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The Heart of Hospice Care: Understanding Our Interdisciplinary Care Plan Approach

Learn how our team-based Interdisciplinary Care Plans at Lavender Hospice provide comprehensive, personalized support for patients and families in Phoenix.
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At Lavender Hospice, we believe that truly compassionate end-of-life care requires more than just medical expertise—it demands a holistic approach that addresses each person’s unique physical, emotional, spiritual, and social needs. This is why the Interdisciplinary Care Plan (ICP) forms the foundation of the care we provide to our patients and their families throughout Phoenix and the surrounding communities.

What Is an Interdisciplinary Care Plan in Hospice Care?

An Interdisciplinary Care Plan (ICP) is the roadmap that guides all aspects of a patient’s hospice journey. Unlike traditional medical care that might focus primarily on physical symptoms, our ICPs take a whole-person approach, considering every dimension of wellbeing.

At its core, an ICP is a comprehensive, personalized plan developed collaboratively by our entire hospice team. We design each plan specifically for the individual patient, taking into account their unique needs, preferences, values, and goals for their remaining time.

The Key Components of Our Interdisciplinary Care Plans

Our ICPs cover several essential dimensions of care:

  • Physical comfort and symptom management – addressing pain, breathing difficulties, nausea, and other physical concerns
  • Emotional and psychological support – helping patients and families process complex feelings around end-of-life
  • Spiritual care – honoring and supporting each person’s faith traditions or spiritual needs
  • Social support – addressing practical needs and helping maintain meaningful connections
  • Family education and support – providing guidance, resources, and comfort to loved ones

Each of these components is regularly assessed and adjusted as needs change, ensuring that our care remains responsive and appropriate.

The Interdisciplinary Team Behind the Plan

What makes our approach truly special is the diverse team of professionals who collaborate to create and implement each ICP. Our interdisciplinary team includes:

Medical Professionals at the Core of Hospice Care

  • Hospice Physicians who specialize in pain management and symptom control
  • Registered Nurses who provide skilled assessment, medication management, and hands-on care
  • Certified Nursing Assistants who offer personal care and comfort measures

Supportive Care Specialists

  • Social Workers who help navigate practical concerns, family dynamics, and emotional needs
  • Spiritual Care Counselors who provide spiritual support aligned with each person’s beliefs
  • Bereavement Counselors who offer grief support to families before and after their loss
  • Trained Volunteers who provide companionship and additional support

Each team member brings unique expertise to the table, and together, we ensure that no aspect of a person’s needs goes unaddressed.

How We Develop and Implement Your Interdisciplinary Care Plan

At Lavender Hospice, we’ve refined our approach to creating ICPs through years of experience serving the Phoenix community. Our process typically includes:

Initial Assessment and Plan Development

When a patient begins hospice care with us, we conduct a thorough initial assessment. This involves:

  1. Meeting the patient and family to understand their situation, concerns, and wishes
  2. Reviewing medical history and current symptoms
  3. Assessing comfort needs, emotional state, and spiritual preferences
  4. Identifying family dynamics and support systems
  5. Determining practical needs and resources

Using this information, our team collaboratively develops the initial ICP, outlining specific goals and interventions for each area of care.

Regular Team Conferences and Plan Updates

One of the most important aspects of our ICP approach is our commitment to ongoing assessment and adjustment. Our interdisciplinary team meets regularly to:

  • Review each patient’s current status and needs
  • Discuss what’s working well and what needs adjustment
  • Share observations and insights from different team members
  • Update the care plan to reflect changing circumstances

These team conferences ensure that our care remains coordinated, comprehensive, and responsive to evolving needs.

The Unique Benefits of Our Interdisciplinary Approach

There are several reasons why we at Lavender Hospice are passionate about our interdisciplinary approach to care planning:

Holistic, Person-Centered Care

By bringing together diverse perspectives and expertise, we can address the whole person—not just their physical symptoms. This means we can help patients find comfort, meaning, and even moments of joy during their hospice journey.

