Also Known As: hospice evaluation, admission assessment, intake visit, initial hospice visit
Type: Initial hospice evaluation visit
The Main Goal: To get a deep understanding of the patient’s overall health status, the symptoms they are experiencing and what care they need in order to figure out if hospice is an option and to start developing a personalized plan of care that puts the patient’s comfort, dignity and quality of life first.
When It Happens: When hospice is first on the radar and the patient or family is thinking about hospice services. This visit happens either before or at the time of admission.
Who’s Involved: A registered nurse (and sometimes a social worker), the patient, family members or caregivers, and the hospice medical director who looks at and makes sure the patient meets the eligibility criteria.
Where It Takes Place: In the patient’s home, hospital room, assisted living community, nursing facility or inpatient hospice unit — wherever the patient is currently living.
How Long It Takes: Typically 60 to 90 minutes, depending on how complex the patient’s condition is and how many questions or concerns the family may have.
What It Covers: Covered under the Medicare Hospice Benefit, Medicaid, and most private insurance hospice plans when it’s related to hospice eligibility and admission.
What To Expect: Medical history review, looking at symptom management, checking out medication, a safety assessment, talking about what the patient’s goals of care are, emotional support, and putting care planning in place.
A Common Misunderstanding: An assessment is not a test and it won’t automatically put someone into hospice. It’s an informational and clinical visit that is designed to figure out if hospice is an option and explain what services are available.
What It Means
An assessment is the first face-to-face visit that takes place after a family gets in touch with hospice. It’s the foundation for all the care that might follow. During this visit, a registered nurse – and sometimes a social worker – meets with the patient and family to get a real sense of how the patient is doing and what they need in terms of support. They get a picture of the patient’s medical condition, what’s changed physically and emotionally, and what the patient’s personal wishes are.
The nurse takes a close look at the patient’s medical history, recent hospital visits, and what medications they are taking. They also check up on how the patient is managing day-to-day – how well they can move around, how much they are eating, how much pain they are in, how they are breathing, and how their memory and thinking are doing. All this helps figure out if the patient meets the criteria for hospice.
Just as important as the clinical stuff, the assessment is also a conversation. The family can share what’s on their mind, ask questions, and talk openly about what matters most to them. It’s a time for education, reassurance, and planning – which can be a really emotional time.
What Happens During An Assessment Visit
Every assessment is a bit different, but it often includes things like:
- Looking back at how long the patient has been dealing with their medical condition
- Talking about what’s changed lately in terms of health or hospital visits
- Checking in on how much pain they are in and any other symptoms they might be experiencing
- Taking a look at what medications they are taking, whether they are working and what side effects they might have
- Checking how well they can move around and what kind of fall risk they have
- Looking at how healthy their skin and general safety are
- Talking about what they would want if they were unable to make their own decisions in the future
- Explaining what hospice can do for them and what the team is like
- Giving them a chance to ask questions and get things straight
The nurse wants to get both a clinical picture of the patient and what’s important to them so that the care they receive really adds up.
How An Assessment Helps Patients And Families
For many families, the assessment is a real relief. Hospice can be pretty overwhelming at first, and this visit helps break down everything into plain language and gives it a human touch.
It helps families understand:
- What hospice can do to help the patient
- How often will the hospice team visit
- What kind of support is available at all hours of the day
- How to manage symptoms and what to expect going forward
This visit also helps prevent crisis situations from happening by identifying what’s needed early on and putting support in place before symptoms get really bad.
Eligibility And Care Planning
Once the assessment is done, the nurse and other members of the hospice team review the information they gathered. If the patient is eligible for hospice and wants to join, services can often start the same day or very soon after.
The information gathered during the assessment forms the basis of the patient’s individualized plan of care. The hospice team uses it to coordinate nursing visits, help from aides, social work services, spiritual care, any equipment that’s needed, and any medications that are needed.
In short, the assessment makes sure that hospice care gets started in a way that is thoughtful, safe, and in line with the patient’s wishes – giving them the comfort and support that they need from the very beginning.