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Part Three- Palliative Care and Hospice

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Pays staff salaries, overhead , durable medical supplies, medications ... Compounding Pharmacist. Volunteer Coordinator and Volunteers. Certified Nursing Aides ... – PowerPoint PPT presentation

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Title: Part Three- Palliative Care and Hospice


1
Part Three- Palliative Care and Hospice
  • Improving care at the end-of-life
  • Hospice
  • Palliative Care
  • Interdisciplinary teamwork
  • Types of palliative care programs

2
HOSPICE
  • Various meanings
  • A place
  • An organization or program
  • An approach to or philosophy of care
  • A system of reimbursement

3
Medicare Hospice Benefit
  • Certified organization (non-profit or for-profit)
  • Receives a capitated fee (approx. 100 daily per
    patient) to provide care to qualified
    patients,usually at home
  • Pays staff salaries, overhead , durable medical
    supplies, medications for admitting condition

4
Hospice Medicare Benefit
  • Patient must have 6 mo. prognosis if disease
    follows expected course some live longer- can
    recertify if still qualifies
  • Request to enter usually by MD patient or family
    can request admission
  • Hospice is a choice- can revoke anytime
  • Provide bereavement services for 13 mo. for
    family

5
Hospice
  • Referral visit- to explain program
  • Admit by RN- assessment , sign papers
  • Establish plan of care, scheduled visits
  • Visits by team members (within 72 hrs)
  • Re-assess q 2 wks at full team meeting
  • Re-certify in 90 days, then q 60 days if still
    qualifies

6
Hospice Medical Director
  • Administrative role certifies,re-certifies,attend
    s weekly team meetings, has little contact with
    patients( part-time)
  • Active in patient care, makes some home visits,
    manages pain and other symptoms
  • Teaches end-of-life care to healthcare
    professionals, students, and community

7
Palliative Care
  • What is it? Short answer care that aims to
    relieve suffering and improve quality of life.
  • WHO and Institute of Medicine definition It
    seeks to provide the total active care of
    patients whose disease is not responsive to
    curative treatment.
  • Control of pain, of other symptoms, and of
    psychological, social, and spiritual problems is
    paramount.

8
Palliative Care (contd)
  • Its goal is to achieve the best quality of life
    for patients and families.
  • It affirms life and regards dying as a normal
    process. It neither hastens nor prolongs death
  • Palliative Care can be applied to anyone
    undergoing active or aggressive Rx for cancer or
    other disease

9
Curative / remissive therapy
Presentation
Death
Hospice
Palliative care
10
(No Transcript)
11
The Team
  • The Nurses Director, Patient Care Coordinator,
    and Nurse Specialists
  • Social Workers
  • Chaplain and Bereavement Coordinator
  • Compounding Pharmacist
  • Volunteer Coordinator and Volunteers
  • Certified Nursing Aides
  • Medical Director

12
Levels of Palliative Care
  • Level 1 Personal Physician
  • Level 2a. Palliative Medicine Consultant
    office or hospital based, for pain and other
    symptom management
  • Level 2b. Hospice- Hospital partnership, with
    inpatient and outpatient components and with
    elements of the interdisciplinary team
  • Level 3 Tertiary academic and treatment
    centers

13
Cost-effectiveness of Hospital-based Palliative
Care
  • Recent evidence presented by the Center to
    Advance Palliative Care indicates
  • Reduction in symptom burden- less pain, dyspnea,
    etc.
  • Improved patient and family satisfaction
  • Reduction in ICU and hospital length of stay
  • More appropriate use of high-tech. therapy

14
Teaching Palliative Care
  • Survey 806 of 4000 hospitals have palliative
    care programs, including 26 of teaching
    hospitals. (CAPC,2003). Rapid growth in past
    year.
  • Approx. 1000 certified EPEC trainers
  • 1200 board-certified in Palliative Medicine
    Hospice

15
Summary- Part Three
  • Improving the quality of life for the dying is
    our responsibility
  • Suffering is treatable!
  • We CAN change the ways we care for those at the
    end-of-life
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