Patient
Care Handbook Education and Training for the Caregiver
Thank you.
We would like to express our gratitude for trusting Coastal Hospice and allowing us to care for you and your family.
Our team of doctors, nurses, social workers, spiritual counselors, certified nurse assistants, and bereavement counselors are committed to providing the best medical care, honoring your wishes, and supporting the emotional and spiritual well-being of you and your family.
Our promise, as leaders of this organization, is to provide you and your loved ones with all the care and support you need in your journey and to uphold the quality of care that you and your loved ones deserve. We are available 24/7 to address your questions and concerns at 410-742-8732.
We are committed to be with you every step of the way with skilled and compassionate care. Thank you for the privilege of serving you.
Coastal Hospice Services
OUR MISSION
Coastal Hospice promotes dignity and quality of life for patients and families who face life-limiting conditions.
VISION STATEMENT
Every patient and family facing serious illness is honored, supported, and comforted as they receive the right care, at the right time throughout their journey.
What is hospice?
When facing a life-limiting illness, it is only natural to have questions about care, medications, safety, and practical concerns. This Patient Care Handbook provides information to help answer these questions. Our team will review this book with you and help you use it as a guide to your care.
Our goal is to help you maintain control of your life and to live as fully and comfortably as possible, without pain. We will also help address your physical, emotional, social, financial, and spiritual concerns, while addressing your loved ones’ needs as they care for you.
and
Hospice eligibility
Hospice care is for people with a life expectancy of 6 months or less if the illness runs its normal course. You can get hospice care if you accept palliative care (for comfort) instead of care to cure your illness and you sign a statement choosing hospice care instead of other Medicare-covered treatments for your terminal illness and related conditions.
If you live longer than 6 months, you can still get hospice care, as long as the hospice medical director recertified that you’re terminally ill. Coastal Hospice accepts payment for services from Medicare, Maryland Medicaid, VA benefits, and most private insurance plans.
Hospice care is given in benefit periods. You can get hospice care for two 90-day benefit periods followed by an unlimited number of 60-day benefit periods. At the start of each benefit period, the hospice medical director or other hospice doctor
must recertify that you’re terminally ill, so you can continue to get hospice care. A benefit period starts the day you begin to get hospice care and it ends when your 90 day or 60-day benefit period ends.
You have the right to change your hospice provider once during each benefit period.
Hospice coverage
Medicare beneficiaries who elect hospice care receive non-curative medical care and supportive services for their terminal illness covered at little to no expense. All services, treatments, medical equipment, supplies, and medications related to the hospice diagnosis are provided by and must be authorized by the hospice interdisciplinary team for Medicare to maintain financial responsibility.
You have the right to request a list of any uncovered services, medications, treatments or supplies at any time.
Levels of Care
Medicare and many private insurance companies use the term "Level of Care" to refer to the intensity or setting a patient needs at any given time. Patients may move between levels of care as their needs change. The level of care is determined by medical need and must fit specific guidelines.
Sometimes patients move from one level of care to another during their stay in hospice.
ROUTINE HOME
• For patients whose pain and symptoms can be managed in their own residence
• Comprises the care for most Coastal Hospice patients. Symptoms can be managed and support provided by their primary care team in the patient's own home.
• Provided in private residences, group homes, nursing homes, and assisted living facilities
• Referred to at Coastal Hospice as "Home Hospice".
CONTINUOUS CARE
• When patients are in an acute crisis that requires frequent medical intervention wherever they reside. It requires a minimum of 8 hours of care in a 24 hour period (beginning and ending at midnight) with 51% of the care being provided by an RN or LPN.
• Provided in private residences, group homes, and assisted living facilities until the acute crisis is resolved or the patient requires transfer to receive acute care.
GENERAL INPATIENT CARE (ACUTE CARE)
• Provided at Coastal Hospice at the Lake and Macky and Pam Stansell House.
• For patients with acute pain and/or symptom management needs that cannot be addressed therapeutically in any other setting.
• Provides highly-skilled, short-term care to address the medical crisis and assist the patient in achieving comfort to return home.
• Is a short-term solution to a crisis.
RESPITE CARE
• Coastal Hospice families can benefit by taking time off from caregiving. The patient will stay at Coastal Hospice at the Lake, Macky and Pam Stansell House or at a contracted facility for up to 5 days at a time so the primary caregivers can rest and recharge.
• The patient will return to their previous residence following the 5-day stay.
What does hospice provide
Hospice is a specialized type of care with a compassionate approach for those facing a life limiting illness, as well as their families. Hospice care treats the whole person, with a focus on improving the quality of life that remains, rather than trying to cure the disease.
The hospice concept affirms life; it does not hasten or postpone death. The goal is to manage a patient’s pain and symptoms, so that they may live each day as fully and comfortable as possible.
Through a team-oriented approach, hospice provides expert medical care, pain management and symptom relief, as well as emotional, spiritual, psychosocial and practical support, tailored specifically for each patient, a hospice care team member is available 24 hours a day, 365 days a year.
As a service, hospice is provided in the place the patient calls home. This can be a private residence, a nursing home or residential facility, or at a contracted inpatient facility.
REGULAR HOSPICE SERVICES:
• Managing the patient’s pain and symptoms
• Providing medications, medical supplies and equipment needed for the palliation (relief) of symptoms
• Maintaining the patient’s comfort, including regular assessments and support for their loved ones
• Assisting patients with personal care and activities of daily living
• Providing education for caregivers on how to properly care for patients
• Delivering therapy services, such as physical, occupational, and speech therapy, as needed
• Meeting emotional, spiritual and practical needs for patients and families with questions or concerns at the end of life
• Providing companionship and supportive community resources
• Offering bereavement services and counseling for families dealing with grief
Your hospice care team
Coastal Hospice provides hospice services and offers you an expert team of professionals and volunteers to help develop a plan of care to meet your individual needs and the needs of your family/caregivers.
PHYSICIAN
The physician of your choice may continue to provide care in collaboration with the hospice team, or you may choose to designate a hospice medical director or nurse practitioner as your primary clinician.
REGISTERED NURSE
The nurse provides hands-on care and education and offers options to best manage pain and other symptoms of illness. They will teach caregivers how to administer medication and identify medical equipment needs*
SOCIAL WORKER
The social worker helps you and your family cope emotionally and communicate openly. Your social worker will also assist with accessing community resources, preparing Advance Directives and making alternative living arrangements.
