Contact is made with the patient and family as soon as possible. There should be no delay because the family caregiver is often in urgent need of advice and support.
An appointment is made to visit the patient's house. The first visit is usually made by a nurse who will spend up to two hours with the patient and family. She will listen sensitively and attentively to all their concerns and will examine the patient. She will check the layout of the patient's bedroom and bathroom to ensure that the patient is comfortable and has access to the toilet. She will then discuss the current problems and possible solutions to these problems with the patient and the family.
The nurse will leave detailed written instructions about such matters as medications, dressings, nutrition, skin and mouth care. She may suggest equipment which could be purchased or hired. She will explain the emergency call system.
The nurse will tell the patient and family when she will contact them again. Usually this will be by a phone call the next day when she will check that the family caregiver has understood her instructions and whether the patient is feeling a little better after her intervention. If symptoms are not controlled, she will arrange for the hospice doctor to visit as soon as possible. If there are social or financial problems, the hospice social worker may be asked to visit.
