Admission Guidelines
Clinical opportunity to join our team
Aurora House staff share would like to share these general guidelines with our partners in the hospice agencies in order to facilitate open communication and safe transitions for our mutual patients and their families.
Referral process
A comfort home referral must be received for every patient that is admitted to Aurora House. Occasionally, a dying person comes to our attention through other means. When that occurs, the person is referred to his/her physician or hospice agency, so a referral can be generated within a team environment.
As a professional courtesy, Aurora House staff will acknowledge each referral and update the case workers on the bed status. We would respectfully ask that you not share our bed situation with the families of potential residents or let them know that we are evaluating a referral until we have talked with you to set up a meeting. Be assured, when we meet with the family, it will be with the intention of offering the bed.
Diagnosis
The best fit for our home is a person with a definitively, life-ending disease that is progressive in nature such as an advanced neoplasm. We will consider people with other disease processes if the person truly desires only to receive comfort measures only. For example, a person with end-stage heart disease who remains on medication to control heart rhythm, blood pressure, fluid balance, and blood chemistry levels is treating the disease from our perspective and would not be appropriate for our home. If the same person decides simply to treat chest pain, shortness of breath, and anxiety with medication and oxygen, that would be an appropriate fit.
Adult failure to thrive, disability not otherwise specified, and dementia, while they are terminal diagnoses, are not appropriate for our home. People do thrive in the caring, loving environment of our home, and it is traumatic for both the resident and family when we have to make a discharge plan for long term care. People suffering from advanced dementia are not able to appreciate the love and beauty that is offered in our setting, and although they are just as deserving, it is also important for our volunteers to feel they are making a difference in a person’s life.
Infectious disease will not disqualify a person from admission to Aurora House. Gloves and appropriate personal protective equipment are provided. The volunteers have been trained and coached on Universal Precautions. The staff appreciates your openness when you know of this issue.
Weight
We are a home environment and do not utilize lifts. We rely on the muscles of our volunteers (mostly little old ladies) to turn, reposition, and transfer our residents. The maximum weight that we can safely accommodate is 180 lb. If it’s close, we will ask you for a scaled weight.
Medical Technology
We are happy to welcome patients who are using PCA/CADD pumps for either subcutaneous or IV symptom control. Our RN staff members are comfortable with mediports and PICC lines. Patients with simple drains such as a foley catheter, colostomy, or G-tube are all appropriate in our setting. Oxygen and nebulizers can be accommodated.
We do not use suction at the Aurora House, so we are unable to care for a patient with a tracheostomy. Nursing staff is not on the premises at night and the home health aides would be beyond their scope of practice to suction a trach. CPAP and BiPAP also exceed the training of the volunteers and the scope of practice for the home health aides.
Aurora House nursing staff is happy to assist with simple dressing changes, catheter changes, subcutaneous disc changes, and facilitating communication between the agency and the physician. Our volunteer base is primarily non-medical, so we have to be sensitive to them. It is important that we have very clear communication regarding wounds, especially wounds at risk for dehiscence, draining wounds, or very deforming surgeries.
Pain/Symptom Control
The home environment is not always suitable to achieve symptom control. If a person is transferred to Aurora House from a facility, we will ask for evidence that symptoms have been under good control on the current regimen for at least 24 hours.
Family Dynamics
While we recognize that the end of life is a difficult emotional time, some families are not appropriate for the comfort home environment. If there is significant difficulty with disruptive, mentally ill, or addicted family members, please be open about those situations. Our volunteers are not equipped with professional skills, and they are giving their time and their hearts. We don’t want volunteers or the family of another resident to have to deal with drama or trauma.
If you have any questions, please feel free to call the house (585-617-4863). The volunteers will help you contact the nursing staff directly, and we are happy to partner with you in determining a safe disposition for your patients.