Care Delivery

Care Delivery

Palliative Care

Service Offering Playbook

Care Delivery


Once you have signed a client on for care, it is important that you understand how to now deliver high quality care to that client. There are a number of factors to take into consideration when it comes to care delivery including have a detailed care plan, training caregivers effectively, and receiving payment for services provided. In this section, we will go into detail on these topics to help you understand how to provide high quality care to palliative and hospice clients.

Care Planning

Care plans are created out of the in-home assessment after you’ve had the opportunity to speak with the client and/or family members and see the status of their home environment. Building a care plan for a palliative patient involves considering a range of factors to ensure their unique needs are met.

At Qualicare, each and every care plan is personalized to the client’s needs to ensure the brand experience is of the highest quality and that clients are taken care of – not only will this ensure clients get the care needed but it will also help with receiving word of mouth recommendations from clients and/or family members who are impressed with the services you provide.

Effective Care Plans

In order to design an effective care plan for a client with palliative care needs, it’s important to incorporate the following elements. These are included in the care plan documents that can be found on QCentral.

o Comprehensive assessment: Conduct a thorough assessment of the client's physical, emotional, social, and spiritual needs. This assessment should involve input from the client, their family, and healthcare professionals. It will help identify the specific care requirements and determine the level of support needed.
o Multidisciplinary team involvement: Involve a multidisciplinary team of healthcare professionals, including physicians, nurses, social workers, and palliative care specialists. Collaborate with them to develop a holistic care plan that addresses the client's medical, emotional, and psychosocial needs.
o Pain and symptom management: Palliative care focuses on pain and symptom management. Ensure that the care plan includes a detailed approach to addressing the client's pain, discomfort, and other distressing symptoms. This may involve medication management, alternative therapies, or interventions to enhance comfort.
o Emotional and psychosocial support: Palliative care encompasses emotional and psychosocial support for the client and their loved ones. Develop strategies to address emotional distress, anxiety, depression, and grief. This can involve counseling, support groups, or referrals to mental health professionals.
o Communication and decision-making: Facilitate open and honest communication among the client, their family, and the care team. Ensure that the client's wishes, values, and goals of care are clearly understood and respected. Implement mechanisms for advance care planning and help with important decision-making processes.
o Caregiver support and education: Provide caregivers with the necessary support and education. Offer training on caregiving techniques, pain management, and emotional support.
o Coordination of services: Ensure effective coordination among various healthcare providers involved in the client's care. This includes medical professionals, therapists, and specialists. Regular communication and sharing of information are vital to ensure continuity of care.
o Safety and accessibility: Assess the home environment for safety hazards and make necessary modifications to ensure the client's safety and accessibility. This may include installing grab bars, ramps, or other assistive devices.
o Cultural and spiritual considerations: Respect and accommodate the client's cultural and spiritual beliefs and practices. Consult with cultural or spiritual advisors, if necessary, to provide appropriate support and care that aligns with the client's values.

The care plan should be flexible, as the needs of a palliative patient are likely to change over time. Regular assessments should be performed to ensure the care plan remains appropriate and effective. Training your caregivers to notice any changes that may need to be made to the care plan is also a helpful way of determining if a new assessment must be completed as a client’s progresses.

Training Staff

Having a detailed and effective care plan is going to ensure your staff are clear on what a client needs in order to be effectively cared for during their time at the home. As a business owner, you want to ensure that your caregivers are also trained in providing palliative care for clients as it does require specialized training to be most effective. Being able to adequately explain how your caregivers are trained is going to help the client and family members feel comfortable with having caregivers come into the home to provide care.

There are a number of resources you can look at and use when it comes to training caregivers. As an example, training platforms such as Relias have multiple courses related to caring for a client with palliative care needs. Good training will include the following items:

● Basic caregiving skills: Caregivers should receive training in basic caregiving skills, including assistance with personal hygiene, bathing, dressing, grooming, and mobility support. They should learn proper body mechanics and techniques for safe lifting and transferring of clients.
● Medication management: Caregivers need to understand medication management, including medication schedules, proper administration techniques, and recognizing and reporting medication side effects or adverse reactions. They should also be trained on the importance of medication adherence and documentation.
● Pain and symptom management: Palliative care often involves managing pain and other distressing symptoms. Caregivers should receive training on different pain management techniques, including medication administration, non-pharmacological approaches (e.g., positioning, relaxation techniques), and the use of assistive devices.
● Emotional support and communication: Caregivers should be trained in providing emotional support, active listening, and effective communication techniques. This includes empathetic communication, validation of feelings, and providing a comforting presence. They should also be trained to identify signs of emotional distress and know when to seek additional support from healthcare professionals.
● Safety and emergency procedures: Caregivers should receive training on safety measures, including fall prevention, infection control, and emergency procedures such as CPR (Cardiopulmonary Resuscitation) and first aid. They should also be familiar with the client's emergency contacts and know when and how to seek immediate medical assistance.
● Cultural competence: Caregivers should receive training in cultural competence to understand and respect the diverse backgrounds, values, and beliefs of their clients. This training helps them provide culturally sensitive care and communicate effectively across different cultural contexts.
● Documentation and reporting: Caregivers need training on proper documentation and reporting procedures. This includes maintaining accurate records of care provided, observing and documenting changes in the client's condition, and reporting concerns or incidents to the appropriate healthcare professionals.
● Self-care and caregiver well-being: Caregivers should be educated on the importance of self-care and managing their own well-being. Training in stress management, recognizing signs of burnout, and accessing support resources can help caregivers maintain their own physical and emotional health while providing care to others.
● End-of-life care and grief support: Training in end-of-life care is essential for caregivers working with palliative clients. This includes understanding the dying process, providing comfort care, and offering emotional support to the client and their loved ones. Caregivers should also be trained in grief support to help individuals cope with loss and bereavement.

