Hospice and Palliative Care
WHAT IS HOSPICE
- Compassionate care and guidance during end-of-life period
- Medical oversight
- Treatment of symptoms
- Help with physical needs
- Medication management
- Emotional support
- Spiritual counseling
- Education about what to expect
- May occur in the home, facility, hospital or Hospice Houses located in different places in the region
- Benefit of Medicare Part A covering 100% of cost of all services related to terminal illness
- Hospice services
- Medical care
- Medications related to hospice diagnosis
- Medical equipment and supplies
- Also covered by Medicaid and most employer-provided healthcare plans
- Requires an order from a provider
WHEN TO CONSIDER HOSPICE
- Indication from a provider that life expectancy is less than 6 months
- Focus shifting from cure to comfort care
- Terminal illness associated with
- Multiple hospital stays in the past six months
- Decreased appetite
- Significant weight loss
- Sleeping more
- Feeling cold
- Worsening shortness of breath
HOSPICE TEAM MEMBERS
Physician/ Physician Assistant/Nurse Practitioner
- Conduct initial visit
- Work closely with hospice nurses and existing medical provider to coordinate patient care and symptom management
Care Team Manager
- Coordinate overall care
Nurse Case Manager
- Manage patient care and symptoms
- Educate regarding what to expect within a specific disease process
Nursing Assistant
- Hands-on care including feeding, bathing, and moving needs
Social Worker
- Guidance for practical and emotional issues
- Referrals to community resources
Volunteer
- Companionship
- Respite for caregiver
Chaplain
- Spiritual care if desired
- Support family in bereavement
Grief Counselor
- Grief and bereavement care
WHAT IS PALLIATIVE CARE
- Provided for someone living with a serious illness
- Quality of life emphasis
- Management of difficult symptoms
- Education regarding progression of illness
- Guidance for decisions about complex treatment options
- Care plan based on desired goals and preferences
- Close communication and support
- Advocate personal health choices with existing provider
- Assist with Advance Care Planning if needed (Living Wills, Powers of Attorney, etc)
- May occur in the home, hospital, facilities, and outpatient clinics
- Covered by Medicare Part B and most commercial insurance plans
- Requires an order from a provider
WHEN TO CONSIDER PALLIATIVE CARE
- Quality of life is suffering due to advanced illness
- Advanced cancer
- Chronic heart, kidney or liver disease that is life-limiting
- Advanced dementia
- Parkinson’s disease
- HIV/AIDS
- Congestive heart failure
- Chronic obstructive pulmonary disease (COPD)
- Catastrophic illness or injury
- Symptoms related to a serious illness
- Pain
- Nausea and vomiting
- Delirium, anxiety, agitation
- Breathing difficulty
- Chronic cough
- Insomnia
- Worsening condition despite best care by provider
- Frequent provider visits or hospitalizations over a few months
- Lack of knowledge about the future and available choices
PALLIATIVE CARE TEAM MEMBERS
Physician/Physician Assistant
- Medical team dedicated to supportive care for serious illness
- Specialized knowledge
- Compassionate care and guidance
Palliative Nurse Laison /Nurse Practitioner
- Conduct initial visits to obtain baseline information
- Personal understanding of illness and prognosis
- Spiritual and cultural beliefs
- Coping strategies
- Physical assessment
- Coordinate care and symptom management with existing provider
