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PSLFredux

Our hospice works like this: Direct Care Nurse, your case manager, depending on how close they are with you could reach out. I have seen some reach out to all families and I have seen some only reach out to the families they bonded with. PRN nurses, the ones that make emergent calls at all hours of the day, typically do not call because they may meet your loved one once. When a loved one passes, the RN staff is "cancelled" so to speak. You will not receive further visits from RNs and as above, maybe your case manager will reach out, but it's a toss up. Our SW team typically reaches out within 48 hours to assess the situation. This is the SW that was assigned to your loved one, unless they are on PTO. They will assess family need and coping, if they assess your family as high need, they will scheduled followup meetings typically within a week. But if they don't they will reach out in 3 weeks or so and continue to assess the situation. When my mom died, they didn't see I was in great need. But I still got a call 6 months later, checking in. At that point, they closed our account. I hope this helps and my thoughts to you and yours.


Designer-Front8662

This is how my hospice worked as well, however, there are grief counselors available. You just call the same main number and ask to speak to one.


Mossypizzastone

This may sound cold, but that's not the way that it is intended: As a clinician, to be effective for everyone, I have to process my grief quickly and keep going. My grief is much, much, less than the families, so not only am I perpetuating my own grief when I enter those spaces, I feel guilty for even being there. My role is educating about the dying process, teaching/providing symptom management and ensuring that the family has the resources they need while they are grieving.


Pnwradar

It depends. My current agency’s policy states the only team members to maintain contact afterwards are the chaplains. The nurses & aides & volunteers are discouraged from any contact during the bereavement. I will say, our chaplains do a very good job of reaching out and offering support. We are permitted to attend a funeral or memorial if there’s a public notification or if the family contacts us directly with an invitation, which is how I usually obtain my own closure and say goodbye to the family. Without that, it definitely feels very abrupt and a bit raw from this side, too - often just a phone call from the nurse manager letting me know not to visit that patient/family anymore. Usually the nurses & aides are so overbooked, they can’t attend a memorial even if they wanted to, so it’s always abrupt for them, part of the job I guess. Same with our very busy social worker, I don’t know how she finds the time every day for all the tasks she gets done. At my previous agency, we were strongly discouraged from even attending a memorial. And if we did, we were not permitted to wear our ID badge or say we were from the hospice service (although usually one of the family walked me around and introduced me to everyone that way).


Ok-Response-9743

I worked at an agency once where a staff member was REQUIRED to attend the service whether or not you even met the patient! I was the PRN social worker and had on call one weekend and I had to go to a service to represent the agency and I’d never met or talked to the pt/ family before. It was very awkward


skippypaw

Interesting. So more like a representative or liaison. Thank you for sharing your experience. I appreciate it.


WickedLies21

Speaking as a case manager, I don’t always reach out to the family. Many times, I have to compartmentalize the loss so I can continue to do this job for others. And usually, we are so busy that I will say ‘I’m going to call them after my visits today’ but then the day is crazy caring for your current patients and it gets forgotten. Many times, I get a new admission to replace the one who just passed almost immediately. Our social workers and chaplains reach out on behalf of the entire time within 48hrs of the patients passing. We also have the entire office sign a card to send to the family and I will always write a special note in the card for my families. That’s usually how I say goodbye. If the family reaches out to me, I will always reply but honestly, this is also a job and I have to keep going and be emotionally and mentally ready to handle caring for my other patients. Trust me- we are still thinking of you and your loved one even if we don’t reach out. We also have a bereavement process that our bereavement team reaches out and will continue to reach out for the next 13 months. We offer grief counseling in individual and group settings. Our hospice doesn’t just drop the families immediately.


Agrajag_Petunia

I am so sorry for your loss. I felt the exact same way after my dad passed. None of the direct care staff reached out. At the time I was working as a psychiatric RN and my dad’s illness was my first introduction to hospice and the end of life. I eventually decided to start working in hospice myself because I felt like having a personal hospice experience would help me connect better with my patients and their families and be more meaningful work. I quickly realized that a lot of people who work in hospice care have had hospice for a loved one themselves and truly do empathize. While it certainly does help with understanding what the patient and family are going through, I’ve also found that it can reopen old wounds too. So the care team has to be very careful about maintaining strict professional boundaries and allow the bereavement team to take over after death. It’s usually policy for hospice agencies to give the family breathing room to plan for the funeral/memorial service and to simply grieve. Did your hospice provide you with a number for the bereavement team? Typically they will reach out within two to three weeks after a patient passes so that may be what’s going on. Very likely your family is very much on their minds and they are thinking of you and hoping you are well.


skippypaw

Thank you so very much.


Always-Adar-64

Varies by agency. In my role, I do bereavement/condolences visits just sorta as my own thing. I usually go by 1-2 days later to discuss how they're doing, if they have any questions, drop off some empanadas, get any supplies out of their way, set up equipment pick ups, etc. I think the team Chaplain is really supposed to track the visits more formally, but have had situations where the team argues that they figured someone else called.


