Last Updated on May 15, 2021 by Frank Davis
As of 2018, there were 1.55 million Medicare recipients receiving hospice care within the United States. This is a figure that has been increasing by around 4% annually. However, not all hospice care recipients are getting the same kind of care. There are four levels of hospice care, namely routine home care, continuous home care, general inpatient care, and inpatient respite care.
Most hospice patients start off at level 1. If pain and symptoms become unbearable, the hospice agency switches them to level 2. If the pain and symptoms still happen in level 2, then it is moved up to level 3 (24 hour supervision), and level 4 is for primary caregivers who need a temporary break.
Understanding the difference between the four levels of hospice care will help you select the ideal one for your needs. Here is a detailed breakdown of what these four levels are and how they work:
Level 1: Routine Home Care
Routine home care is the most popular level of hospice care that patients are receiving. When someone receives routine home care, they have chosen to get their hospice care in the comfort of their own home, although it may also be given to a patient living in an assisted living center or nursing home.
This is the most basic level of hospice care and uses a team of hospice staff to give end-of-life comfort that a patient is hoping for. The services included in routine home care may include:
- Medical social services
- Spiritual guidance
- Bereavement counseling
- Home medical equipment
Level 2: Continuous Home Care
Continuous home care is the level of hospice care that is given for at least 8 hours and up to 24 hours. The focus of this care is to manage the pain and uncomfortable symptoms a patient may be suffering. Continuous home care is generally provided as nursing care, and is also offered alongside caregiver and hospice aide service.
This kind of care places a nurse within the home of a patient for a longer amount of time than any of the other levels, especially when there is a medical crisis. Once the crisis is over, the decision is usually made to switch the patient to general inpatient care.
Level 3: Short Term General Inpatient Care
General inpatient care is given to hospice patients to help them manage their pain and acute symptoms more easily and readily. This level of hospice care gets switched to once other ways to manage symptoms have fallen short. General inpatient care is most often given at a hospice inpatient center, nursing home, or Medicare-certified hospital.
There are times when pain or symptoms are both so severe that the care needed to properly address them cannot be given in a patient’s home. Once the severe pain is brought under control, the patient can return to their home and switch back to routine home care.
Level 4: Short Term Inpatient Respite Care
Respite care provides brief relief to caregivers who are not getting paid to take care of a hospice patient. These are usually family members who are looking for a temporary break.
To receive inpatient respite care, a patient needs to be moved to a Medicare-certified hospice facility, such as a hospital or nursing home. These facilities can provide the 24/7 hospice care a patient may require.
Depending on what a patient is suffering from, as well as where they are in the progression of the disease, different levels of hospice care will apply. Every so often, the type of hospice care received will have to be changed to reflect the current state of a patient, and can be paid for in many different ways. With these four levels of hospice care, every patient will get to receive the exact care they need if a medical crisis arises. Now that you know the differences between these kinds of hospice care, you can make the choice that benefits you or a patient as much as possible.