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OK, this call I got working hospice triage this weekend has me scratching my head. 
The suck is minimal, mostly just sad.
For those of you coming in late, I work part time doing telephone triage for my local hospice organization. Patients call an answering service number, the answering service calls me, I call the patient back after I pull up their chart on my computer and trouble shoot their problem, sending a nurse to visit as necessary. /background.
Today was a pretty busy day, calls coming in a quick pace. I got several calls within a few minutes of one another. One call was from someone requesting information about our services. This is not unusual.
Usually I call back, get the name of the potential patient, their DOB, medical diagnosis, and some other eligibility information and pass it along to the referral nurse to follow up on Monday. It's a quick call, but not a high priority one (actual patients take precedence).
I deal with other patients who were waiting call backs, when I get another call from the answering service (ours is really good, and we work well together).
Cast of characters:
Me
AS: Answering service lady
PD: Patient's Dad
Cue my phone ringing. It's AS.
AS: Panacea, PD is calling back. He is very upset that you haven't called him back yet.
Me: It's only been 20 minutes and it's not like I haven't been busy.
AS: I know. I tried to explain to him you were getting a lot of calls today, but he is pretty unhappy.
Me: OK. I'll call him right now.
*Most referral patients aren't this demanding before they've even talked to me.*
Me (calling PD): Hi, this is Panacea from Hospice returning your call.
PD: Yes, I need to get information about getting services for our son. He is [non life threatening disability withheld for privacy purposes] and he's been sick. My wife and I can't handle him anymore. We are elderly. A friend of ours told us hospice could help us take care of him. We need to get something right away.
Me: *now clued into the fact this is an adult not a child* OK, I can give you some information. I'll need his name, age, and medical diagnosis.
PD: He's got [disability].
Me: Uhm. OK. Does he have a medical diagnosis to where he is expected to die in the next six months?
PD: No, nothing like that.
Me: I'm sorry, sir. We aren't going to be able to help you. Our services are for patients who are expected to die within six months.
PD: Oh. But our friend told us hospice sometimes helped people like us.
Me: I'm sorry, sir but no. Our organization cares for those who are dying. What you need is a home health organization. Do you have insurance?
PD: Yes, [names major well known insurance company].
Me: You may qualify for a home health benefit. You should call your insurance company in the morning and ask them. Or you can call the state and see if there are any state programs that provide care givers in the home.
PD: But, we were told you did that.
Me: Yes, sir. For the dying. Your son is not dying.
PD: We are elderly. We can't take care of him any more. He yells and screams and we just can't handle it.
Me: I'm very sorry, sir. You should call your insurance company, and call the Department of Health and Human Services to see what other programs you might qualify for.
I felt very sorry for them. But the frustrating part was the insistence that "hospice takes care of people in the home."
We do. Just not all people.
We've been getting a lot of this lately: people signing up for our services who have no intention of going along with the hospice philosophy (comfort care only, emphasis on symptom management not active treatment of disease) and who expect 24 hour care givers to be provided so they don't have to do any of the care themselves.
That's an awful lot to expect for $135/day.
The suck is minimal, mostly just sad.For those of you coming in late, I work part time doing telephone triage for my local hospice organization. Patients call an answering service number, the answering service calls me, I call the patient back after I pull up their chart on my computer and trouble shoot their problem, sending a nurse to visit as necessary. /background.
Today was a pretty busy day, calls coming in a quick pace. I got several calls within a few minutes of one another. One call was from someone requesting information about our services. This is not unusual.
Usually I call back, get the name of the potential patient, their DOB, medical diagnosis, and some other eligibility information and pass it along to the referral nurse to follow up on Monday. It's a quick call, but not a high priority one (actual patients take precedence).
I deal with other patients who were waiting call backs, when I get another call from the answering service (ours is really good, and we work well together).
Cast of characters:
Me
AS: Answering service lady
PD: Patient's Dad
Cue my phone ringing. It's AS.
AS: Panacea, PD is calling back. He is very upset that you haven't called him back yet.
Me: It's only been 20 minutes and it's not like I haven't been busy.
AS: I know. I tried to explain to him you were getting a lot of calls today, but he is pretty unhappy.
Me: OK. I'll call him right now.
*Most referral patients aren't this demanding before they've even talked to me.*Me (calling PD): Hi, this is Panacea from Hospice returning your call.
PD: Yes, I need to get information about getting services for our son. He is [non life threatening disability withheld for privacy purposes] and he's been sick. My wife and I can't handle him anymore. We are elderly. A friend of ours told us hospice could help us take care of him. We need to get something right away.
Me: *now clued into the fact this is an adult not a child* OK, I can give you some information. I'll need his name, age, and medical diagnosis.
PD: He's got [disability].
Me: Uhm. OK. Does he have a medical diagnosis to where he is expected to die in the next six months?
PD: No, nothing like that.
Me: I'm sorry, sir. We aren't going to be able to help you. Our services are for patients who are expected to die within six months.
PD: Oh. But our friend told us hospice sometimes helped people like us.
Me: I'm sorry, sir but no. Our organization cares for those who are dying. What you need is a home health organization. Do you have insurance?
PD: Yes, [names major well known insurance company].
Me: You may qualify for a home health benefit. You should call your insurance company in the morning and ask them. Or you can call the state and see if there are any state programs that provide care givers in the home.
PD: But, we were told you did that.
Me: Yes, sir. For the dying. Your son is not dying.
PD: We are elderly. We can't take care of him any more. He yells and screams and we just can't handle it.
Me: I'm very sorry, sir. You should call your insurance company, and call the Department of Health and Human Services to see what other programs you might qualify for.
I felt very sorry for them. But the frustrating part was the insistence that "hospice takes care of people in the home."
We do. Just not all people.
We've been getting a lot of this lately: people signing up for our services who have no intention of going along with the hospice philosophy (comfort care only, emphasis on symptom management not active treatment of disease) and who expect 24 hour care givers to be provided so they don't have to do any of the care themselves.
That's an awful lot to expect for $135/day.
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