AS CARE NEEDS INCREASE
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General Inpatient Level of Care (GIP) General Inpatient level of care (GIP) is for patients who require symptom management at an advanced level that cannot be managed at the home or facility where the patient lives. This can happen at the Elizabeth House or other contracted facilities and is different from respite care. These symptoms can include pain, trouble breathing, anxiety, restlessness, and nausea. The patient’s condition is assessed on a daily basis by your care team to determine medical needs and eligibility for GIP. There are certain criteria set by Medicare that your team will consider when deciding which level of care is appropriate. There is no set length of time that someone can receive GIP, but it is expected that once symptoms are brought to a manageable level that the patient will no longer require such advanced care and can return home or move to a skilled nursing center. Your social worker and care team will help assist you or your loved one on next steps. Sometimes patients have such an advanced illness that they die while at the Elizabeth House. It is our goal to support you and/or your loved one in whatever way is important and meaningful for you. If you would like to speak with someone at Elizabeth House, please call 828.692.9633. Specially trained hospice nurses, social workers, spiritual care providers, and volunteers staff Elizabeth House around the clock. Medical providers are available to ensure that the needs of patients are always met. The team at Elizabeth House will help the patient and family be prepared to return home if at all possible. Sometimes patients will go to an assisted living or nursing facility after their stay at Elizabeth House. Ei- ther way, the patient will still have a Four Seasons Care Team after they leave Elizabeth House. If the patient dies while at Elizabeth House, the Care Team will give support to family and friends. Family and friends are allowed to be present as much as they and the patient choose, respecting other patients and families that are present. INPATIENT CARE FOR SYMPTOM MANAGEMENT Four Seasons can arrange for a transfer to our specialized hospice inpatient unit, Elizabeth House. If nec - essary or if the patient chooses, we can also arrange for admission to several area hospitals, with whom we contract, while continuing hospice care with Four Seasons. Four Seasons’ Elizabeth House When symptoms need more attention than can be managed at home, we can offer you the option of 24- hour care at our hospice inpatient facility, Elizabeth House. You will receive specialized round-the-clock care in a home-like environment. Rooms at Elizabeth House are private. All rooms are equipped with sleeper sofas for family members who wish to stay overnight. Visitors may come 24 hours a day, 7 days a week. Children and pets may visit, within certain guidelines. A family kitchen, laundry, great room, meditation room, and garden are avail- able for patient and family use.
Death is a process of physical, emotional, social, and spiritual changes. The end-of-life may approach rapidly or gradually over many days. Each person is unique and the transition towards death is often reflects the person’s life and personality. The goal is to honor and respect these changes, and to comfort and support all of you through this process. Four Seasons values life and does not hasten nor prolong the natural process of dying. Physical signs of approaching death: • Increasing sleep, though night and day sleep may switch; eventual inability to wake up. • Increasing weakness, more time resting in bed or in a comfortable chair. • Time and usual routines become less important. • Withdrawal from activities such as visiting with people or watching TV. • Decreased eating and drinking; eventual inability to swallow. • Slower or irregular breathing with pauses between breaths (apnea). • Skin may be cool, become grey-blue, or be splotchy (mottled). • Skin may be very warm often due to low or high-grade fevers not caused by infection. • No control of emptying bowels or bladder. • Decrease in amounts of urine and urine that is dark in color. • A relaxed face and forehead suggests that the patient is comfortable. Frowning or grimacing sug- gest they are having some type of discomfort. • Limited or no swallowing, causing drooling or noisy breathing because of pooled saliva in the back of the throat mouth/throat. • Visions, often of people who have died, are common and can be comforting to the patient • Restlessness or agitation, such as reaching into the air, picking at blankets or trying to climb out of bed. How you can help: • Create a quiet, peaceful, private area. • Limit visitors or lengths of visits if the patient seems agitated. • Continue to offer words of love, support, care, forgiveness, and encouragement that the family will be sad, but ok. Hearing is the last sense that leaves us, so be aware the patient could hear what is said nearby even when they cannot respond. At the very least, they hear familiar voices even if they can no longer understand the words being said. • Gently continue to provide personal care, keeping skin clean, and the mouth moist. See the earlier sections on basic care. • Give medications with the guidance of your hospice nurse as advised by the medical provider. Many medications can safely be stopped, but some should be continued to provide comfort. • Elevate the patient’s head slightly with pillows or by raising the head of the bed, especially if noisy breathing or vomiting occurs. • Take care of yourself. Eat, rest, and drink fluids. Ask for the help you want or need. Four Seasons is here for you.
866.466.9734
FourSeasonsCare.org
FourSeasonsCare.org
866.466.9734
Four Seasons
Four Seasons
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