For VNS Health home health aide Delores Yearwood Pile, her job providing care to VNS Health Hospice patients at a large skilled nursing facility in the Bronx keeps her on her toes—literally. “I might begin my shift by giving one patient a bath and then dressing her in a set of fresh clothes and feeding her,” she says. “Then I’ll walk a short distance and do the same with another patient. An hour later, I’m on to a third patient. And in between these visits, I’ll circle back to check on the others. Every minute I’m there, I’m providing important help to someone rather than simply sitting at their bedside during the times they don’t need me—plus it gives variety to my day!”
When Yearwood Pile’s shift is done, another aide will follow a similar routine with the same patients. This rotating care is a hallmark of VNS Health’s new “Cluster Care” hospice model. Designed for nursing homes and other group settings, the model calls for assigning a number of hospice-trained home health aides (HHAs) to the facility on a permanent basis. These HHAs then circulate among multiple hospice patients as needs arise, serving as a key member of VNS Health’s visiting hospice care team in between the regular visits from VNS Health’s hospice nurses, social workers and spiritual counselors.
The model has a number of benefits: Since Medicare covers only a limited number of HHA hours for each hospice patient, having HHAs visit hospice patients repeatedly for shorter periods when their assistance is most valuable—rather than simply waiting beside the patient until they’re needed—allows the nursing facility and VNS Health Hospice to provide more effective HHA support for each patient in the HHA hours allotted to them.
“Often our hospice patients don’t fully benefit from four straight hours of care, since they may be sleeping or quietly resting for part of that time,” explains Roisin Rogers, Director of Strategic Account Development at VNS Health. “Additionally, many hospice patients have needs that arise at different times of day. By dividing each HHA’s shift among several patients, we can spread out each patient’s HHA coverage over the course of the day.”
“Since launching our first Cluster Care team earlier this year in the Bronx, we’ve gotten very good feedback from the nursing facility,” notes Natalie Cheltenham-Festa, Associate Vice President, VNS Health Hospice Care. “We look forward to employing this model with other nursing home partners in the coming months.”
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