Info Sheets/Pocket Resources
Introduction to Palliative Care and Care of the Dying Patient Info Sheet (Piscitello 2017) – includes info UCMC specific resources, DNR forms, comfort care order set, patient support resources
***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): ■ Doctor visits ■ Nursing care ■ Medical equipment (such as wheelchairs or walkers) ■ Medical supplies (such as bandages and catheters) ■ Drugs for symptom control or pain relief (may need to pay a small copayment) ■ Hospice aide and homemaker services ■ Physical and occupational therapy usually for functional ADLS/ not rehab ■ Speech-language pathology services for swallow evaluation/ coaching for appropriate food choices ■ Social worker services/ chaplain support ■ Grief and loss counseling for pt and their family ■ Short-term inpatient care (for pain and symptom management) ■ Short-term respite care (may need to pay a small copayment) ■ 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
***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
***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), gtube teaching, pleurx/drainage tube teaching, ostomy care. There is a case manager who coordinates services that the MD/ mid-level provider orders.