Everflowing

I received an email from a practitioner who has recently been contracted to provide massage for hospice clients. He has no training in adapting massage to this population and therefore has contacted me. His availability for training however is several months behind the beginning of his new venture.

He shared today that he had gone to his first client and the client had declined massage. It seems that the physician had been the referring agent and had not received the confirmation from his patient. He had only suggested it.

In the Everflowing “Providing Massage In Hospice Care” instructional manual I have a full chapter on how, and from whom, to gather information. Let’s cover just a few basics about taking hospice referrals.

The Home-Based Client

1. This initial phone call is your opportunity to acquire information about the prospective
client. The initial intake should include:

• client name, address, phone number
• primary diagnosis
• with whom the client lives
• phone numbers of other team members (case manager, nurse, etc.)
• the client’s physical and attitudinal symptoms
• the goal plan for massage
• how to invoice for payment

In the case of a physician referral, contact the care manager for invoice information

2. Call the client to confirm the interest. If the client is not alert confirm with the attendant or family member.

The referral agent may not have all the information you need.
You will then follow up with the appropriate calls.

3. If a home care nurse is involved, I suggest calling the nurse to follow up on the initial information concerning the client’s physical symptoms. Ask for the following information:

- medication considerations
- site and/or position restrictions
- other special precautions
- goal plan for the session
- anything else they feel you should know

This information will allow you to assess if your scope of practice is appropriate for the referral.
Sometimes this information will be included in the initial phone call however, I suggest checking in with the nurse if appropriate, to introduce yourself, explain your scope of practice, and ask if he/she has any questions for you.

4. A case manager is the team member who can give you information on relationships within
a home setting. If your prospective client is living with family members, I suggest you call
the case worker to acquire clear information on what to expect within the dynamics of the home so you may establish appropriate boundaries. If your client is experiencing difficult psychological
behaviors, the case worker may also give you very important information on establishing trust
with your client.

• If you choose to see the prospective client and the client is home based you will call the on site attendant to gather information concerning the client’s schedule and the environment:

- What time of day is the client’s energy best suited for massage?
- What are the client’s movement restrictions?
- When is a health care attendant on-site?
- What equipment is available, such as a wheel chair, recliner, or hospital bed?
- Are there extra sheets, a blanket, 2 or 3 bed pillows, extra towels?
- Can the client use a massage table? Is there room for a table? Are there stairs? Is there
parking on-site?

Knowing what team member to ask what questions can save a lot of confusion, time, and energy.

For more information on this topic check out the Providing Massage in Hospice Care instructional manual in the Everflowing resource center at www.everflowing.org.

Blessings,
Irene Smith

Posted by Irene Smith on Thursday, January 13th, 2011 at 5:05 pm.