Info Sheets/Pocket Resources
Care of the Hospitalized Aging Medical Patient (CHAMP) Pocket Teaching Cards
Hospice services
***varies by location/ hospice agency
- Can be offered at home/inpatient (for symptoms/ transitional time, usually not permanent) or Nursing home (this also depends on insurance, you need long term care insurance or Medicaid to have hospice at nursing home)
- Hospice services when they’re needed to care for your terminal illness and related condition(s): Γûá Doctor visits Γûá Nursing care Γûá Medical equipment (such as wheelchairs or walkers) Γûá Medical supplies (such as bandages and catheters) Γûá Drugs for symptom control or pain relief (may need to pay a small copayment) Γûá Hospice aide and homemaker services Γûá Physical and occupational therapy usually for functional ADLS/ not rehab Γûá Speech-language pathology services for swallow evaluation/ coaching for appropriate food choices Γûá Social worker services/ chaplain support Γûá Grief and loss counseling for pt and their family Γûá Short-term inpatient care (for pain and symptom management) Γûá Short-term respite care (may need to pay a small copayment) Γûá Any other Medicare-covered services needed to manage your pain and other symptoms related to your terminal illness, as recommended by your hospice doctor
- MEDICARE HOSPICE BENEFIT/ and most HOSPICE BENEFIT PROGRAMS DO NOT COVER THE FOLLOWING: Prescription drugs to cure your illness, care from multiple specialist, room and board at a nursing home/ unless for respite stay, care in an emergency room, ambulance transportation unless arranged by the hospice team and related to hospice diagnosis.
- Open access programs: certain programs (Vitas/Seasons) are able to pay for more complex services such as inotropes for CHF patients, short courses of IV antibiotics, radiation treatments, TPN lite (basically a banana bag and LR)
- Visits by RNs depending on patient need/acuity, nurses’ aides 2-3 times a week
Palliative Care
***Not a universal service, many areas do not have outpatient palliative care programs, In Chicago- Seasons and Horizon. Most academic hospitals have inpatient palliative care services
- Infrequent services (1-2 times a month)
- Usually done by Advanced Practice Nurses/ MDs
- For symptom management/ continued decision making guidance
- Meant for patients who are still pursuing treatments, able to get back/forth for appointments, not requiring significant support services
- You can have home health and palliative care services in conjunction
Home health
***Various levels of home health care/ there are high tech companies that provide for PCA’s, TPN, extensive wound care services
Most home care plans cover intermittent skilled nursing care, PT/OT, speech therapy, wound care, medication management (setting up pill boxes), G-tube teaching, Pleurx/drainage tube teaching, ostomy care. There is a case manager who coordinates services that the MD/APP orders.