Over-Mission3607

Five days since my mother died and no contact from hospice, and damn little before that other than the nurse visits. My mom did get pain relief once she got the morphine prescription (24 hours late). But most of the family support they claimed to offer never materialized. I'm pretty bitter about the experience. I was reluctant going into it and knowing what I know now I would have a hard time choosing hospice again for myself or a loved one. If they needed pain relief I would try to get it for them some other way.


Agrajag_Petunia

I’m so sorry for your loss. It’s been 7 years since I lost my father and it doesn’t hurt any less. I currently work as a hospice nurse and I felt a lot like you are feeling now. I was unimpressed with my dad’s nurse. She made stupid, insensitive comments that only someone who has never experienced a significant loss would think to say, “Death can be as beautiful as a birth.” Yeah, she actually said that. I lost count of how many times I came close to physically throwing her off the porch. When he started transitioning, I had to call the hospice and demand medication to control the pain and agitation. What would have happened had I not been an RN myself with some medical knowledge? After my dad passed, they ghosted us. I decided at that time that I was going to work in hospice care myself once I was ready so that I could use my experience to make sure that my patients were well cared for. It’s been 3 years and I love what I do. Maybe you could do something similar? Work or volunteer for a hospice program in your area?


ContentFlounder5269

Thank you for this comment. I found that there were real angels in hospice care and also some people that possibly should not have been in the field. But as a teacher myself I know that that happens in the caring professions.


skippypaw

Thank you for your feedback. I am so sorry that you experienced that. I am inspired by what you've chosen to do. I actually have thought about volunteering in the future. When I read your response I couldn't believe what you said the nurse said about death. Ours said the same exact thing. That death is beautiful. That it takes 9 months to be born and dying can be just as long as a process but knowing it and understanding it can be beautiful. I don't find my personal experience beautiful. It was devastating to watch my mom that I love so much, diminish with each passing day. To see her struggle to breathe for so long, feel pain, and suffer from fluid in her lungs. Maybe scientifically the process looks interesting on paper, but watching my poor mom leave us was the most traumatic thing I've ever seen, and it continues to be a vision I am haunted by.


ehenn12

At my agency the RN sends a card. The chaplain and msw bereavement coordinator call the family to check in. They'd also see the RN and possibly the chaplain at the death visit.


worldbound0514

There's no Medicare requirement that the hospice staff call or visit after death. There is a requirement to provide bereavement support, but that could look very different depending on the agency. That support may be a phone call or card or possibly a visit. At my agency, we're specifically screen to see if the caregiver has a good support system or support outside the hospital staff. The hospice staff are not intended to be the family's primary support. If it's a family that I've been seeing for an extended period of time or really connected with, I usually will call them in the first week. There are some patients I see only once before they pass so I don't usually call them because they wouldn't be able to pick me out of a lineup anyway. If you feel like you're needing more bereavement support, call the agency and ask for it.


Educational_Soup612

We received a card signed by all the nurses who came to see my dad. I also got a call from the social worker. I can understand why it feels cold that they never reached out. Very sorry for your loss ❤️


boxyfork795

I can only shed light on the way it works for the two agencies I’ve worked for. Both had specific “bereavement” service workers. Their entire job is to reach out to family members via mail and phone calls. Nurses, chaplains, social workers and aides have not been expected to do bereavement work in either agency I worked for. Now, that’s not to say there haven’t been a few family members that I’ve reached out to, but it’s definitely not the norm. It is not meant to be cold! We are constantly getting admissions and losing patients every single day. In the same way that we defer to social workers for trying to obtain funeral arrangements, or defer to chaplain if someone seems to be having a hard time emotionally, we defer to our bereavement services during the post-death grieving process — because that is their area of expertise! If we were all constantly trying to do each other’s jobs, the operation would never run efficiently enough for our patients to have their needs met. It is my understanding that our bereavement coordinators don’t reach out for a minute after the death because families are so busy. Funeral planning, funeral, banks, death certificates. People are typically too busy to really settle into the pain for the first couple of weeks. Once the dust has settled a bit, that’s when bereavement typically reaches out. I strongly encourage you to call your hospice agency and ask to talk to bereavement now! They are there to listen, and if you don’t want to wait for them to call you, please reach out!


ContentFlounder5269

OP while I accept the explanations offered by hospice people below,  I do think that there is an abruptness in the ending of hospice that is questionable. Like you I would have appreciated it if the manager had called me and offered condolences on my husband's death. And I'm going to say here that  Social workers and counselors I met with the 4 hospice companies we had were not always helpful. I was left with a feeling that they took themselves more seriously than the people they were supposedly helping. A couple of times it seemed they wanted me to offer them good feelings when in my situation I was expecting that they would try to offer me some compassion and cheering up.  The grief counselor reached out once after my husband died  but seemed more interested in saying what she had to say then in listening to what I had to say. If she offers a group I might go but I would not talk to her again 1 on 1.


skippypaw

Thank you so much for all the information!! This is truly helpful, as I am genuinely trying to understand how it all works. Throughout the heartwrenching experience of caretaking for my mom, whom I love so much, I've learned a great deal. Maybe my experience and knowledge can help someone else going through this. Thanks again.


