Over the course of their fellowship, our fellows have the chance to work in home hospice, gaining experience for home and long-term care settings. The fellow will have opportunities to visit patients in their homes and at long-term care facilities over the year, with a concentrated frequency of visits during the home/long-term care visit rotations. The fellow will have opportunities to provide consultative care to improve symptom management in conjunction with the home hospice IDT and collaborating with the patient's primary community physician.

The fellow will be assisted by members of the IDT on most home and long-term care visits. As the fellow becomes more skilled at home visits, they will make visits with increasing independence. The home visit experience is one of the anchors to ensure patient care continuity across clinical sites.

The fellow will work with the home teams of Kansas City Hospice & Palliative Care during home visit/long-term care rotations. This Interdisciplinary team is comprised of a team manager, social workers, a chaplain, nurses (RN and LPN), care partners, and volunteers. Additional members of the IDT include music therapy, art therapy, child-teen specialists, bereavement counselors, and lymphedema specialists as needed for a given clinical situation. Many home visits are made concurrently with another member from the IDT allowing for good communication of the care plan and opportunity for teaching of the fellow from IDT members who have years of hospice experience.

The fellow will attend the long-term care hospice team's IDT meeting on Wednesday afternoons when they are on Kansas City Hospice & Palliative Care based rotations. The IDT will be comprised of a team manager, social workers, a chaplain, nurses (RN and LPN), and care partners. This experience affords the fellow a better chance to learn more about the administrative duties of a hospice medical director. The fellow will communicate with the patient's primary attending if a major change in medical orders is indicated. The fellow will also communicate with the long-term care facility staff, including the patient's primary physician and the director of nursing as necessary to ensure excellent clinical care.