Patients who enter a hospice expect their medical needs to be taken care of by the hospice. They expect good pain control, good symptom management, adequate nursing staff to help them when they need it and access to all the medications needed to relieve their suffering. Families expect the hospice to meet their needs for counseling, whether it involves social workers, chaplains or other spiritual counselors, dietitians or other services. It is also a violation of Federal and State law for a hospice to exploit its patients by not providing the services they need and which they are entitled to receive. Some doctors do not honor the wishes of the patient about their own care and medical treatment.
Some patients wish to die at home with their family.
That's a simple request and in many cases, the family is willing to help out 24 hours a day. Even with the family helping out 24 hours a day, some families do not have the knowledge or skill or experience in working with terminally ill patients. They do not know how to give narcotic or other medications to reliably relieve the symptoms of their loved one. It is for the hospice RN case manager to teach them what they need to learn. But if the family is not teachable, does not have the knowledge base to allow them to learn how to give the medications, or if the family simply is too weak physically to provide the care, the hospice is required by law to provide the needed nursing care at home, during a period of crisis .