CHAPLAIN
The chaplain will listen and help you reflect on what is most meaningful in life, while supporting your faith and beliefs. Along with your own clergy, the chaplain will provide support to help you and your loved ones find spiritual comfort.
CERTIFIED NURSING ASSISTANT (CNA)
The certified nursing assistant will demonstrate and provide personal care, such as bathing, shaving, dressing, and changing linens. The CNA will provide companionship, while helping you maintain dignity and independence.
VOLUNTEERS
Volunteers serve as companions to you and your loved ones. They can relieve your loved ones of the constant demands of caregiving through a variety of support activities, such as sitting with you while your caregiver takes a break, listening and sharing things you enjoy most.
GRIEF COUNSELORS
Grief counselors, are available to support you and your loved ones. They collaborate with your social worker and chaplain to meet the emotional needs of the family.
Complementary hospice care offerings
MUSIC THERAPY
Music therapy can help improve quality of life by reducing stress, anxiety and agitation while also giving individuals a way to express themselves, even if they can no longer communicate. Our music therapists meet the social, emotional, spiritual, and cognitive needs of the individual and family.
WE HONOR VETERANS
We Honor Veterans is a program designed to meet the unique needs of veterans and thank them for their sacrifice and service to our country. Coastal Hospice partners with our local VA office to provide veteran to veteran outreach and other initiatives to ensure that the contributions and needs of veterans are recognized and respected.
PET COMPANIONSHIP
We offer pet visits in collaboration with Pets on Wheels. Pets on Wheels share the love of friendly therapy pets to help improve life, connecting pets with people to make a profound positive difference every day.
THERAPY SERVICES
Therapists of different disciplines support the hospice team by providing interventions that may extend the patient’s level of independence, preserve their dignity, and create a safe environment for the patient and caregiver.
Volunteer Services
Hospice volunteers are a group of highly trained, motivated, caring individuals with a broad range of life experience. Many have been touched by personal experiences with illness and care giving. Volunteers are committed to maintaining your privacy and are respectful of your choices. They can be a great source of assistance and support.
How can a volunteer help me and my family?
• Be a companion and provide friendly socialization in person and/or by phone
• Provide respite for caregivers (giving caregivers time to run errands, go out to eat, rest, etc.)
• Sit quietly at patient’s side / provide presence
• Be a trusted listener; give emotional support to both patient and family members
• Listen while patient and/or family participate in a life review; help patients create a legacy book
• Pick up and deliver a prepaid grocery order
• Mail letters; make phone calls
• Assemble a sandwich / heat up a light meal
• Participate in interests, such as reading, playing a game, doing crafts, watching TV, listening to music
Veteran volunteers are available to provide a We Honor Veterans presentation (delivery of a blanket and certificate) to our veteran patients.
Our volunteers can assist patients and families in many ways, however, volunteers cannot:
• Be the primary caregiver (primary caregiver is a family member, friend, or hired person)
• Give nursing care or any medical assistance, including giving shots or medications
• Take temperature or blood pressure, weigh the client, etc.
• Bathe, lift, transfer, turn / reposition, assist with ambulation
• Provide personal care for patients including assisting with toileting and giving pedicures
• Provide housekeeping / cleaning
• Transport patient or caregiver
• Answer medical questions (please direct medical questions to your nurse)
• Offer resource contact information
Please reach out to the Volunteer Services department with your needs. You can call the main Coastal Hospice phone number 410-742-8732 and ask for Volunteer Services. We’ll be here when you need us.
Understanding Your Care Options
Advance Directives
Advance Directives are legal documents stating the medical procedures you do and do not want in the event you are unable to communicate these wishes yourself. It is important that your wishes are clear should you not be able to make them known.
Medical Orders for LifeSustaining Treatment (MOLST )
A MOLST form states whether you want CPR (cardiopulmonary resuscitation) attempted, or the Limited Care or Comfort Care options. We strongly suggest that you keep the MOLST form on your refrigerator.
Resources
ADVANCE DIRECTIVES
Use your phone to read the QR Code and visit our website for more information on Advance Directives or to download the forms.
• Five Wishes: A form to help you document your wishes for end-of-life treatment. https://www.fivewishes.org/
• Maryland Advance Directive: Planning for Future Health Care Decisions, A guide to Maryland law on health care decisions. www.marylandattorneygeneral.gov/Health%20 Policy%20Documents/adirective.pdf
• Maryland Advance Directive Planning for Important Health Care Decisions: An additional resource for completing advance directives https://www.caringinfo.org/wp-content/ uploads/Maryland.pdf
Need to Complete Advance Directives or MOLST? Talk to your Coastal Hospice team. They will help you complete the forms and answer questions.
Managing Your Symptoms
Symptoms may arise as disease progresses. Some of the more common symptoms are listed below, along with training on how you can manage them. We are here to support you day or night. If there are any changes in condition, please don’t hesitate to call us.
Shortness of breath
Breathing difficulties can cause anxiety and discomfort.
To reduce discomfort:
• Turn on a fan or open a window to promote air circulation.
• Raise the head of the bed or prop head up on pillows.
• Use slow, calming breaths. Practicing meditation may help.
• Medical air or oxygen may be ordered to increase comfort, when appropriate.
• If medication has been ordered, make sure it is taken as directed.
• Pace activity to conserve energy.
Constipation
Constipation may cause pain and discomfort, and may be due to lack of activity, reduced food and fluid intake, general weakness or pain medications.
To prevent constipation:
• Take laxatives and stool softeners as directed.
• If possible, increase daily intake of fluids and high fiber foods (e.g., room temperature water, fruit juices, fresh raw fruits and vegetables).
• Increase activity as tolerated.
• Talk to your nurse before using over-the-counter medications or enemas.
• Call the nurse if there has no bowel movement in three days or more.
Nausea, vomiting, or diarrhea
Gastrointestinal upset can be caused by your disease, certain foods, different treatments or medication.
To reduce discomfort:
• Take prescribed medications as early as possible when symptoms occur.
• Adjust food choices to reduce irritation (drink clear liquids, avoid caffeine, etc.)
• Choose bland options like popsicles or Jell-O.
• Maintain good mouth care. Keep skin clean and dry to prevent skin breakdown and irritation.
Fatigue
Sometimes, they may feel like they are running out of energy even when doing small activities. In addition to feeling tired physically, they may also feel tired emotionally and spiritually.
To help manage fatigue:
• Conserve energy by spacing out activities throughout the day.
