ADMISSION PROCESS

Hungarian Hospice Palliative Association

community of Hungarian hospices

Hospice/palliative care is for those patients with advanced stage, primarily tumorous, illness and agonising symptoms, whose life expectancy is 6 to 12 months. Care can be initiated by the patient, the patient’s legal representative or family member, family doctor or specialist physician. All forms of hospice/palliative care are free for the patient.

Procedures for entry into hospice/palliative care for advanced stage, primarily terminal stadium cancer patients

In order to receive home hospice care a referral from a specialist physician is needed, which is recorded in the epicrisis of the discharge report. Based on the specialist’s recommendation the family doctor can prescribe the first 50 days of specialised home hospice care, which in case of need and want may be extended twice.

Within 48 hours of a request the hospice specialist nurse and/or coordinator of the home hospice provider contact the family and the patient. They complete the necessary admittance forms (agreement, hospice registration form), record the nursing anamnesis, and determine goals and a plan. The pain symptoms are evaluated using the various scales (pain assessment form, ECOG, Karnofsky, nursing category, ESAS). The necessary team members (palliative physician, dietician, physical therapist, physiotherapist, mental health professional, social worker, trained volunteers) are organised based on need and request, and they expertly care for the patient as well as aid the family with advice, professional know-how and education.

Home hospice care is integrated with regional community and social care. It is a totality of specialised medical tasks; looking after the patient and household tasks are not part of it. The time spent with the patient is determined by the wishes of the patient and the professional tasks to be performed.
Part of home hospice care is the organisation of social services; this extends to involving local government, religious, civil organisations, etc., providing assistance with household chores and other care providers.
Institutional hospice care is provided for those patients for whom home hospice care is not feasible, or when the needs or care requirements increase such that the family or patient request it. The majority of hospice departments work by an appointment system, based on submission of an application form completed by the patient, family, specialist physician and family doctor. The period of care is determined by the internal rules of the facility, which generally does not exceed three months.

Admittance from a hospital department requires a discharge report, whereas admittance from home requires a referral from the family doctor.

Institutional hospice care is not the last stop in a dead end, not chronic care or oncological rehabilitation, but rather a multidisciplinary unit with a separate, independent profile.

The Mobile Team provides professional care within the hospital, with the objective of assisting in the care of patients at an advanced stage of illness in a variety of departments, and to represent and use the principles of palliative care. They provide professional assistance to patients, primarily cancer patients, in the terminal state and to their family members with the aid of a trained interdisciplinary team; they also ensure professional assistance and consultation to the professional staff of the hospital.

The Mobile Team works on the basis of consultation requests. The specialist physician or the patient’s primary physician request from the specialist nurse and coordinator of the Mobile Team, in writing or orally, a consultation. They make themselves available in the hospital department within 24 hours. They discuss the patient’s status and the reason for the consultation request at the patient’s bedside. In the course of joint discussions with the specialist physician, the patient and the family, the coordinator organises the patient’s hospice/palliative somatic, psychic and social care.

In all three forms of care information on the patient’s status needs to be continually shared with the patient, and involvement of the patient in the treatment and nursing process occurs according to the patient’s wishes.