Caregiver Skills Toolkit: Practical Tips for Hospice at Home in Orange County

Summary: Caring for a loved one at home in hospice can feel overwhelming. This toolkit gives you clear steps to keep your loved one comfortable and safe, with simple checklists you can start using today. The guidance reflects how hospice works in Orange County, Los Angeles County, the Inland Empire, and nearby areas. If something does not feel right, you can call your hospice nurse at any time, day or night.

1. Create a Calm, Safe Space. The goal is a home that supports rest, comfort, and privacy.
   • Clear pathways. Remove small rugs. Coil cords. Keep pet beds out of walking routes.
   • Improve lighting near the bed and bathroom. Add nightlights in hallways.
   • Set up a bedside care station. Include gloves, wipes, washcloths, lip balm, lotion, tissues, and a lined trash bin.
   • Post the call list on the fridge and save it in your phone. Include the hospice 24/7 number, the primary caregiver, and a backup contact.
   • Keep frequently used items within reach. Water, medications in original containers, and the comfort kit stored safely.
2. Safe Moves and Positioning. Gentle, safe movement protects skin, lungs, and comfort.
   • Body mechanics. Keep feet shoulder-width apart. Bend your knees. Keep the person close to your body. Pivot your feet. Do not twist your back.
   • Repositioning. Turn at least every two hours unless your nurse suggests otherwise. Use pillows to float heels and pad bony areas.
   • Transfers. If your loved one cannot bear weight, do not lift alone. Call for help or use the equipment your nurse recommends.
   • Cough and lung health. Raise the head of the bed. Encourage slow breaths. Use any breathing device your nurse provides.
     
     Tip: If movement causes sudden pain, shortness of breath, or dizziness, stop and call the hospice nurse.
3. Comfort Kit Basics and Medication Tracking. Many families receive a small set of medications called a comfort kit. Your nurse will teach you how and when to use each item.
   • Keep medications in original, labeled containers. Store them safely away from children and pets.
   • Use a simple log for each dose. Record date, time, medication, amount, and the symptom you were treating.
   • If you are unsure about a dose or timing, call the nurse before giving it.
   • Ask how to dispose of unused medications when they are no longer needed.
     
     Important: Do not crush, split, or mix medications unless your nurse or pharmacist says it is safe.
4. Skin, Mouth, and Personal Comfort Care. Small, consistent steps prevent skin breakdown and ease discomfort.
   • Skin. Keep skin clean and dry. Pat rather than rub. Use barrier cream on moist areas. Smooth out wrinkles in sheets.
   • Mouth. Offer sips of water if allowed. Use soft sponge swabs. Moisturize lips and mouth to reduce dryness.
   • Bathing. Give gentle bed baths with warm water and mild soap. Wash and dry skin folds well.
   • Nails and hair. Trim sharp nails. Brush hair gently to reduce tangles and pressure points.
5. Food, Fluids, and Swallowing. Appetite often changes near the end of life. The goal is comfort, not a target amount.
   • Offer small sips or ice chips if swallowing is safe.
   • Try soft, favorite foods in small amounts, such as yogurt or applesauce.
   • Keep the head and shoulders raised during and after eating or drinking.
   • Stop and call the nurse if coughing, choking, or pocketing food appears.
     
     It is normal to worry when intake falls. This can be part of the natural process. Focus on comfort and mouth care.
6. Communication That Soothes. Your presence matters. Calm, simple communication helps your loved one feel safe.
   • Speak in a quiet voice. Use one short sentence at a time.
   • Maintain eye contact. Sit at eye level. Allow extra time for a reply.
   • Use gentle touch if it is comforting, such as holding a hand or brushing hair.
   • Reduce background noise. Limit the number of visitors at one time.
7. Dementia-Friendly Approaches. If your loved one has memory loss, structure and simplicity help.
   • Keep a steady daily rhythm for bathing, meals, and rest.
   • Give one-step directions and show the task as you say it.
   • Use labels or pictures on doors and drawers.
   • Offer two simple choices, such as blue shirt or green shirt.
   • Avoid arguing. If agitation rises, switch to a calming activity or music.
8. Paperwork and Preferences Ready. A few documents help the care team honor your loved one’s wishes.
   • Advance Directive. Names a decision-maker and shares general preferences.
   • POLST. A medical order used for people with serious illness. Keep a copy where emergency responders can see it.
   • DNR, if chosen. Ask the nurse how it is documented in your setting.
   • Where to keep forms. A folder near the bed. A copy on the fridge. A photo on your phone. Tell the family where originals are stored.
     
     If you are not sure which forms are right for your situation, your social worker or nurse can guide you.
9. The Five-Minute Daily Log. A short, consistent log helps your team spot patterns and adjust the plan quickly.
   
   Use four rows each day:
   • Comfort level and pain score, for example 0 to 10
   • Medications given and any effect, helpful or not
   • Food and fluid intake, and bowel movements or changes in urination
   • Questions or changes you want to discuss with the nurse
     
     Keep the log on a clipboard by the bed. Take a photo before each nurse visit.
10. A Calm Visit Routine for the Care Team. You can help visits go smoothly.
    • Have the medication list, daily log, and any new forms ready.
    • Share what changed since the last visit. Start with the biggest concern.
    • Ask to be shown any skill you want to practice, such as turning, mouth care, or using equipment.
    • Write down the plan for the next 24 hours.

When To Call Hospice

Call the hospice nurse immediately if you notice any of the following. If you are worried, call even if the symptom is not on this list.

• Pain that is not improving
• Trouble breathing or new noisy breathing
• New agitation, restlessness, or sudden confusion
• Repeated vomiting or signs of choking during meals
• No urine for 12 hours or new foul-smelling urine
• A fall, new wound, or skin that looks red or purple over bony areas
• Fever higher than your nurse expects, or shaking chills
• A medication error or a missed dose that worries you
  
  You can call any time, day or night. You never need to wait for the next scheduled visit.

Local Help for Caregivers in Orange County and Nearby Areas

Maxcare supports families across Orange County, Los Angeles County, the Inland Empire, and nearby communities.

• Respite options. Short breaks that help caregivers rest and recover.
• Spiritual and emotional support. Chaplains and social workers who listen, guide, and connect you with community resources.
• Wound care and symptom management. Nurses who teach, support, and adjust the plan as needs change.
• IHSS application support. Guidance on how In-Home Supportive Services can work alongside hospice for practical daily help.

Quick-Grab Checklists

Bedside Supply Checklist

• Disposable gloves, wipes, washcloths, lotion, barrier cream
• Mouth swabs, lip balm, toothbrush, toothpaste
• Tissues, paper towels, gentle soap, hand sanitizer
• Extra fitted sheet, draw sheet, absorbent pads
• Thermometer, pill crusher only if approved, medication cup and oral syringe
• Flashlight or night-light, clipboard with daily log

Two-Hour Reposition Schedule

• 8 a.m. back, head elevated
• 10 a.m. left side with pillows
• 12 p.m. right side with pillows
• 2 p.m. back, heels floated
• Repeat through the day and adjust for comfort or naps

Five-Minute Daily Log Template

• Pain or comfort score, 0 to 10
• Medications given, time, effect
• Intake, output, bowel movement
• Notes and questions for nurse

Need Hands-On Help Today?

You are not alone. If you need hospice in Orange County or Westminster, CA, our team can guide you step by step at home. We can coach you on safe transfers, comfort kit use, calm communication, and home setup, and we can help coordinate respite and IHSS support so you feel confident caring for your loved one. Call (714) 844-7777. We support families across Orange County, Los Angeles County, and the Inland Empire.