• Talk to the nurse about reducing medications that are no longer working.
• Talk to the nurse about need for assistive devices, like shower chairs, walkers, and bedside commodes to help with daily activities.
Changes in food or fluid needs
The inability to eat and take fluids may be related to the illness, medication, difficulty swallowing, fears, or changes in the sense of taste or smell. A loss of appetite is normal and expected.
To reduce discomfort:
• Take pain and nausea medication 30 minutes before meals, as prescribed.
• Eat smaller portions and allow a relaxed diet with no restrictions.
• Consider eating together, even if it is not in the kitchen or at a table.
• Maintain frequent mouth care.
• A decrease in urination may occur as less fluid is consumed. Expect the urine to become darker; a catheter may be needed to manage incontinence.
Restlessness and agitation
Depending on one’s illness, restless and/or agitated behaviors can occur and may be very difficult on everyone in the care environment. Call the hospice nurse when you notice changes.
To manage restlessness and agitation:
• Provide increase presence at bedside
• Speak in a low, calm voice and provide reassurance (e.g., “I am right here with you, Mom”).
• Reduce any external stimulation and manage the light or darkness of the room.
• Provide distractions that bring comfort, such as music, reading, guided imagery or light massage.
• Medications may be prescribed as needed or around the clock to help ease these symptoms.
Anxiety and sadness
It is normal to be anxious or have feelings of sadness during this journey. The whole team of hospice staff is equipped to offer support to help cope with these feelings.
To help manage anxiety and sadness:
• Discuss fears and worries with our trained hospice team.
• Ask the nurse about medications or treatments that may help.
• Provide a calm, peaceful presence in order to encourage sharing.
• Utilize aromatherapy, guided imagery, meditation, journaling, storytelling, etc.
Pain Management
Pain can keep your loved one from being active, sleeping well, enjoying family and friends, or eating — all of which may lead to feeling afraid or sad. If there is pain, tell the hospice team right away. Getting help for pain early on can make pain management more effective.
Pain and as needed medication log
Keeping record of your loved one’s pain and medication use will assist the hospice team in making medications changes when needed. Use the pain intensity scale below to rate the pain before and after medication is taken.
If a verbal response is not an option, we will assess non-verbal behaviors. Some non-verbal behaviors that may indicate pain, especially if two or more behaviors are present, are:
• Difficulty breathing
• A frown or sad face, furrowed brow or grimace, especially when care is being provided
• Moaning, groaning, or crying
• Stiffening or withdrawing when care is attempted
• Agitation and restlessness
Faces pain rating scale modified from Wong DL: Whaley & Wong’s essentials of pediatric nursing, ed 5, pp. 1215-1216, St. Louis, 1997, Mosby.
FLACC pain scale
The FLACC scale or Face, Legs, Activity, Cry, Consolability scale is a measurement used to assess pain for children or individuals that are unable to communicate their pain. The scale is scored in a range of 0-10 with 0 representing no pain. The scale has five criteria, which are each assigned a score of 0, 1, or 2.
Criterial 1 Score 0
Face
• No particular expression or smile
Legs
Activity
• Normal position or relaxed
Score 1
• Occasional grimace or frown
• Withdrawn
• Uninterested
• Uneasy
• Restless
• Tense
• Lying quietly
• Normal position
• Moves easily
Cry
• No cry (awake or asleep)
• Squirming
• Shifting
• Back and forth
• Tense
• Moans or whimpers
• Occasional complaint
Score 2
• Frequent to constant quivering chin
• Clenched jaw
• Kicking
• Legs drawn up
• Arched
• Rigid
• Jerking
• Crying steadily
• Screams or sobs
• Frequent complaints
Consolability
• Content
• Relaxed
• Reassured by occasional touching, hugging or being talked to
• Distractible
• Difficult to console or comfort
1. FLACC Scale Archived 2008-12-10 at the Wayback Machine (Extracted from The FLACC: A behavioral scale for scoring postoperative pain in young children, by S Merkel and others, 1997, Pediatr Nurse 23(3), p. 293–297)
Pain medication
Don't wait to get your pain under control.
Pain medication side effects
Below are common side effects of pain medication. Please call Coastal Hospice nurse if any of these or other symptoms occur:
• Drowsiness and confusion
• Constipation - Please report to your nurse if patient has gone three days or more without a bowel movement.
• Nausea
• Itching
• Dry Mouth
Charting pain medication
Keep track of how pain medicine is working before and after taking a dose. Making this a daily habit may make your treatment more effective. Our Coastal Hospice nurse will show how to chart pain and medication. A medication tracking chart is included at the end of the handbook.
Comfort kit
Coastal Hospice recognizes that you may have physical changes requiring medicine during late night and weekend hours when pharmacy
services are not readily available. To more quickly manage sudden symptoms, a "comfort kit" has been developed and approved by the Coastal Hospice Medical Director. The physician may order this kit and Coastal Hospice will arrange for its delivery. Call your Nurse prior to using any of the medications contained in the kit.
Medications provided in the comfort kit help to relieve symptoms such as pain, anxiety, agitation, nausea, and shortness of breath. The standard comfort kit may include the following medications:
• Morphine- for new onset of pain or shortness of breath
• Haloperidol-nausea
• Lorazepam-for anxiety that may accompany pain or shortness of breath episodes
• Hyoscyamine tablets -to decrease congestion
• Acetaminophen suppositories-for pain or fever
• Senna Plus tablets-for bowel regularity and prevention of constipation
• Bisacodyl (ducalox) suppository
• Other
These medications are for urgent or emergency purposes only, and once begun, a routine dosing of the medications will be ordered by the physician. Other medications may be substituted for individualized care.
Location of comfort kit in the home:
Patient Safety
Our goal is to keep patients safe and to prevent harm from falls, medication and oxygen use. Please read the following guidelines to help decrease the risks for injury and to create the safest environment possible.
Fall safety
A fall is any event resulting in a patient coming to rest unintentionally on the floor or other lower level. While every patient is at risk for falling, the risk is even higher if falls have occurred within the last six months, regardless of the reason. Below are other fall risk factors.
Patients, families and your Coastal Hospice team have a shared responsibility for helping reduce injuries from falls in all settings. Patients may feel fine when sitting or lying in bed, but then fall as soon as they move to a standing position.
