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

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