The hospice nurse says oxygen equipment will be delivered. Soon, a medical equipment company calls to arrange a time.
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This can sound like a simple delivery. It is a service handoff. The hospice orders the equipment, a supplier brings it into the house, someone teaches you how to use it, and the equipment remains there until the order changes or hospice care ends.
You do not need to decide whether oxygen is needed or how it should be set. Those are clinical decisions for the hospice. Your job is quieter and more practical: follow the equipment from the order to the final pickup, and do not let an unanswered question leave with the driver.
Begin with the hospice order
Ask the hospice nurse to tell you exactly what was ordered. Write down the equipment, supplies and settings as the nurse gives them to you. Do not rely on a message that says only that oxygen is coming.
Ask these questions before delivery:
What equipment should arrive? Will there be a concentrator, portable tanks or another backup source? What tubing and other supplies are included? Where does the hospice want the equipment used? Who is allowed to change a setting? What number should you call if the delivery does not match the order?
Under the federal hospice rule, medical appliances and supplies related to palliation or management of the terminal illness belong in the written plan of care. Medicare also says equipment used at home under the hospice benefit is provided by the hospice. The company at your door may be a contractor, but the hospice has not handed away its responsibility for the service.
Make a place before the van arrives
Ask the supplier what space and electrical access the equipment requires. Clear a route from the outside door to that place. The route needs to work for the actual equipment, not merely for a person carrying a small box.
Tell the dispatcher about steps, a steep driveway, a locked building entrance, a narrow doorway or a room far from the entrance. If the house has an animal that must be secured, settle that before the driver arrives.
Do not choose a final location by guesswork. Ask the installer to confirm where the equipment can stand, what must remain clear around it, and what fire precautions apply in this house. If anyone smokes or uses an open flame in or near the home, say so plainly before installation. Let the supplier and hospice give the safety instructions that fit the equipment.
Check the delivery before installation starts
When the driver arrives, compare the delivery with your written list. Read the label on each piece. Ask what each item is called and what job it performs.
If the order and the delivery do not match, stop and call the hospice. Do not negotiate a substitute setting or piece of equipment yourself. The supplier may need confirmation from the hospice before changing what was sent.
Ask whether every item belongs to the supplier and must be returned. Keep any delivery record, equipment list or serial number sheet in one place. A photograph of the labels can help you identify the equipment during a later phone call, but it does not replace the supplier's paperwork.
Stay for the full setup
The federal hospice conditions require the hospice to ensure that the patient, family or caregiver receives instruction in safe use of durable medical equipment. The hospice may have the supplier provide that instruction. The rule also expects the caregiver to be able to demonstrate appropriate use.
That means the service call should not end with a machine placed near the wall.
Ask the installer to connect the equipment and show you the normal start-up. Ask what lights, sounds or display you should expect during ordinary operation. Then ask what an alarm sounds like and what the written instructions say to do.
Have the installer show you how the tubing connects, where extra supplies are kept and how to avoid pulling or pinching the line. If a backup source was delivered, ask the installer to show you how it is placed into service. Do not wait for a power loss or equipment problem to meet the backup for the first time.
Now repeat the steps yourself while the installer watches. If your hands cannot manage a connector or control, say so. If another person will cover the night, that person also needs a demonstration. A signature on a delivery screen does not teach the next caregiver what to do.
Put both call paths beside the equipment
You may receive a supplier number and a hospice number. Ask which one you call first for each kind of problem.
Write down who handles a late delivery, missing supplies, an alarm, damaged tubing, a power interruption, an empty portable tank and a machine that does not appear to be operating. Ask whether the supplier answers directly after hours or returns calls through a dispatch service.
For any question about the person's condition, the order or the prescribed setting, call the hospice. Do not change a setting because a relative, visitor or internet page suggests it. If the machine is not working as you were taught, use the call path the hospice and supplier gave you.
Place the numbers where a tired person can find them. Include the hospice name, supplier name, equipment name and any identifying number the supplier asks callers to provide. The permitted contacts on this site are collected at Local Help for Hospice Families, but your first working list should be the one supplied for this particular equipment.
Close the service call before the driver leaves
Before signing, ask the driver to wait while you check five things: the ordered equipment is present, the equipment is operating, the backup is present if one was ordered, written instructions and phone numbers are in the house, and at least one caregiver can demonstrate the steps taught.
Also ask how replacement supplies arrive. Find out whether they are delivered automatically or only after someone calls. Ask how much notice the supplier requests. You are not asking how much oxygen the person should use. You are finding out how the supply service works.
If the driver cannot answer a clinical or order question, call the hospice while the driver is still there. If the installation cannot be completed, ask both parties to state the next step and who owns it.
Know how changes are made
A later change should begin with the hospice, not with an informal request to the delivery company. Ask the hospice to explain what is changing in the plan and what the supplier will add, exchange or remove.
When new equipment arrives, repeat the same check. Match it to the new order, receive a demonstration, test the after-hours call path and update the paper beside the equipment.
If the supplier removes one item, confirm that it is the item the hospice intended to discontinue. Keep the pickup record with the delivery record.
Plan for the final pickup
Oxygen equipment supplied through hospice does not become household property. When hospice care ends, the supplier will usually need to retrieve it. That may follow a discharge, transfer, revocation or death.
Ask early who will request pickup and who will call the family. Ask what should remain untouched until the supplier arrives. Do not dismantle, discard or give away equipment or tanks.
At pickup, compare what leaves with the original equipment list. Ask for a receipt showing what was collected. If an item remains in the house, write down its identifying information and call the hospice or supplier before assuming the service is closed.
The short record to keep
One sheet can carry this service from beginning to end. Record the hospice order in plain language, the supplier's name, the equipment delivered, the installation instructions, both after-hours numbers, the supply replacement process and the pickup record.
This is not busywork. It gives the person awake in the house a place to begin when a light comes on, a delivery is incomplete or someone says the equipment should be removed.
The governing sources include Medicare's hospice benefit materials, the federal hospice regulations on covered equipment and caregiver instruction, and Missouri Department of Health and Senior Services hospice oversight materials. They are collected on the site's Sources page. For the larger division between scheduled hospice visits and the care that remains with the household, read The Hours Between Hospice Visits.