Ways to help reduce injuries from falls:
ENVIRONMENTAL:
• Remove obstacles (clutter, throw rugs, cords, etc.) and rearrange furniture for clear pathways
• Remove objects from all stairways
• Provide adequate lighting throughout the home, including nightlights
What to do if a patient falls
1. Call the Nurse Helpline immediately to report the fall and to receive further instructions: 410-742-8732 .
• Add handrails and grab bars in bathrooms and hallways
• Place nonslip mats in the bathtub
• Place frequently used items in easy-to-reach cabinets and areas
• Keep emergency numbers in a visible place
• Keep phone within reach
MEDICAL:
• Notify your nurse of any medication changes
• Notify your nurse of any changes in symptoms
• Discuss with your nurse the possible side effects of medications
PHYSICAL:
• Wear non-skid footwear
• Wear glasses (if needed)
• Dangle legs over side of bed for a few minutes prior to standing
• Rise from sitting or lying positions slowly
• Use assistive devices, such as canes or walkers, as instructed
• Ask for assistance with activities as needed
2. DO NOT move the patient if they complain of severe pain. If any area looks strange or out of shape (possibly due to a broken bone) or if the patient is or has been unconscious, make sure they stay where they fell.
Infection control in the home
Hand washing with soap and water is the most important protection against infection.
The Coastal Hospice team will wash their hands before and after providing care. When their hands are visibly soiled, they will ask for a convenient place with liquid soap and paper towels to clean them.
INFECTION CONTROL TIPS:
Wash your hands before meals, before food preparation, after using the bathroom, after touching blood or bodily fluids, and after removing disposable gloves.
Use soap, warm water and friction when washing hands. Rub hands vigorously for at least 20 seconds.
Cover your mouth and nose with the bend of your elbow when sneezing or coughing. Keep tissues handy. Be sure to dispose of used tissues and wash hands.
If anyone in the household is sick, report symptoms to hospice team and avoid close contact with other people.
Keep rooms well-ventilated to decrease the risk of colds, flu and other airborne communicable diseases.
Wash soiled linen in hot soapy water as soon as possible.
Mop or wipe up blood/bodily fluid spills with hot soapy water and then disinfect the area with a bleach solution (use one-part bleach to tenparts water or another disinfectant). Wear gloves while cleaning up a spill.
In addition to gloves, your Coastal Hospice nurse carries additional types of personal protective equipment (PPE) such as masks and gowns. If it is determined the patient has an infection that requires use of PPE, they will be provided.
Masks may also be worn during care to protect patients at high risk for infection from everyday germs, including FLU and COVID-19.
Gowns may be used during procedures when the risk of splashing bodily fluids or blood is likely, such as wound care or suctioning.
Stop
Stop
COVER YOUR COUGH
Cover your mouth and nose with a tissue when you cough or sneeze
Put your used tissue in
Cover your mouth and nose with a tissue when you cough or sneeze
Cover Cough Clean Hands your
or cough or sneeze into your upper sleeve, not your hands.
cough or sneeze into your upper sleeve, not your hands.
You may be asked to put on a surgical mask to protect others.
Clean your hands after coughing or sneezing
Wash with soap and water or clean with alcohol-based hand cleaner.
your
after coughing or sneezing.
You may be asked to put on a surgical mask to protect others. or
clean with alcohol-based hand cleaner.
Put your used tissue in the waste basket.
Medication safety
Have medications out and ready for nurse to review at time of visit.
The Coastal Hospice nurse will review medications and how they are administered at each visit.
General guidelines to ensure safe medication use:
• Store medication in their original containers, with original labels intact, in a central location and away from children. The Coastal Hospice nurse will check medication at least weekly to obtain timely refills.
• Unless instructed to place medications in a refrigerator, do not expose them to extreme cold or heat.
• Do not mix medications in the same bottle. Use a pillbox to store and organize.
• Take all medications as prescribed. Keep track of given and missed doses. The Coastal Hospice nurse will use this information to help guide your care.
• Use your In-Home Medication List to keep track of all medications (prescription or over the counter) and supplements.
• Inform the nurse of any changes or additions to medications, both prescription and over-thecounter, including nutritional supplements or natural/herbal remedies.
• Review all information including labels on medications delivered to your home. Be sure medication names and dosages match what you were told to expect.
• It is illegal to transfer/use/retain medication prescribed for another person, even if the person is deceased. In the event that the family/caregiver refuses to destroy medications, authorities may be notified; this information is also reported to the physician and documented in the clinical record.
Emergency plan
In preparation for an emergency situation, the Coastal Hospice team will call or visit you to ensure your safety and comfort. Please help your hospice team set priorities by communicating your immediate needs.
We live in a hurricane area. It is important that you are prepared ahead of time and have a plan ready, should you need to move your loved one to another location.
1. Discuss with your team if your loved one will need assistance in evacuating or with care during the emergency.
2. In the event you need to leave your home for safety prior to the event, and you don’t have a place to go, your Coastal Hospice team will help find a safe place to relocate. You must bring your medical equipment, oxygen, medications, and MOLST form with you.
3. If you choose to remain at home during an emergency, make sure that you have enough medications, portable oxygen, and medical supplies for at least a week
If you have concerns about an emergent event, please don’t hesitate to contact your Coastal Hospice team for support.
General preparation recommendations include having on hand:
• Working flashlight
• Battery powered radio or TV
• Extra food, water, and medicine
• First aid supplies
• Fire extinguisher
• Listen to local radio/tv stations for emergency updates
• Keep mobile phones and electronic devices charged
Additional safety reminders
• Electric Heating Pads: While an electric heating pad is usually regarded as safe, it can be dangerous if you have decreased sensation due to diabetes, spinal cord injuries or stroke, or if you are taking medication for pain or sleeplessness. Do not use a heating pad if you are receiving oxygen therapy.
• Medical Equipment: Report medical equipment that needs repair to Coastal Hospice. Do not use until replaced or repaired.
• Emergency Numbers: Keep emergency numbers posted on or near the telephone.
• Smoking: If your loved one smokes, it is possible they might light a cigarette and drift back to sleep. This poses an obvious fire risk. Try limiting smoking to times when they can be watched closely or limiting access to smoking materials to minimize fire risk.
• Smoke Detectors/Fire Extinguishers: We strongly recommend you have a functioning smoke detector and fire extinguisher, and someone in the residence who can correctly operate it. Check these safety devices monthly to ensure they remain in working order.
In the event of severe weather or a natural disaster, our staff may not be able to provide services to all areas. If you cannot reach us by phone and have a medical emergency, please call 911.
