Also Known As:
Continuous Home Care (CHC), crisis hospice care, bedside symptom management, Level 2 hospice care
Type:
Short-term, intensive hospice care level, one of the four levels of hospice care
Primary Purpose:
To provide around-the-clock nursing care at home during an acute symptom crisis so the patient can stay home instead of going to the hospital.
When It Applies:
When uncontrolled pain, severe breathlessness, severe nausea, agitation, or active dying require continuous nursing presence.
Who Is Involved:
Hospice RNs, LVNs, and aides under the supervision of the hospice medical director, with at least eight of the 24 hours provided by a nurse.
Where It Occurs:
In the patient’s primary residence, home, assisted-living apartment, or memory-care community.
Duration:
Hours to several days, until the crisis is controlled and routine care can resume.
Coverage:
100% covered by the Medicare Hospice Benefit at a higher reimbursement tier than routine home care.
Key Focus:
Symptom crisis control, medication titration, family education, and avoiding an unnecessary hospital transfer.
Common Misunderstanding:
Continuous care is not the same as 24/7 staffing of every hospice patient. It is a crisis-only level of care that is initiated when symptoms can’t be controlled with routine visits.
What Triggers Continuous Care
Continuous care is one of the most powerful tools in hospice, and one of the least understood. It is initiated when the patient’s symptoms become severe enough that a routine visit schedule cannot keep them comfortable. Common triggers include:
- Severe, uncontrolled pain that requires aggressive medication titration
- Breathlessness that cannot be managed with as-needed medications
- Severe nausea, vomiting, or terminal agitation
- Active dying, the final hours when families need a nurse at the bedside
- Severe anxiety, hallucinations, or restlessness
What Continuous Care Looks Like at Lifted
At Lifted, continuous care means an RN or LVN at the bedside for up to 24 hours a day during a crisis, supported by aides for personal care and the medical director by phone. Medications are titrated in real time. The family is taught what to do and what to expect. The goal is twofold, control the crisis and keep your loved one home.
The Medicare rule is that at least 8 of every 24 hours must be nursing care. In practice, Lifted’s continuous-care shifts are heavily nurse-staffed because that’s what crisis symptom control actually requires.
Why It Matters
Without continuous care, a symptom crisis often ends with a 911 call, an ambulance ride, and an ER visit. The patient is moved to a strange room, surrounded by strangers, hooked up to unfamiliar equipment, sometimes for the last time.
Continuous care is the alternative. The team comes to you. The home stays the home. Read about all four levels of hospice care or contact us with any questions.