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Hospice and Home Health Acupuncture
Online Continuing Education Trainings for Acupuncturists
6 NCCAOM PDAs including Safety and Ethics
Gain clarity and confidence for working with patients at the end of life and home visits. Whether you work in hospice or simply want to have tools to provide comfort care for loved ones, patients, and their families.
In the Hospice and Home Health Acupuncture training you will learn:
- Practical skills for safely treating medically fragile patients, which may require a different approach than treating patients in a clinical setting.
- Strategies to connect compassionately with patients at the end of life.
- Ways to navigate home healthcare, including travel, general safety, and interactions with family and other caregivers.
- About the role of acupuncture in hospice care, both as a unique medical service and integrating within the hospice system and hospice team.
- About the stages of dying from the Eastern and Western perspective.
Hospice work is a calling. To care for people with a terminal diagnosis and less than six months to live requires a different approach to medicine and healing. Whether we are a nurse, doctor, social worker or acupuncturist, we want to help the patient feel comfortable, whole, and human.
I worked for several years as an acupuncturist in hospice. I visited patients in their homes or care facilities, using acupuncture and gentle touch to help with symptom management. I collaborated with hospice administration to craft policies and procedures, and worked to educate the medical and care team about acupuncture services. Most of this post is based on my personal experience, with the goal of helping other acupuncturists connect with this kind of work.
Every Hospice is Different
Every hospice organization is different. In size, location, philosophy, direction, management, funding, culture, etc.
A hospice may be small and local, part of a large hospital system, or a nationwide company. The hospice may provide extensive training and support for providers, or hardly any.
Some hospices have acupuncturists attend the weekly Interdisciplinary Group (IDG) meetings, and others do not. Pay rate can vary quite a bit. Charting and data collection is different from place to place.
How Acupuncture is Funded in Hospice
Most hospice patients use Medicare* to cover hospice services. This allows patients to receive medical care including nursing, occupational therapy, medications and home medical supplies.
In the meantime, for a hospice to include acupuncture services it may be paid through alternative means such as a grant or special fund from donations. The existence of these grants and funds are due to dedicated efforts from medical directors, grant writers, private donors, and other advocates.
Volunteering
Volunteering is always a great way to gain experience, network, and serve the community.
While it is possible that volunteer positions can lead to, or turn into, paid positions, it is not a guarantee. I once had a mentor caution me against volunteering as an acupuncturist in hospice because it could perpetuate an unpaid track in the system. I have seen this to an extent with massage therapy in hospice and oncology, where there is an established track of massage volunteer positions and a lack of paid ones in some hospice organizations and hospitals. I don’t know if this is causation or correlation but it’s worth noting.
On the other hand, I have heard of at least one case of a volunteer acupuncturist being offered a full-time paid position in hospice. So it can happen if the administration is willing to set aside funding and prioritize acupuncture services.
In the Hospital Handbook Project, acupuncturist Megan Gale suggests volunteering in a hospital (can also apply to hospice) in a non-acupuncturist role. She said that it allows you to become familiar with hospital protocols and culture, while meeting people and helping out, but not giving away your acupuncture services for free on a regular basis.
In either case, it is important to be advocating for reimbursement for our expertise, training, and services, just like any other healthcare provider.
Private Practice
It is possible to have a private practice working with hospice patients. Here are some tips for hospice private practice:
- Most hospice patients are in their homes or care facilities, you will be going to them rather than them coming to your clinic.
- Keep in mind that these patients will have to pay out of pocket since Medicare does not cover acupuncture.*
- It may be possible to bill a patient’s private insurance, but find out if it covers home visits.
- If there is no insurance coverage, find a price point you feel comfortable with, that will be accessible to patients and also cover your costs.
- Reach out to cardiologists, oncologists, pulmonologists, and dialysis clinics with information about how acupuncture can help terminally ill patients with symptom management. You can also connect with retirement homes and senior centers and offer services there.
- Look up “home health bag technique” and tips for home health nursing online so that you can maintain clean technique in the home environment.
A Job in Hospice, Gaining Experience
I worked with two different hospice organizations as a contracter. Even though these positions are not full-time employment, I gained valuable experience in this field including working with patients directly, navigating different hospice organizations, and learning how to advocate and promote acupuncture as a service.
If you can take a contract position, shadow with another acupuncturist, see patients in private practice, or volunteer, it can open doors such as:
- Meeting other providers in hospice who can become part of your professional network as mentors, colleagues, and references.
- Building a good reputation in your community as the “hospice acupuncturist” and gaining multiple referral sources.
- If you are contracting with a hospice organization, advocating for a raise in your contract rate, or for full-time employment.
- If you are volunteering, advocating for a paid position.
- Having relevant experience on your resume that can lead to employment at another hospice or hospital.
- Working in a challenging and rewarding field that opens up opportunities you may not yet know of.
My advice is to take advantages of opportunities to treat patients and learn about the hospice field. At the same time advocating to turn contract, part-time, or underpaid work into full-time, well-paid positions.
Some Things I’ve Done to Work in Hospice
Here is some of what I’ve done over the years to be involved in hospice:
- Volunteered in hospice providing massage therapy for the nursing staff and patients.
- Worked in hospice as a nurse assistant.
- Researched acupuncture in hospice and palliative care while in the masters program at acupuncture school.
- Asked around constantly if anyone knew anyone who did acupuncture in hospice, and eventually connected with an acupuncturist working in hospice who became my mentor.
- Joined the Washington State Hospice and Palliative Care Organization (WSHPCO).
- Cold-called and cold-emailed every hospice I could find in the area, asking if they had acupuncture positions or were interested in learning about the benefits of acupuncture.
- Connected with the Hospital Handbook Project.
- Connected with the medical director of a hospice and palliative care organization who was interested in starting an acupuncture pilot program. I helped create policies and procedures for acupuncture, educate the healthcare team about acupuncture, bring another acupuncturist on the team, and find ways to gather outcome data. After 6 months the pilot program was considered successful and the medical director has asked all departments to refer patients to acupuncture.
- Connected with a local hospice that already had a grant-funded program in place for integrative therapies, but no acupuncturist. They just needed an acupuncturist to help create policies and procedures for acupuncture, particularly for home visits. I work with some excellent people and have learned a lot about hospice.
- Wrote an article for Acupuncture Today interviewing the founder and director of the NAHPCA. This was a chance to spread the word about this organization and also learn more from someone who has worked in this field for many years.
- Shadowed with an acupuncturist who has a full time job in hospice to learn more about what she does.
- Presented about acupuncture in hospice for the WSHPCO, and the Washington Acupuncture and Eastern Medicine Association.
If you feel called to do this work, then start to network, reach out to people and organizations that you think could benefit from acupuncture services. Write grants to start a pilot program. Talk to practitioners that work in the hospice field and ask if they know of any opportunities for mentorship, shadowing, or otherwise getting involved.
*As of 2020 acupuncture for low back pain is covered by Medicare. There is momentum toward advocating for acupuncturists to be Medicare providers, but how all of this will play out in general, or in hospice in particular, remains to be seen. More information on Medicare and acupuncture here.