Oxygen safety
• Oxygen can be beneficial when it is used correctly in a safe environment. However, in unsafe situations, the risk of starting a fire is real. Ensuring everyone’s safety while oxygen therapy is used is a shared responsibility.
• The oxygen supply company will provide you with initial training when the oxygen equipment is delivered. The Coastal Hospice team will monitor the effectiveness of the oxygen to make sure it meets your comfort needs.
• You are responsible for your own safety and for following the use and storage guidelines provided by the oxygen supply company and your Coastal Hospice team.
• Your safety and the safety of those around you is our priority. If at any time the Coastal Hospice team observes or suspects unsafe behavior involving oxygen use or storage, we will work with you to remove the oxygen from your home and replace it with alternatives to oxygen therapy.
Important oxygen safety reminders
• Use the firebreak device delivered with your equipment on the oxygen tubing at all times.
• For your safety, smoking (including e-cigarettes) should not be permitted for patients using oxygen. Family members or caregivers should not smoke in the same room where oxygen is in use or stored, and should move outside and wait 10 minutes before smoking after being in contact with the person using the oxygen.
• DO NOT cook with a gas or electric stove while using oxygen.
• Keep ALL oxygen equipment at least 10 feet away from heat sources, including stoves, candles, space heaters, heating pads, hair dryers, electric razors, e-cigarettes, cigarettes, or cigars.
• Oxygen equipment and cylinders should be stored upright in a cart or lying flat on the floor in a well-ventilated area, 8-10 inches from curtains or walls and never in a closet or car trunk.
• DO NOT use grease, oil-based, alcohol-based or petroleum-based products, or aerosol sprays on or near any oxygen equipment, including tubes and cannulas.
• Do not plug the oxygen equipment into extension cords or ungrounded or overloaded outlets.
• Place oxygen tubing in areas where it is less likely to pose a tripping hazard and maintain evacuation routes free of clutter to permit space for safe exit.
• Check smoke detectors and fire extinguishers monthly, notify your local fire department that you have oxygen in the home, and ensure someone in the home can correctly operate the extinguisher.
• Check the oxygen flow rate each morning, evening and each time the oxygen is turned on. Turn off oxygen equipment and valves when not in use, and wipe the cannula or mask with plain water if it becomes soiled.
• If at any time you find the oxygen does not provide relief, please contact Coastal Hospice so we can work with your physician to find a more effective treatment.
• The Coastal Hospice oxygen safety signs provided by your nurse should be displayed at all times.
• Fall risk: The use of supplemental oxygen increases the risk of falling. Store oxygen in an upright stand. Extra tanks may be placed in a flat position under bed. Avoid storing the oxygen in a closed space such a closet.
• Avoid placing the oxygen tubing under rugs or other areas where it can be damaged. Leaking tubing may saturate the room with additional oxygen increasing the risk of fire.
DO NOT SMOKE IF YOU ARE USING OXYGEN AND DO NOT ALLOW OTHERS TO SMOKE INSIDE THE HOUSE.
Oxygen in use sign
An “Oxygen in Use, No Smoking” sign should be displayed on your front door and in the window of the room where the oxygen is stored.
OXYGEN IN USE
No one should smoke in your home –the fire danger is too great.
AVOID FLAMMABLE PRODUCTS 10 ft.
Keep at least 10 feet from heat sources: pilot lights, electric appliances, candles, etc.
Avoid the use of alcohol-based and petroleumbased products: lip balms, lotions, oils, grease.
Caregiving
Pressure sores
Broken skin may occur as a result of pressure, changes in nutritional status or contact with bodily fluids. Pressure sores are common at the end of life.
What to look for:
• Red areas on the skin that do not go away, even if the pressure is removed.
• Cracked, blistered, scaly and broken skin.
• An open sore involving the skin surface or deeper tissue.
• Yellowish stains on clothing or sheets.
• Complaints of pain.
Wound care guide
To help prevent pressure sores:
• Change position frequently.
• Use pillows to “bridge” any potential pressure areas, particularly heels and lower back (sacral) areas.
• Use the therapeutic surfaces provided by Coastal Hospice.
• Clean promptly after bowel movements and urinary incontinence.
• Change the patient’s clothing or bed linen as soon as you notice soiling.
Keys to good wound care:
• Comfort
• Pressure relief
• Keeping it clean and dry, and
• Preventing infection
Location #1:
Location #2:
Location #3:
Location #4:
Location #5:
Treatment #1:
Treatment #2:
Treatment #3:
Treatment #4:
Treatment #5:
Change dressings: and as needed
Steps to cleaning wounds:
1. Give pain medication(s) 30 minutes before cleaning.
2. Wash hands.
3. Gather materials.
4. Put on gloves.
5. Remove old dressing and put in trash using double bagging technique as instructed by nurse.
6. Change gloves.
7. Apply treatment as ordered above.
8. Apply cover dressing.
IMPORTANT!
Call Coastal Hospice at 410-742-8732 if you notice any of the following:
• Pain
• Odor
• Bleeding
• Wound looks worse
• You have one week’s worth of supplies left.
Bathing
Frequency of bathing may vary considerably. For some, only two or three times a week is necessary, with only a partial bath on other days. As the patient becomes weaker, bathing can be difficult. Hospice aides are available to assist with bathing and other personal care.
To ease difficulties with bathing and promote safety:
• Place a chair or stool inside the tub or shower.
• A sponge bath may be taken sitting beside the sink.
• If these methods are difficult, give the bath in bed.
Skin care
Maintaining skin integrity is key to comfort and safety. It is important to keep skin clean, dry, and moisturized.
To provide preventive skin care:
• Keep skin soft with water-based lotion to help prevent cracking of the skin.
• Keep sheets as clean and wrinkle-free as possible.
• Reposition patient frequently to protect pressure points. Areas that are prone to pressure are the hips, elbows, shoulder blades, heels, ankles, back of the head, and ears.
• Use a folded flat sheet under the midsection to pull the patient up or reposition.
• Avoid leaving wet clothing or bed linen on or under the patient.
Mouth care
Good mouth care is important to prevent problems and to reduce discomfort caused by dryness, infection and open sores.
To provide routine mouth care:
• Use a soft toothbrush every morning, after eating, and at bedtime.
• Remove and clean dentures every day. Avoid wearing them if they fit poorly.
• Keep the lips moist with water-based lubricants to avoid cracking.
