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