Principles of Interdisciplinary Care
Like a tapestry woven with many different threads, care by The Connecticut Hospice, Inc. is an interplay of the skills of so many different professions. Within Hospice home and inpatient care, physicians, nurses, pharmacists, social workers, clergy, artists, volunteers, and consultants actively assist each patient and family in resolving the myriad of difficulties surrounding irreversible illness. It is the “team” approach – comprehensive, coordinated palliative care without gaps or overlaps – that truly distinguishes Hospice within the health care system.
How Does It Work?
In the inpatient building, each day begins with morning reports and chart rounds. At this time, nurses, physicians, and pharmacists discuss medication regiments, pain and other symptom control, and other issues related to patient care. After reviewing each patient’s chart, the physician begins morning rounds on each patient. These daily meetings of the nurse, physician and other members of the team assure coordinated care. The weekly interdisciplinary team conferences resolve problems and plan care for the patient and family. In this way, team members learn from each other and reinforce each others’ strengths. Team members also assess and refer patients to other disciplines as the need arises. Because irreversible illness has many ramifications, team care also includes the family.
The primary nurse initially assesses the patient and identifies problems and needs to be addressed. The nurse develops a custom-designed care plan and presents this to the rest of the interdisciplinary team. This occurs in both the home care and inpatient programs. The pharmacist, for example, provides patients and families with drug information, patient monitoring and patient counseling. An individualized approach to the design of all patients’ drug regimens takes into account the unique characteristics and problems of each patient.
Pastoral caregivers provide spiritual support, upon request, with respect for individual values and beliefs. They work closely with community clergy whenever possible to assess the patient’s and family’s religious history and the ability to be supportive at this time. Hospital and home care clergy sit on the interdisciplinary rounds weekly and make daily assessments of referrals. A broad range of religious ceremonies are provided, including weekly mass, weddings, baptisms, bar mitzvahs, and more.
Social Work is an integral part of the team approach. Hospice social workers help patients and families bridge communication breakdowns and deal with the reality of irreversible illness. Social workers also help arrange community and financial supports. The bereavement program, which offers support to the grieving family for up to one year, is coordinated by the Social Work Department.
Bereavement, a non-judgmental supportive set of practices, reminds families that there is no right or wrong way to grieve. Individual responses to loss are as unique as fingerprints. Multiple reactions to the multiple challenges faced by families after the death of a loved one require the most intensive training in education of the volunteers participating in these plans.
Hospice care affirms life and focuses on the quality of life. To this end, Hospice embraces and views the arts as an important component of care. As members of the team, art therapists, music therapists, artists, musicians, writers and other complementary therapists assist patients and families in individual and group creative activities. In addition, live performances, changing art exhibits, and The Wellness Empowerment Program provide further opportunities for creative fulfillment and quality of life. Please click here for further information.
The dietary department works closely with other members of the team to provide balanced, appealing menus for patients in the inpatient program and advice to families caring for their loved one at home. Dietary care includes dietary assessment and the preparation of special therapeutic diets, the preparation of nutritious foods presented in gourmet style, meeting individual dietary requests, and nutrition consultation for home care patients.
Volunteers have a nobility of character and a gentleness of soul which when combined with learning all of the nuances of The Connecticut Hospice, Inc. through a three-month orientation program, make them part of the Connecticut Hospice community. Many staff have said they could not perform as they do without the volunteers, and many patients and families have expressed their gratitude for the extreme kindness that brings so much comfort to those in need. Volunteers participate in both direct patient care and support functions at Hospice. Lay and professional volunteers provide a variety of services as part of the interdisciplinary team. They are “someone like me” to the patient and family – a listening ear, a friendly visitor, a fresh perspective – in a difficult time. Hundreds of volunteers, ranging in age from 16 to 94, support The Connecticut Hospice. Volunteers are divided into two broad categories: caregiving and program support. Caregiving volunteers have direct contact with patients and families, while program support volunteers give their time to departments in which there is no direct contact. Volunteers in both categories complete a period of orientation and/or training. Between October, 1999 and January, 2000, volunteers contributed a staggering 14,000!