• Rinse mouth, as needed, for comfort.
• Use of toothettes may be helpful.
Planning Ahead
There are several practical concerns you may want to consider prior to the death of your loved one. Attention to these issues now allows your loved one to communicate their wishes while they are still able and prevents future stress and hardship on the family. Your Coastal Hospice social worker is available to help with some of these issues.
Financial planning
• Contact the Social Security Administration regarding disability and retirement benefits to determine eligibility.
• If the patient is a veteran, ask about Coastal Hospice’s We Honor Veterans program. We will assist with veteran benefit information.
• Make sure the titles to assets are as the patient wishes.
• Consider designating a Power of Attorney if the patient is not able to manage finances.
• Review the will to ensure financial assets and personal effects will be distributed as the patient wishes.
• Check the designation of beneficiaries for life insurance, pension plans, retirement and other accounts to ensure they are as the patient wishes.
• Contact your lawyer or financial planner for assistance.
Planning for children
Who does the patient wish to serve as guardian of minors? Consider establishing a financial trustee for children.
Planning for final arrangements
Decide which funeral home or cremation service will handle final arrangements. We advise you to
consult a licensed funeral director to help with final arrangement options and pre-planning.
If considering organ donation or donating the body to science, plan ahead. The patient’s signature may be required.
Meet with your clergy to plan for the funeral or memorial service. If you do not have a clergy member to perform the service, a Coastal Hospice chaplain may be able to do it for you or your funeral director may recommend another celebrant.
Consider designating a charity to receive donations in lieu of flowers.
Helpful items for making final arrangements:
• Locate important papers and passwords for deeds, bankbooks/online banking, stock certificates, birth and marriage certificates, deed to the cemetery lot, veteran’s papers (DD214 Service Separation papers) and passwords to frequently used accounts.
• Know the date of birth and birthplace of your loved one.
• Know the full name of the father and maiden name of the mother of your loved one.
• Know your loved one’s Social Security number.
• Gather information for the obituary.
• Locate the life insurance policy or the policy numbers.
When Death Occurs
The moment of death will likely be jarring, even if you have spent weeks or months preparing for the loss. Your Coastal Hospice team will help guide you so you can know what to expect and what to do when death occurs.
What to expect when death
occurs:
• After your loved one has died, call Coastal Hospice first at 410-742-8732 , any time of day or night.
• A Coastal Hospice nurse will be sent to the residence for further support and guidance.
• Our nurse will confirm the absence of vital signs and determine the time of death.
• During the visit, Coastal Hospice team members will help prepare your loved one’s
body for the funeral home or for those who have been chosen by the family to claim the body for burial, cremation or other arrangements. We ask that you have final arrangement information on hand.
• Coastal Hospice will notify the durable medical equipment (DME) company when equipment pick-up is needed. Then a representative of the DME company will call you to make the pick-up arrangements.
Coastal Hospice will also offer information on our Counseling and Support services.
Medication Destruction Policy
In review of EPA and DEA guidelines, Coastal Hospice has adopted the following policy:
1. Our nurses will not dispose of medications in the homes. We will teach caregivers (home-based settings) how to dispose of patient medications in a safe and legal manner when the medications are discontinued or when patient has passed away.
2. Our nurses will not pick-up and deliver any medications. We will guide and empower caregivers to pick up medications from the designated pharmacy.
At home disposal teaching points:
1. Federal Prescription Drug Disposal Guidelines Urge You To Return unused, unneeded or expired prescription drugs to pharmaceutical take-back locations for safe disposal.
2. Pharmacies such as CVS have medication collection containers during regular business hours and State Police Barracks have 24hour take back programs.
3. You may call your local pharmacy for additional locations.
To dispose at home:
1. Take unused, unneeded or expired prescription drugs out of their original containers.
2. Mix the prescription drugs with an undesirable substance like coffee grounds or kitty litter and put them in impermeable, nondescript containers such as empty cans or sealable bags. That ensures the drugs are not diverted or accidentally ingested by children or pets. Some pill containers now have devices that can neutralize the drugs while encasing them inside the containers. Free medication disposal bags are also available on request (see information below).
3. Throw these containers in the trash as part of the waste stream into your local landfill.
4. Do NOT flush prescription drugs down the toilet.
Get A Free Medication Disposal Bag
1. You can dispose of prescription drugs at home by taking certain precautions, through a pharmacy take-back program or with a disposal pouch.
2. 211 Maryland and the Rx Abuse Leadership Initiative (RALI) of Maryland are partners in stopping the opioid epidemic. RALI provides free disposal pouches that allow you to safely dissolve medication at home.
3. You fill the sealable pouch with medication, add a little water, shake it and throw the pouch away.
4. The bag contains carbon which deactivates the medication making it safe to throw in the trash.
5. Text MDHope to 898-211 to request a free disposal pouch. Press 1 for education/prevention and then 3 for safe prescription disposal.
When you throw away pills safely, the medications don’t end up in the wrong hands and you help prevent substance use and the potential for an overdose. Medication can also cause environmental problems when improperly disposed of in the trash or toilet.
First Aid for Poisoning
SWALLOWED POISON:
• Gently wipe out mouth and give a small amount of water.
• Do not make the person vomit.
• Call the poison center.
POISON ON THE SKIN:
• Remove contaminated clothing and jewelry.
• Rinse skin with lukewarm water for 10 minutes.
• Call the poison center.
POISON IN THE EYE:
• Flush the eye with lukewarm water from cup, faucet, or shower for 15 minutes.
• Do not force the eyelid open.
• Call the poison center.
INHALED POISON:
• Get the person to fresh air.
• Open doors and windows.
• Call the poison center.
What you need to know about Medicine Disposal
Taking medicines to permanent drop-off locations or take back events is the safest way to dispose of them. Many local police departments serve as permanent medicine drop-off locations in Maryland. To find a location nearest you, call your local pharmacy or the DEA Call Center at 1-800-882-9539. If you are unable to do the above, here’s another safe disposal method.
Follow these simple steps to dispose of medicines in the household trash.
MIX
Mix medicines (do not crush tablets or capsules) with an unpalatable substance such as dirt, kitty litter, or used coffee ground.
PLACE
Place the mixture in a container such as a sealed plastic bag.
THROW
Throw the container in your household trash
SCRATCH OUT
Scratch out all personal information on the prescription label of your empty pill bottle or empty medicine packaging to make it unreadable, then dispose of the container.