Coordinated, Seamless Support

Our team-based approach means that care is seamlessly coordinated. Families don’t have to navigate multiple disconnected providers or worry about important needs falling through the cracks. Our team communicates effectively with each other, ensuring consistent, comprehensive care.

Flexibility and Responsiveness

End-of-life needs can change rapidly, sometimes from day to day. Our interdisciplinary approach allows us to quickly recognize these changes and adapt our care accordingly, ensuring patients always receive exactly what they need, when they need it.

Family Support and Involvement

We recognize that hospice care supports not just the patient but the entire family. Our interdisciplinary team provides education, emotional support, and practical guidance to loved ones, helping them navigate this challenging time with greater confidence and peace.

How Families Participate in the Interdisciplinary Care Plan

At Lavender Hospice, we view family members as essential partners in care. Here’s how we involve families in the ICP process:

  • Input into care goals – We seek family perspectives on what matters most to their loved one
  • Regular updates and education – We keep families informed about the care plan and any changes
  • Skills training – We teach family caregivers specific techniques to enhance comfort
  • Support for difficult decisions – We provide guidance when challenging choices must be made
  • Ongoing emotional support – We offer counseling and resources for coping with grief

This partnership approach ensures that both patients and families feel supported, informed, and empowered throughout the hospice journey.

The Interdisciplinary Care Plan in Action: A Patient’s Journey

To illustrate how our ICPs work in practice, consider the experience of a typical patient (with details changed for privacy):

Maria came to us with advanced heart disease. Her initial ICP identified several key needs: pain management, breathing support, anxiety reduction, spiritual counseling, and practical support for her daughter who was her primary caregiver.

Our nurse established a medication routine that effectively managed Maria’s physical symptoms. Our social worker helped arrange transportation for Maria’s daughter, who was struggling to balance caregiving with work. Our spiritual counselor provided comfort through prayer and conversation aligned with Maria’s Catholic faith. Our volunteer visited weekly, giving Maria’s daughter much-needed respite.

As Maria’s condition changed, our team adapted quickly. When swallowing became difficult, our nurse adjusted her medication forms. When Maria expressed fear about the dying process, our social worker and spiritual counselor collaborated on interventions to ease her anxiety.

Throughout Maria’s journey, our interdisciplinary team worked together seamlessly, addressing each new challenge with coordinated expertise. This comprehensive approach allowed Maria to remain comfortable and at peace, while her daughter felt supported and prepared.

Why Choose Lavender Hospice’s Interdisciplinary Approach

In Phoenix and throughout Arizona, families have choices when it comes to hospice care. Here’s why our interdisciplinary approach at Lavender Hospice stands apart:

  • Truly personalized care that considers each person’s unique needs and preferences
  • Comprehensive support addressing physical, emotional, spiritual, and practical concerns
  • Expert coordination among team members, ensuring seamless care
  • Regular reassessment to adapt to changing needs
  • Genuine compassion from team members who are called to this important work

We believe that everyone deserves dignity, comfort, and personalized support during life’s final journey. Our interdisciplinary care planning approach helps us deliver on that promise every day.

Beginning Your Journey with Lavender Hospice

If you’re considering hospice care for yourself or a loved one, we invite you to learn more about our interdisciplinary approach. Our team is ready to answer your questions, address your concerns, and help you understand how our care can make a difference during this important time.

In Phoenix and the surrounding communities, Lavender Hospice is committed to providing exceptional end-of-life care through our comprehensive, team-based approach. We’re here to walk alongside you and your family, providing expert care, heartfelt support, and genuine compassion every step of the way.

How to Apply

To apply for Lavender Hospice care in Phoenix under Medicare, consult with your doctor about your health status and eligibility. The physician must certify a life expectancy of six months or less. Upon certification, contact Lavender Hospice to arrange for an assessment and discuss the specific services needed. Remember, opting for hospice means choosing comfort care over curative treatments.

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Hospice The Heart of Hospice Care: Understanding Our Interdisciplinary Care Plan Approach

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