Hospice Workers Combine Compassion and Autonomy

Hospice is not a place, but a philosophy of care for people who are in the last six months of their lives. Hospice workers care for patients and their families in a variety of settings.

"We take our service to them, whether it's their home or in a residential setting such as skilled nursing facility, assisted living, group home or residential hospice," explained Gloria Cade, hospice director for Allina Home and Community Services (allina.com).

Patients vary by diagnosis, age

Most of Allina Hospice's patients are 65 and older, and about 40 percent have cancer, Cade said. But patients may be newborns, young children or young adults. "We care for patients of all ages," said Lisa Hurt, director of for Ridgeview Home Care and Hospice at Ridgeview Medical Center (ridgeviewmedical.org).

Hospice organizations want seasoned health care workers who are more confident in their skills and abilities. "Having experiences in a variety of situations is extremely helpful," said Cade. "Having experience in facing death and dying issues is an obvious plus. Our staff work autonomously, so being able to make assessments and decisions independently is very important."

How often hospice staff interact with patients and families depends on the patient's condition and the family's needs, according to Pam Lamb, hospice social worker and bereavement coordinator at Ridgeview.

Who's on the team?

• Medical director, a physician who leads the team

• Nurses, whose primary role is pain and symptom management. "It's not limited to that," Lamb aded. "They wear multiple hats to meet the patient's needs, providing physical, emotional and spiritual care."

• Home health aides, or certified nursing assistants, who perform personal care for patients, including bathing, oral care and applying lotion, for patient hygiene and personal dignity. These workers may be hired directly out of school but must receive additional training in hospice care.

• Social workers, who connect families with resources in the community

• Chaplains, who care for patients' and families' spiritual needs

• Music and massage therapists, who provide comfort and reduce some distressing symptoms

• Physical therapists, who also help with pain relief and with strengthening, to the patient's ability. They also teach family members about safely lifting and transferring patients, assess wheelchair fit and make recommendations for cushions.

Hospice organizations choose workers very carefully, according to Hurt. "It's difficult to interview for compassion, but we look for people who are intuitive, who can demonstrate life experience with death and dying, knowing when to listen, when to touch."