Patient Rights and Responsibilities
Notice of Patient Rights
1. Be involved in the development of his or her plan of care
2. Be informed about the scope of services the hospice provides and any specific limitations on those services;
3. Refuse care or treatment;
4. Choose his or her attending physician;
5. Receive effective pain management and symptom control for conditions related to the terminal illness;
6. Be free from mistreatment, neglect, or verbal abuse, including injuries of unknown source, and the misappropriation of patient property;
Patient and family responsibilities
1. To give accurate and complete information about current complaints, past illnesses, hospitalizations, medications and other matters relating to the patient’s health, as well as advance directive documentation, living will information and who has been chosen to make decisions for the patient should the patient not be able.
2. To assist in developing and maintaining a safe environment by reporting perceived risks in their care and unexpected changes in their condition.
3. To provide information to Coastal Hospice about service needs and expectations.
4. To ask questions when care, treatment and service, or instructions are not understood.
5. To participate in the development and update of the Plan of Care. To consult with Coastal Hospice prior to making additions or changes to the care plan.
7. Have person and property treated with respect by anyone providing services on behalf of the hospice;
8. Voice grievances to the hospice, The Joint Commission, or a state entity without fear of discrimination or reprisal;
9. Voice grievances regarding treatment or care that is – or fails to be- provided;
10. Be informed and receive written information concerning the hospice’s policy on advance directives, including state law and regulation;
11. Have a confidential record per state and federal law regulation;
12. Receive information about the services covered under the hospice benefit.
6. To follow the care, treatment and service plan developed. If concerns arise regarding the Plan of Care, to express to Coastal Hospice the concerns and the ability or willingness to adhere to the Plan of Care. To understand that the anticipated care outcomes may not be achieved if the care plan is not followed.
7. To follow established Coastal Hospice rules and regulations.
8. To show respect and consideration toward Coastal Hospice staff and property.
9. To meet financial obligations as agreed in the Coastal Hospice Service Agreement.
10. To inform Coastal Hospice when appointments cannot be kept.
11. To provide Coastal Hospice the name of the attending physician desired to manage their hospice care. This may include a hospice physician.
Coastal Hospice Standards of Conduct
Coastal hospice strives to ensure that all patients, families, volunteers, and staff experience a supportive, inclusive, and equitable environment. We do this by offering resources and support tailored to the unique needs of patients and their families.
We seek to create an atmosphere where staff and volunteers feel valued, respected, and supported. Therefore, threats of violence, abusive behavior or harassment towards volunteers or staff will not be tolerated and may result in discharge or transfer from our service.
Guide to Financial Assistance
Coastal Hospice provides care and services to patients and their families regardless of their financial circumstances. To meet this goal and establish the level of need for financial assistance, Coastal Hospice will apply a financial assessment (application for reduction/waiver) and sliding scale fee structure.
The sliding scale may be used to determine what portion of the fee is waived for patients who:
1. Have no insurance for hospice services
2. Have a co-pay/deductible on their insurance for hospice services
3. For residential care room and board fees.
A patient’s responsibility may be 100% waived and services not be billed, or they may be billed for service or a portion of service depending on their income and placement on the sliding scale.
Following a patient's request for financial assistance, application for medical assistance, or both, Coastal Hospice shall make a determination of probable eligibility and notify the patient. On a case by case basis, a payment plan may be arranged with the Coastal Hospice Finance Department for low income patients who do not qualify for full financial assistance but are unable to bear their share of financial responsibility.
Non-Discrimination Policy
Discrimination is against the Law
Coastal Hospice, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex, including sex characteristics, intersex traits; pregnancy or related conditions; sexual orientation; gender identity, and sex stereotypes. Coastal Hospice, Inc. does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex.
Coastal Hospice provides people with disabilities reasonable modifications and free appropriate auxiliary aids and services to communicate effectively with us, such as:
• Qualified sign language interpreters
• Written information in other formats (large print, audio, accessible electronic formats, other formats)
Provides free language assistance services to people whose primary language is not English, such as:
• Qualified interpreters
• Information written in other languages
If you need these reasonable modifications, appropriate auxiliary aids and services, or language assistance services, contact our Diversity Equity and Inclusion Officer.
If you believe that Coastal Hospice has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:
Diversity Equity and Inclusion Officer at Coastal Hospice
PO Box 1733, Salisbury, MD 21802-1733 410 742-8732 (Fax: 410 543-8213).
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, our Diversity Equity and Inclusion Officer is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
ATTENTION: If you require language assistance, language assistance services, free of charge, are available to you. Call 1-410-742-8732.
Spanish: Coastal Hospice, Inc. cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-410-742-8732.
Haitian Creole: Coastal Hospice, Inc. konfòm ak lwa sou dwa sivil Federal ki aplikab yo e li pa fè diskriminasyon sou baz ras, koulè, peyi orijin, laj, enfimite oswa sèks.
ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-410-742-8732.
Korean: [Coastal Hospice, Inc.]은(는) 관련 연방 공민권법을 준수하며 인종, 피부색, 출신 국가, 연령, 장애 또는 성별을 이유로 차별하지 않습니다.
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-410-742-8732.
[Coastal Hospice, Inc.]: Urdu 410-742-8732.
[Coastal Hospice, Inc.] Arabic 410-742-8732-1
Persian/Farsi:
Amharic:
1-410-742-8732.
Ibo: Ige nti: O buru na asu Ibo asusu, enyemaka diri gi site na call 1-410-742-8732.
Yoruba: AKIYESI: Ti o ba nso ede Yoruba ofe ni iranlowo lori ede wa fun yin o. E pe ero ibanisoro yi 1-410-742-8732.
Kru/Bassa: Dè ɖɛ nìà kɛ dyéɖé gbo: Ɔ jǔ ké m [Ɓàsɔɔ -wùɖù-po-nyɔ ] jǔ ní, nìí, à wuɖu kà kò ɖò po-poɔ ɓɛ ìn m gbo kpáa. Ɖá 1-410-742-8732.
Gujarati: સુચના:
French: Coastal Hospice, Inc. respecte les lois fédérales en vigueur relatives aux droits civiques et ne pratique aucune discrimination basée sur la race, la couleur de peau, l'origine nationale, l'âge, le sexe ou un handicap.
ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-410-742-8732.
Vietnamese: Coastal Hospice, Inc. tuân thủ luật dân quyền hiện hành của Liên bang và không phân biệt đối xử dựa trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính.
