Dr. Saul Ebema
Glad you asked. Many of you Hospice Chaplains and Hospice supervisors have been wondering what the acceptable caseload for a full-time Hospice Chaplain is. Instead of answering you all individually, to avoid a big caseload, here is the answer for all those who may be wondering the same thing.
Every hospice agency in the United States agrees that the spiritual needs of their patients and families are important and are all doing what they can to meet those needs. However, the process of going about meeting those spiritual needs differ from hospice to hospice.
Some hospice agencies expect their staff chaplains to visit all patients on the team unless chaplain services are specifically declined.
Secondly, some hospice agencies only arrange chaplain visitation at the specific request of the patient and family. Therefore, they rely on PRN (per required need) hospice chaplain services.
Other hospice agencies rely on the patient’s faith community to provide primary spiritual care with support and guidance from their staff hospice chaplain.
Furthermore, the hospice chaplain’s caseload can also be impacted by the hospice agency’s requirement for their staff chaplain to be routinely involved in providing or participating in funeral and memorial services for their patients who have died.
Last but not least, the hospice chaplain’s caseload can also be impacted by the hospice agency’s requirement for their staff chaplain to be involved in hospice presentations, community education on end of life care and other office administrative duties.
All the above unique characteristics heavily influence the Hospice Chaplain’s work, caseload and perceived productivity.
Now that we have established the fact that the hospice chaplain’s caseload is heavily influenced by the above factors, here is what the Hospice Chaplaincy Board recommends as a standard caseload that sustains quality productivity.
In this recommendation, we assume the following:
- The hospice chaplain is expected to visit all patients apart from those who decline chaplain services.
- The hospice chaplain is expected to be available as needed to provide funeral and memorial services
- The hospice chaplain is expected to be available as needed for death visits
- The hospice chaplain will have some on call responsibilities
- The hospice chaplain is not the only spiritual care provider for the patients but will also coordinate care with the patient’s faith community and clergy. Thereby making him/her available for where they are needed most when spiritual needs arise.
- The hospice chaplain is not required to do a lot of administrative work to free him/her to be on the field.
- The hospice chaplain is not required to attend every funeral or memorial service but only attending those invited to attend by the families.
Based on the above assumptions, we recommend:
For a hospice agency with a census of under 50 patients. The fulltime chaplain can handle the caseload of 40 patients without affecting their productivity. Some of these patients will only need once a month visits, others will hold off on visits until their health worsens etc.
For a hospice agency with a census of 50-80 patients. The fulltime Chaplain can handle the caseload of 50 patients without affecting their productivity. But the agency should begin thinking about hiring a part-time or a cost per call chaplain to support the fulltime chaplain.
For established hospice agencies with a caseload of over 100 patients. The full-time Chaplain can handle a caseload of 60 patients. But begin to form a good spiritual care department by hiring more part-time and cost per call chaplains. Remember this, proper end of life care does not need overburdened staff but requires a well supported staff.
“Proper end of life care does not need overburdened staff but requires a well supported staff.” Saul Ebema
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