Hospice agencies are beginning to adjust to their new operational normal during the coronavirus (COVID-19) pandemic. These days many hospice leaders are identifying how their team members can provide exceptional and safe hospice care and accommodate psychosocial needs of patients in long-term care facilities. The Centers for Medicare and Medicaid Services (CMS) has provided guidance to long-term care facilities restricting visitors, including family members, while requiring them to allow hospice team members access to their shared patients. These requirements can be quite stressful for hospice patients residing in long-term care facilities, their family members and loved ones, and the long-term care facility staff members and hospice team providing end-of-life care.

The Plan of Care Isn’t Just for the Patient

CMS requires hospice agencies to provide support to patients’ loved ones as part of the hospice patient’s Plan of Care. Updating the Plan of Care to reflect the current needs of loved ones is now more important than ever. To help alleviate the stress of patients and their loved ones, hospice agencies should continue to provide holistic care to both, despite the loved ones not being allowed on site. This includes not only providing the required appropriate direct care for patients’ loved ones, but also partnering with them during this pandemic.

Create Interventions and Goals for Added Support

Accompanying Plan of Care interventions and goals should be in line with alleviating the stress that your patients may experience. Interventions should reflect the changing guidelines regarding visitors in long-term care facilities, as well as the needs of your patients and their loved ones. When developing interventions, it is important to remember to keep them practical and to take credit for what you are already doing well. For example, interventions can include having members of the hospice team provide updates to loved ones after each visit. When there is a complex family structure, the intervention can specify which family member will be receiving the report and sharing it with other family members.

While assigning this intervention to all members of the team may seem to make it easier to remain in compliance, it is only successful with clear communication among team members to ensure that someone is following up.

Other Psychosocial Services Are Beneficial

Ramping up psychosocial services is imperative during this pandemic or any other emergency. The social work and spiritual counseling teams should be increasing their visit frequencies. Whether it is a visit or phone call, careful documentation of these touchpoints, including referencing the new COVID-19-related problem statements, will provide the support that patients and their loved ones need while giving credit for the very important work that your team is doing.

By formalizing the actions that you and your team are taking to address the increased needs of your patients residing in long-term care facilities and their loved ones during a pandemic, your agency will continue to provide exceptional hospice care while remaining compliant.

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