Hospice Care

Differential Diagnosis

When studying hospice care, carefully distinguish it from related but distinct concepts: end of life care, advance directives, pain management paramedic. Exam questions often test your ability to select the most specific and appropriate answer when multiple options seem partially correct. Look for the option that most completely addresses the scenario presented.

Common Errors

Common nursing assistant errors with hospice care:

• Not applying proper body mechanics: use mechanical lifts for residents who cannot bear weight; tighten core muscles before lifting; raise bed to working height to avoid bending
• Forgetting to identify the resident before providing care
• Not reporting changes in condition promptly to the nurse
• Performing tasks outside the CNA scope of practice

Key Values & Ranges

Palliative approach focused on comfort, dignity, and quality of life for terminally ill patients with prognosis of 6 months or less. Hospice care philosophy and CNA role tested on CNA exam.

Resident care connections: Right to privacy for personal care, mail, phone conversations, medical information. Right to be treated with dignity and respect at all times.

Patient Communication

When communicating with residents about hospice care:

• Use open-ended questions to encourage residents to share feelings
• For cognitively impaired: use simple sentences, one instruction at a time, consistent routine
• Therapeutic silence: allow time for the resident to process and respond
• Report behavioral changes to the nurse: withdrawal, aggression, crying, confusion
• Active listening: face the resident, maintain eye contact, nod, paraphrase
• For hearing-impaired: face the resident, speak clearly (not louder), reduce background noise

Safety Considerations

Safe practice of hospice care requires proper body mechanics and fall prevention:

• Pivot feet instead of twisting the spine
• Wide base of support with feet shoulder-width apart, one foot slightly forward
• Push rather than pull when moving objects or residents
• Raise bed to working height to avoid bending
• Use mechanical lifts for residents who cannot bear weight