By providing comprehensive training in these areas, caregivers can acquire the skills and knowledge necessary to provide high-quality care, enhance the client's quality of life, and support their physical, emotional, and psychosocial well-being. This type of training will also help your caregivers feel more equipped at caring for a client at a very hard time in their life, and help prevent unnecessary caregiver turnover.

Beginning Services

Starting in-home care services for a new client with palliative care needs requires careful planning and sensitivity to the client's needs. It is a transition for a client to have someone coming into their home and this can create nervousness, anxiety, and fear for the client and their family. Having a strong process in place to alleviate these feelings will provide a stronger brand experience for everyone involved. Here are some of the best practices related to beginning service for a new client with dementia:

1. Involve the Family - Work closely with the family or other close support persons to gather detailed information about the client's lifestyle, preferences, routines, and medical history.
2. Gradual Introduction - Start with short visits to allow the client to become comfortable with the caregiver. Gradually increase the duration of care as the client becomes more accustomed to the caregiver's presence.
3. Consistent Caregivers - Try to maintain consistency with caregivers, as changing caregivers often can be confusing and stressful for individuals with high care needs.
4. Clear Communication - Ensure clear communication about the roles and responsibilities of caregivers. Make sure the client and their family understand what to expect.
5. Reference the Care Plan – The care plan has been developed to be focused on the client’s needs. Ensure the care plan is being referenced regularly to address a client’s medical needs, personal preferences, daily routines, cognitive challenges, and social and emotional needs.
6. Prepare for Changes – Palliative care is dynamic, so the care plan must be flexible and adapt to changing needs over time. Regularly assess the client's condition and adjust the care plan as necessary.
7. Address Emotional Needs - The transition to in-home care can be emotionally challenging for both the client and their family. Provide emotional support and reassurance throughout the process.
8. Be Patient – Caring for a palliative client can be very challenging, particularly as their disease progresses. Be patient with the challenges that come up and coach your caregivers to have patience. This can help both the client and the family members to remain calm during a very emotionally trying time.

Putting focus on the steps above helps to provide a client and their family members with a brand experience that exemplifies the 360 Approach. Not only are you and your caregivers ensuring high quality care is being delivered for the client but you are also focused on ensuring the family receives what they need for their peace of mind.

Invoicing Services

As with any service you provide in your business, you do need to have a system and process in place for payment of care provided. Knowing this process, and communicating it clearly to the client and/or family member paying for the service, is vital to ensuring smooth collection of outstanding amounts and prevents you from having a growing pile of unpaid invoices. However, invoicing for in-home care services, especially for palliative clients, requires a clear, compassionate, and ethical approach. Here are some best practices to consider:

o Transparency and Clarity - Clearly itemize all the services provided and their respective costs in the invoice. Use simple, non-technical language as much as possible.
o Frequency of Invoicing - Determine a consistent billing cycle (weekly, bi-weekly, monthly) that suits the client or their family's needs. Consistency will help them anticipate when invoices are coming and plan accordingly.
o Format - Make sure the invoice is easy to read. Use a larger font size if necessary. If the client has a designated family member or power of attorney handling their financial affairs, be sure to include them in the invoicing process.
o Due Date - Clearly mention the due date for payment. A grace period before late charges apply can be helpful for family members managing multiple responsibilities.
o Mode of Payment – As much as possible, aim to have a payment that is collected automatically, such as a credit card. The expectation can be set that the invoice will be sent with enough time for the family to review before the payment will be automatically billed. Having automatic payment helps you to avoid having to chase payments, which can become increasingly more difficult as your business grows. o
Communication - Send the invoice to the person responsible for payments, which may not be the client if they have an advanced illness. Email is best but be prepared to send via mail, based on the recipient's preference.
o Invoice Review - Offer to review the invoice with the client or their family. This could be over the phone or in a meeting, offering them a chance to ask questions and better understand the charges.
o Confidentiality - Ensure the client's financial and personal information is kept confidential, respecting privacy regulations and guidelines.
o Disputes - Have a process in place to handle disputes or questions about the invoice. Be prepared to provide supporting documentation or explanations if necessary.

Always remember that patience and empathy are crucial when dealing with palliative patients and their families, who may be under stress due to the illness and the associated costs. It is obviously important that you are paid for the services provided so combining the patience and empathy with clear expectations and communication will lead to fewer missed payments and AR in your business.

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