Hospice Care Support

Part of the Anaya Care Handbook — the source of truth for how the product must behave. When the product needs to change, change this document first, then make the system match it.

Implementation status — this module is specified but not yet built. Every rule below is 🚧 Spec only until the feature ships and this page is audited against the code. Legend: ✅ In code · ⚠️ Partial · 🚧 Spec only (not yet built).

What this covers

This page governs hospice care support: a subscriber-configured capability that an agency turns on only when it offers hospice services. It is not a standard feature — agencies that do not provide hospice care never see it. When enabled, it shifts the care experience toward comfort and end-of-life support: comfort-focused care-plan templates, family communication tuned for the end of life, coordination with outside hospice and palliative-care teams, documentation of symptom and comfort management, and bereavement resources for the family once a client passes.

Hospice support builds on existing parts of the platform rather than replacing them. Care plans and care provider tasks still work the way they do everywhere else — see Care Plans & Care Provider Tasks; outreach to outside hospice and palliative-care teams runs through Care Coordination & Provider Integration; and worsening symptoms still flow through Change of Conditions.

Key terms

• Hospice care support — A subscriber-configured mode an agency enables only when it offers hospice services, shifting care toward comfort and end-of-life support.
• Subscriber-configured — A capability each agency switches on and sets up for itself; off by default and never shown to agencies that do not offer hospice care.
• Comfort-focused care plan — A care plan built from a comfort-care template whose goals are comfort, dignity, and symptom relief rather than recovery or rehabilitation.
• Comfort-care template — A starting template for a hospice care plan, with tasks and goals oriented to comfort and end-of-life support.
• Symptom and comfort documentation — The record care providers keep of a client's symptoms and the comfort measures given, captured during shifts.
• Hospice / palliative-care team — The outside hospice or palliative-care provider whom the responsible party has authorized; coordinated with through Care Coordination.
• Family communication mode — Family-facing messaging and updates tuned for end-of-life, gentler in tone and pacing than standard updates.
• Bereavement resources — Supportive materials and information made available to the client's family after the client passes.

How it works

Enabling hospice support

Hospice support stays off until an agency turns it on. Because it is subscriber-configured, an agency that does not offer hospice services never sees the feature, and enabling it is a deliberate setup step rather than a default. Once enabled, the agency can apply hospice support to individual clients who are receiving hospice care; clients who are not on hospice keep the standard care experience.

Where hospice fits in the lifecycle

Hospice is a branch of the care lifecycle, not a separate world. A hospice client still has a care plan, a Care Task List, and change-of-condition reporting — the same machinery as everyone else — only re-oriented toward comfort. The branch ends not at steady-state care but in bereavement support after the client passes, and then a Closed record.

Comfort-focused care plans

For a client on hospice, the care plan is built from a comfort-care template whose goals center on comfort, dignity, and symptom relief rather than recovery. The plan still behaves like any other care plan — tasks are assigned to care providers, scheduled, and documented during shifts — so the mechanics described in Care Plans & Care Provider Tasks carry over unchanged. What differs is the orientation of the goals and tasks toward end-of-life comfort.

Symptom and comfort management documentation

During shifts, care providers document the client's symptoms and the comfort measures they provide. When symptoms worsen or the client's condition shifts in a way that needs attention, that is recorded through Change of Conditions the same way it is elsewhere on the platform, so the care team and authorized providers stay informed.

Coordinating with hospice and palliative-care teams

Coordination with the outside hospice or palliative-care team runs through Care Coordination & Provider Integration. The agency may share relevant information with, and exchange messages with, an authorized hospice or palliative-care provider — but only after the responsible party has authorized that provider. The agency never reaches out to an outside team on its own; the provider-contact authorization boundary on the Care Coordination page applies here without exception.

Family communication and bereavement

While a client is on hospice, family-facing communication is tuned for the end of life — gentler in tone and pacing than standard updates. After a client passes, the agency makes bereavement resources available to the client's family to support them through their loss.

Rules

1. HOSP-1 — Hospice care support is subscriber-configured: it is off by default, must be explicitly enabled by the agency, and is never shown to agencies that do not offer hospice services. (🚧 Spec only)
2. HOSP-2 — Hospice support is not a standard feature; only an agency that offers hospice services may enable it, and it applies only to clients receiving hospice care. (🚧 Spec only)
3. HOSP-3 — When hospice support is enabled for a client, the care plan must be buildable from a comfort-focused care-plan template oriented to comfort, dignity, and symptom relief rather than recovery. (🚧 Spec only)
4. HOSP-4 — A comfort-focused care plan must otherwise behave like any other care plan — tasks assigned, scheduled, and documented during shifts — as defined in Care Plans & Care Provider Tasks. (🚧 Spec only)
5. HOSP-5 — Care providers must be able to document the client's symptoms and the comfort measures given during shifts. (🚧 Spec only)
6. HOSP-6 — Worsening symptoms or condition changes for a hospice client must be recorded through Change of Conditions, the same path used elsewhere on the platform. (🚧 Spec only)
7. HOSP-7 — Coordination with an outside hospice or palliative-care team must run through Care Coordination & Provider Integration. (🚧 Spec only)
8. HOSP-8 — The agency must never contact an outside hospice or palliative-care team on its own; contact and information sharing are permitted only after the responsible party has authorized that provider, per the provider-contact authorization boundary. (🚧 Spec only)
9. HOSP-9 — Family-facing communication for a hospice client must be tuned for the end of life — gentler in tone and pacing than standard updates. (🚧 Spec only)
10. HOSP-10 — After a client on hospice passes, the agency must make bereavement resources available to the client's family. (🚧 Spec only)
11. HOSP-11 — A change of condition for a hospice client follows the same significance contract as everyone else (COC-8 → RAC-4), but an agency may configure the comfort-care pathway so that worsening symptoms trigger a comfort-care-plan review oriented to comfort and symptom relief rather than a recovery-oriented reassessment. The link from a significant change to a review is not optional; only its orientation differs for hospice clients. (🚧 Spec only)

Who can do what

Decisions needed

• What goes into the comfort-care template (HOSP-3)? The source names a comfort-focused template but does not define its tasks or goals. Options: a fixed platform template; an agency-configurable template; an AI-suggested template drawn from the client's condition.
• How is a client marked as "on hospice" (HOSP-2)? Options: a dedicated client status; a flag on the care plan; a property of the comfort-care template applied to the client. This needs to line up with the client lifecycle on Clients.
• What exactly are the bereavement resources, and who curates them (HOSP-10)? Options: a fixed platform library; agency-supplied materials; links to outside bereavement services. Decide who is responsible for keeping them current.
• How long after a client passes do bereavement resources and family access remain available (HOSP-10)? Options: a fixed grace window; indefinitely; agency-configurable. This interacts with data retention — see Data Ownership & Retention.
• What does "family communication tuned for end-of-life" change in practice (HOSP-9)? Options: tone and templated wording only; reduced notification frequency; a curated set of update types. Decide whether this is a content change, a delivery change, or both.
• Does symptom and comfort documentation need its own structured form, or does it reuse existing shift documentation (HOSP-5)? Options: reuse standard task and shift notes; add hospice-specific structured fields; let the agency configure the fields.