Project Description

General Inpatient Care

Some patients may have symptoms so severe that they cannot get adequate treatment at home or they may feel more comfortable getting treatment at an inpatient facility. For these patients, inpatient care may be an option. Some patients may already be living in a facility that offers inpatient level of care and can benefit from its services. Others would have to be admitted to an inpatient facility.

Symptoms requiring inpatient care are the same as those requiring continuous care (above), only the setting of care may be different. With inpatient care, nurses are available around the clock to administer medications, treatments, and emotional support to make the patient more comfortable. The inpatient hospice services can be provided in a:

  • Hospital – A hospice company may lease a unit in the hospital to provide inpatient care. In this case, hospice trained staff would provide around the clock care. A company may also have a contract with a hospital which would allow hospital staff to provide 24 hour care with hospice staff supplementing care.

  • Long term care facility – As with a hospital, a hospice company may lease a unit in a nursing home or contract with the nursing home to provide care.

As with continuous care, inpatient care is considered short term and would be discontinued once a patient’s symptoms were under control and they were comfortable. If the patient was admitted to an inpatient unit, they may then be discharged back home.

At times, a hospice patient may require inpatient care when their symptoms worsen or can no longer be managed successfully at home. When pain or symptoms cannot be controlled with routine hospice home care, the patient will require extra assistance or more advanced medical attention until the symptoms subside.

Hospice of Grace takes diligent actions to control these symptoms to make the patient comfortable and safe. In order to accomplish this, the patient may need to be temporarily placed in a hospice home, hospital or acute care facility. At this “inpatient” level of care, a real-time assessment of the patient’s condition and their symptom status will be evaluated and a proper course of action will be taken in order to regain symptom control. The hospice care team and the patient’s physician(s) work together to ensure the patient achieves and maintains a tolerable level of comfort. Once pain and symptom management have been achieved, the patient can return home and resume routine hospice home care.

Typically, Inpatient Hospice Care is performed for a brief period of time that is necessary to manage acute symptoms in a clinical setting with a 24-hour nurse on staff. It may be required for certain procedures that require a higher level of nursing care to manage pain or symptoms.

Hospice of Grace has special arrangement with local hospitals and other accredited facilities where patients are able to receive the necessary care when their needs cannot be provided for at home.

What Symptoms May Require General Inpatient Care?

Some examples of symptoms that may require general inpatient care include unrelieved severe pain, severe nausea and vomiting, severe shortness of breath, anxiety or panic attacks. General Inpatient Care is a short-term level of care where nurses are available around the clock to administer medications, implement treatments, and provide emotional support to make the patient more comfortable.

Where is General Inpatient Care Provided

There are three types of facilities that may offer inpatient hospice services:

  • Hospice Home

  • Hospital

  • Long Term Care Facility

Since inpatient care is considered short term, once a patient’s symptoms were under control and they were comfortable, they would return home and back to a Routine Level of Care.


Hospice of Grace is a leading provider of hospice care in Southern California

Minas Kochumian, MD

Medical Director

Dr. Kochumian graduated from the University of California, Irvine School of Medicine in 1994. He works in Northridge, CA and specializes in Internal Medicine and Internal Medicine – Geriatrics.

Geriatrics is a field of medicine that deals with elderly people. The main focus of medical doctors in this field – geriatricians – is the overall health of elderly patients, and diagnosis and treatment of any illnesses they may encounter. Elderly-patient care often involves multiple health concerns at the same time, and patients may not respond to treatments in the same way as younger patients. Geriatricians are trained to deal with these unique situations. Social aspects involving elderly patients, such as home support, may also be evaluated by a geriatrician providing care.

Arpi Grace Kestenian

Chief Executive Officer

Arpine Grace Kestenian is the Chief Executive Officer of Hospice of Grace. She is a leader in the health care industry with over twenty years of quality management experience. She is known for her managed care dealings on behalf of a multitude of medical groups, physicians and hospitals. She is widely respected in the community as a reliable and knowledgeable source with regard to all aspects of healthcare. She provides community education through the media and is revered as an extraordinary resource for navigation through our complicated health care systems. She has served on multiple community and executive boards, including but not limited to: Glendale Youth Alliance, Chamber of Commerce, and branches of the American Medical Society. She volunteers for community foundations and is a leader at procuring funds for the Bone Marrow Donor Registry for those in need worldwide. She has been very successful at individual causes brought to her attention through the “Gift of Life Foundation” dedicated to support for children with life threatening illnesses.

Edward Kocharian, MD

Associate Medical Director

Edward Kocharian, MD, is the Medical Director for Hospice of Grace. He is board certified in Internal Medicine. He completed his residency at Cleveland Clinic Health Systems following medical school. Dr. Kocharian’s clinical area of expertise includes but is not limited to palliative and hospice care. Through his practice he services primarily the geriatric population. He is fluent in English, Armenian and Russian. He is committed to compassionate care and symptom management as well as quality of life. He is respected and revered in the community as a quality physician who takes the needed time to listen to his patients’ needs and to respond with solutions and interventions that make better days for his clients. He is a source of knowledge and support for the Hospice of Grace caregivers and team as well as the individual patients and their families. He attends the Hospice of Grace interdisciplinary team meetings, offering advice and guidance in their quest to provide quality of life.

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