Oxygen in a home on hospice often arrives as a machine that hums in a corner, and for a while it seems to run itself. It does not. A concentrator, a tank, or both need someone who knows what they are, who supplies them, and who gets called when a number runs low. If nobody has been named for that job, it falls to whoever notices first, usually at the worst hour.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Find out who supplies it
Under the Medicare hospice benefit, equipment and supplies related to the terminal illness are generally furnished through the hospice as part of the plan of care. Ask the hospice which company supplies the equipment, what that company's phone line is, and whether it answers after hours. Write the supplier's name and number on the same card as the hospice's after-hours line. Ask whether deliveries happen on weekends and what happens if the driver arrives when no one is home.
Name the owner of each piece
Split the equipment into what you can see and what you cannot. A concentrator has a filter that needs cleaning on the schedule the supplier gives you, and it sits in a room where dust and pets gather. A portable tank has a gauge. Name one adult for each. The person who cleans the filter does not have to be the person who calls for refills, but the family should be able to say, without looking, who is responsible for each one.
Write the setting where it can be read
The flow setting on the machine is the number the prescriber ordered. Do not change it on your own. Write the ordered setting on a card taped to the equipment, and ask the hospice nurse to check the machine against the card at each visit. A hired or in-home non-medical caregiver can tell you whether the machine is running, whether the tubing is connected, and whether the room is clear, but adjusting the setting stays with the family and the hospice team.
Count the hours of supply
How long a tank lasts depends on the setting, the size of the cylinder, and how much it is used, so get the figure from the supplier rather than guessing. Ask how many hours a full cylinder lasts at the ordered setting, how the supplier knows when to deliver the next one, and how much reserve stays in the house. Keep the reserve on the same shelf as your outage supplies. Do not wait for the gauge to reach the bottom before calling. Write the call-in point, the level at which you phone the supplier, as a number on the card.
Keep the fire rule on the wall
Oxygen feeds fire. Put a sign on the door of the room that says no smoking and no open flame, and tell every visitor, including the delivery driver and any tradesman, before they reach the machine. Keep tubing off the floor where a candle or space heater can reach it. Do not store extra cylinders next to a heater or in a hot car.
Ask the supplier these before the next delivery
Ask who calls whom when a delivery is late. Ask whether a backup unit is available and how long it takes to arrive. Ask what happens to the equipment when hospice care ends, and how it is picked up. Ask who the family calls if the machine alarms and no one in the house can tell what the alarm means. Write the answers beside the card, and tell the hospice social worker where the card is kept.
Keep the card current
Once the owners are named and the card is written, the work is repetition. Check the gauge at the same time each day. Look at the filter when one caregiver hands over to the next. Test the call-in route at the start of each week by dialing the number and asking the question. A supply that depends on one person remembering is fragile, so name who keeps the card up to date and tell the hospice who that person is. The federal rules behind these points are listed on the Sources page.