support, memorials and education to help residents and staff mourn and cope with the loss
Hospice recognizes the strain a death has on the community in which a resident has lived, in the same way that hospice recognizes the impact of a loved one’s death on family members.
We continue caring for a resident’s loved ones by providing grief and bereavement support for up to 13 months after a death.
Likewise, memorial services and lessons in “taking care of me” help staff members and other residents mourn and recover from the death of someone they cared for and cared about.
How does VITAS’ clinical expertise keep residents in my facility?
One of the goals of hospice care is to keep the resident in place, and our coordinated services accomplish that.
VITAS offers unsurpassed modalities of care across all four levels of hospice care: routine home care, Intensive Comfort Care® (continuous care), inpatient care and respite care.
How can VITAS help us maintain our competitive advantage?
VITAS is proud to offer a wide array of specialized care programs and benefits.
- Veterans programs
- Alzheimer’s/dementia programs
- COPD program
- Multilingual staff
- Jewish accreditation
- Paw Pals® pet visits
- Music therapy
- Massage therapy
- “Living memorials” to honor a resident’s life
- Anticipatory grief support during the illness
- Bereavement support groups for families
- Memory Bears
Check with your VITAS representative to see what programs are available in your area.
What is VITAS' approach to pain management?
At VITAS, managing residents’ pain is the utmost objective.
As a hospice and palliative care pioneer, our organization has developed effective pain management protocols that are customized for the individual resident—which is critical in an assisted living setting. In addition to addressing physical and medical issues, our interdisciplinary approach addresses spiritual and emotional needs as well.
Will my community lose revenue if a resident elects hospice care?
Your resident will continue to pay their normal fees to the community. The extra services hospice provides, such as medications, supplies, and durable medical equipment related to terminal illness, can help preserve the resident's funds so they may be able to continue to pay for care in your community and reside there as long as possible.
Your assisted living community is home to your residents, and where they want to be. Like our assisted living partners, VITAS supports an aging-in-place approach to care. We have the expertise, the staff and the specialized services to keep your residents at home—out of emergency rooms, hospitals and nursing homes—as they approach the end of life. Your resident will stay home and continue to pay their normal fees to the community.