It has long been thought that when a resident at an assisted living facility is declining in health, the only option is to give up their “home” and enter a nursing home. But, this isn’t necessarily the case. For many terminal patients their final wish is to die at home, and for many home is in an assisted living facility. This is where they may have spent the last several years developing close relationships with other residents and staff. This is where they are most comfortable.
Although most assisted living facilities (ALF) are not equipped with in-house hospice units, many contract out with community-based hospice companies to provide end-of-life services to their residents.
Can Assisted Living Facilities and Hospice Care Work Together?
But is an assisted living facility, which by nature is designed for patients who do not necessitate the skilled medical care of a nursing home, able to accommodate patients in such decline?
According to the Center for Excellence in Assisted Living, in most cases, the answer is yes. After all, hospice was originally designed as an In-home service with the only clinicians being those from the agency. For many ALFs, the collaboration between their clinical staff and the hospice agencies allows for appropriate levels of care for dying patients. For the patient, the family and sometimes even the ALF staff, the hospice agency is able to provide the much needed physical and emotional support.
In case of Emergency
There has been some discussion as to how an ALF can ensure the safety of a hospice patient in the event of an emergency. The non-ambulatory status of many hospice patients poses a distinct problem for assisted living facilities who are accustomed transferring patients with moderate assistance. Although this may be a new dilemma for assisted livings, transporting non-ambulatory patients in the event of emergencies is easily care planned in skilled nursing facilities and hospitals. The most common method is to simply wheel the patients’ bed to safety.
When is hospice the right choice?
According to Homeside Hospice, a privately owned hospice agency inClark,New Jersey, there are several factors which may make hospice an appropriate level of care for an assisted living resident. They include:
- A significant decline in resident’s physical or mental health status
- The resident requires frequent visits to the MD’s office or the Emergency Room
- The resident’s level of mobility has declined requiring frequent intervention by facility staff
- The resident is losing weight which is not intentional
- The resident is becoming weaker and requires more assistance with activities of daily living
- The underlying disease is progressing at a rapid rate or a new diagnosis has been identified
- The resident has recently chosen to stop aggressive treatment options
For residents in a steady decline or for those given a 6-month or less prognosis, hospice may be a comforting option and may even be recommended by the facilities social worker. Most agencies develop collaborations with the assisted livings in order to provide the patients with the best care possible.
The dying process is never easy. For most, it is an unwelcome inevitability; but, being able to die with dignity and honor is paramount for all.