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-410-742-8732.
Russian: Coastal Hospice, Inc. соблюдает применимое федеральное законодательство в области гражданских прав и не допускает дискриминации по признакам расы, цвета кожи, национальной принадлежности, возраста, инвалидности или пола. ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны
услуги перевода. Звоните 1-410-742-8732.
Portuguese: Coastal Hospice, Inc. cumpre as leis de direitos civis federais aplicáveis e não exerce discriminação com base na raça, cor, nacionalidade, idade, deficiência ou sexo. ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-410-742-8732.
Tagalog: Sumusunod ang [Coastal Hospice, Inc.] sa mga naaangkop na Pederal na batas sa karapatang sibil at hindi nandidiskrimina batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian.
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-410-742-8732.
Chinese: Coastal Hospice, Inc. 遵守適用的聯邦民權法律規定，不因種族、膚色、民族血統、年 齡、殘障或性別而歧視任何人。
注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-410-742-8732。
Pursuant to decisions by various district courts regarding the 2024 Final Rule implementing Section 1557, entitled Nondiscrimination in Health Programs and Activities, 89 Fed. Reg. 37,522 (May 6, 2024) (“2024 Final Rule”), provisions are stayed or enjoined as indicated below:
1. In Florida v. Department of Health and Human Services, No. 8:24-cv-1080-WFJ-TGW (M.D. Fla.), the court stayed 45 C.F.R. 92.101(a)(2) (iv), 92.206(b), 92.207(b)(3)-(5), and 42 C.F.R. 438.3(d)(4), in Florida. OCR also may not enforce the interpretation of discrimination “on the basis of sex” in 45 C.F.R. 92.101(a)(2)(iv), 92.206(b), or 92.207(b)(3)-(5) in Florida.
2. In Tennessee v. Becerra, No. 1:24cv161-LG-BWR (S.D. Miss.), the court stayed nationwide the following regulations to the extent they “extend discrimination on the basis of sex to include discrimination on the basis of gender identity”: 42 C.F.R. 438.3, 438.206, 440.262, 460.98, 460.112; 45 C.F.R. 92.5, 92.6, 92.7, 92.8, 92.9, 92.10, 92.101, 92.206-211, 92.301, 92.303, 92.304; and enjoined HHS from enforcing the 2024 Final Rule “to the extent that the final rule provides that ‘sex’ discrimination encompasses gender identity.”
3. In Texas v. Becerra, No. 6:24-cv-211-JDK (E.D. Tex.), the court stayed the 2024 Final Rule in its entirety in Texas and Montana.
Complaints
Our goal is to assist you to meet your physical, psychosocial and spiritual needs during your time in hospice. If you are not satisfied or have a complaint, please discuss it with your nurse or the team manager. If it is not resolved, the following options are available to you:
If you think your grievance has not been resolved, to register a complaint or patient safety concern with Coastal Hospice’s President, please email: concerns@coastalhospice.org
Mail: PO Box 1733
Salisbury MD, 21802
Call: 410-742-8732; TTY: 1-800-735-2258
If your concern is not resolved, you can submit your written grievance to OHCQ to:
Office of Health Care Quality Maryland Department of Health and Mental Hygiene Spring Grove Center 7120 Samuel Morse Dr Second Floor Columbia, MD 21046
To register a grievance with the State of Maryland, Office of Health Care Quality (OHCQ), without fear of reprisal or discrimination, patients and families
may call 1-800-492-6005. The Office of Health Care Quality is available to answer questions related to the agency’s Medicare and/or licensure status, or to receive complaints. This service is in operation 24 hours a day, 7 days a week. Normal working hours are 8 a.m. to 4:30 p.m. After 4:30 p.m., calls are taken by an answering machine.
You may also contact The Joint Commission (an independent non-profit organization that accredits and certifies health care organizations. Coastal Hospice is accredited by The Joint Commission.
Online: https://www.jointcommission.org/ resources/patient-safety-topics/report-a-patientsafety-concern-or-complaint/
Mail: Office of Quality and Patient Safety
The Joint Commission One Renaissance Boulevard Oakbrook Terrace, Illinois 60181
More information can be found at: www.jointcommission.org
An investigation will be conducted by Coastal Hospice of complaints made by the patient or the patient’s family or guardian regarding treatment or care and Coastal Hospice will document the existence of the complaint and the resolution of the complaint.
Emergency Preparedness Plan
Date:
Patient’s Name:
Patient’s DOB:
Emergency Contact Information:
Name:
Phone Number:
Alternate Phone Number:
Primary Care Physician:
Phone Number:
Allergies (provide reactions):
Medical Equipment/Assistive Device Requirements
Activity Level and requirements:
Please remember to collect all of your medications (see medication list) in case of an emergency. Contact Coastal Hospice at 410-742-8732 to update of any change
As Needed Medication Log
As Needed Medication Log
As Needed Medication Log
As Needed Medication Log
In-Home Medication Log
Please list all medications prescribed to patient.
Patient’s Name
Primary Nurse
Physician
In-Home Medication Log
Please list all medications prescribed to patient.
Patient’s Name
Physician
Primary Nurse Allergies
Evening, Bedtime
In-Home Medication Log
Please list all medications prescribed to patient.
Patient’s Name
Primary Nurse
Physician
Bowel Movement Record
Date and Time of BM
Consistency of Stool
Examples include: hard, soft, liquid
Abdominal Symptoms
Examples include: bloating, distention, gas, cramping, nausea, vomiting, reflux, heartburn
Problems with Passing Stool
Examples include: straining, incomplete passage of stool, leakage of stool, diarrhea, hemorrhoidal pain or bleeding
Bowel Movement Record
Date and Time of BM
Consistency of Stool
Examples include: hard, soft, liquid
Abdominal Symptoms
Examples include: bloating, distention, gas, cramping, nausea, vomiting, reflux, heartburn
Problems with Passing Stool
Examples include: straining, incomplete passage of stool, leakage of stool, diarrhea, hemorrhoidal pain or bleeding
Bowel Movement Record
Date and Time of BM Consistency of Stool
Examples include: hard, soft, liquid
Abdominal Symptoms
Examples include: bloating, distention, gas, cramping, nausea, vomiting, reflux, heartburn
Problems with Passing Stool
Examples include: straining, incomplete passage of stool, leakage of stool, diarrhea, hemorrhoidal pain or bleeding
