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the care giving team

Attending Physician

    • Certifies the terminal prognosis
    • Assesses patient needs, manages symptoms,
      prescribes treatment
    • Directs & approves the plan of care
    • Coordinates care with the Interdisciplinary
      Team (IDT)

 

Medical Director

    • Co-certifies the terminal prognosis with the
      attending physician
    • Leads the Interdisciplinary Team in the
      development of a plan of care
    • Provides consultation to other physicians
      regarding hospice care

 

Registered Nurse

    • Assesses patient & family needs
    • Develops a plan of care to meet identified needs
    • Coordinates team visits & ensures
      implementation of approved plan of care
    • Coordinates care with attending physician,
      primary care giver and/or Care Center staff
    • Ensures symptom control & pain management
    • Provides patient/family teaching as needed

 

Social Worker

    • Assesses patient & family emotional, social,
      spiritual & financial needs
    • Develops a plan of care to meet identified
      needs
    • Provides direct counseling or refers patients &
      families to appropriate community agencies
    • Provides bereavement support

 

 

Chaplain

    • Assesses patient & family spiritual needs
    • Develops a plan of care to meet identified needs
    • Provides direct counseling
    • Assists with memorial preparations
    • Provides consultations to community clergy

 

Home Health Aide

    • Provides direct personnal care to patient
    • Provides comfort measures, reports identified
      needs to RN Case Manager
    • Provides emotional support to patient & family

 

Volunteers

    • Provides companionship & support to patient &
      family
    • Provides needed non-medical services, such as
      letter writing, errands, & respite time for family
    • Provides support at time of death & during
      bereavement

 

Dietician

    • Assesses patient's nutritional needs
    • Provides patients & family members with nutritional education
    • Implements a nutritional program which will assist in meeting the patient's nutritional needs

 

see also

Circle of Care    Click to view full size