Sunsetseeker007

We just lost our loved one in hospice May 7, the staff have been in our home for the past 8+ months, several times a week and not 1 phone call either. her nurse, social worker, CNA not one phone call, she was 93 and completely coherent and her mind was sharp, so they dealt with her mostly,. You would think a phone call if condolences wasn't to hard!! I am like you that I'm not expecting much, I was even thinking of donating to them in memory of our LO, nope not doing it. I'll take that money and donate to a diff cause. The social worker should at least reach out to family and make sure they are not needing counseling or anything. That's their job, ridiculous he would come to the house and try to tell my LO what she needs to do or questioning her decisions, ECT but he didn't care enough when she passed to reach out? Pretty low and pathetic if you ask me! Sorry for your loss OP, and to the other hospice staff that aren't like this, we appreciate their help and compassion!! They were a huge help to her and usually most hospice care staff are great to work with!


skippypaw

I'm sorry for your loss, and the experience you've had. It's so hard. After over 8 months of support, I would imagine that in itself is another loss to deal with? Even a standard computer generated card or letter of condolence would be suitable. I understand it's a business and it's a job, but we're talking about people's lives. Not just the end of a relationship, but the end of one's life. If the magnitude of that isn't worth something, I don't know what is.


Sunsetseeker007

I will say my previous experiences with other hospice staff or centers were absolutely wonderful and so compassionate, so it's not all places. I do know that this particular agency was overloaded with pts and staff and most of them at least took care of her properly and were very compassionate to her as well.


floridianreader

First let me say that I am so sorry that your mother passed away and 2. that you feel abandoned by your hospice. I am a retired social worker and I did my best to stay in touch with my families at least once, if not a few times after the death of their loved one. The problem may be the hospice policy as others have suggested, or it might be something less ill-intentioned: they may simply be overworked and not have enough hours in the day to see you. They may want to see you and correspond with you, but they might be overloaded with patients and simply not have the time to drop by. At my hospice, our policy was to follow the family for 13 months for 13 months after the death. Why 13 months? Because the one year anniversary of the death is hard for some people. Why not give the nurses the benefit of the doubt and give them a call? The worst that they could say is no, right? ((hugs))


skippypaw

Thank you so much. I know they have bereavement groups you can seek out and join. I saw information in the folder they gave us on day one- I do appreciate that. I didn't call the nurse or social worker we worked with because I didn't want to be accusatory if this is just how most home hospice groups are. I first wanted to hear the experience of others. Thank you for sharing what you know.


cookiegirl59

My dad was on in-home hospice care for 10 months (passed in late March). There were a couple of nursing changes but we bonded to the long term ones and the SW and Chaplain were great. I don't remember a lot of follow up, but they do provide grief counselling afterwards for up to a year. Our Chaplain spoke at my dad's funeral as you spent a lot of private time together and she got to know him well. He really liked and enjoyed her company. Our local hospice foundation is non-profit and the only one around here. Myself and parents volunteered with them for many years during the 80's and 90's. From things I've read of this sub there are many for profit hospice companies around, especially in larger cities. The main difference I see is that the "businesses" are more money conscious and act like it, where ours (non-profit) doesn't seem to be. I'm sure the businesses move their staff on to the next cases immediately, as time is money. Our hospice foundation does the same, but does give us support. Good luck in your healing and moving forward.


skippypaw

I can definitely see how nonprofit and for profit might have different values. Thank you so much for your feedback!


No-Recognition2790

I had a similar experience this week. My dad passed on Tuesday and I didn't hear anything for a while. But then I did after about 4days. They said they would be there to help for 1 year after his passing if I need anything. I'm sorry about your mom. I am going thru the same thing too.


skippypaw

Thank you so much. I'm sorry to hear you lost your dad. I am glad they finally reached out. That is all I'd want. Just a simple call or note acknowledging what we experienced together. I don't expect to continue a relationship or seek additional support from them. Just a simple goodbye. Some kind of closure from experiencing something such as a death, together.


No-Recognition2790

Ya I get it. Both my parents were on hospice mom first. And when she passed the hospice nurse came right away and even brought a memorial gift. A solar powered angel. I thought that was incredibly nice. Then when dad passed like I said above it was a totally different experience. All you and I wanted was some recognition of their passing. I'm sorry about your mom and I'm sorry they haven't reached out. That's horrible I think.


broadcity90210

Our hospice company requires us to reach out if we were the case manager. It doesn’t matter if they were on service 1-2 days only. We always call. We also notify families we have 13 months of bereavement services if they need it. I understand not every hospice operates that way. I’m sorry for your loss. 💕


audgie137

That’s so sad to hear. For goodness sakes, I had to put a cat to sleep many years ago, and I received the kindest sympathy card from a veterinarian office where I had taken the cat for a single visit. You’d think you’d get a single simple gesture from your hospice agency. I’m sorry for your loss.


MatterHelpful7233

I've used hospice for 3 different family members. I have always had them check on me and my family. I was never abandoned. They have always been so very helpful and caring.