Hospice and End of Life Flashcards
The concept of a “good death” consists of what (3) things?
- free of discomfort
- in the presents of loved ones
- in the environment of their choosing
Palliative care compared to Hospice care: when can they be initiated?
Palliative care - any time following diagnosis
Hospice care - last 6 months of life (based on physicians best judgment)
Which type of care can be provided in conjunction with curative treatments, palliative care or hospice care?
- Palliative care (hospice care is only for patients when curative treatments are no longer appropriate)
Both palliative care and hospice care focus on pain/symptom control and caregiver support. Which is focused more on bereavement services?
Hospice care
Both palliative care and hospice care focus on pain/symptom control and caregiver support. Which is focused more communication and coordination of the interdisciplinary team?
Palliative care
Who is on the hospice team roster?
Nursing - adminiser meds (comfort)
Chaplin - spiritual support
Trained volunteers - caregiver respite, provide reassurance, light work/meal prep.
Social worker - communication of pt’s diagnosis to fam/friends, provide assistance for impact of illness employment, help with transportation, financial concerns
Case Manager - usually in hospital (like a social worker) helps discharge etc.
What is a physical therapist role in supporting a “good death?” (10)
- reduce pain
- optimize remaining function
- enhance QOL
- improve sleep quality
- decrease physiological/psychological stress
- improve respiratory function
- decrease need for pain meds
- maintain safety
- energy efficient mobility
- energy conservation
What are the (2) differences in a physical therapy assessment when patient is on hospice care?
- it’s called “rehab in reverse”
- need to know what the patient’s goal for PT is because PT is more consultant based unless for example the patient wants to walk Kaleb down the isle and needs to gain strength to do so.
Physical therapy interventions when working with a patient on hospice care should consist of?
- maintenance type interventions
- most likely the patient will lose function between PT visits
A person doesn’t have to enroll/sign up for hospice but if they do, what benefit is it for the persons family?
- hospice will prepare the family for signs/symptoms related to the death process
- they also will dispel inaccuracies, reduce fear, regrets and guilt if the family thinks they are not doing enough for their loved one.
What services are covered by Hospice (4)?
- durable medical equipment
- any other medical supplies
- PT, OT, and speed (if indicated)
- lab testing and the diagnostic studies related to the care of the terminal illness
What knowledge might be good to know about the dying process/dying patient if the family were to ask (5)?
- pt may sleep most of the time in days before death
- pt may no longer be interested in food
- assure family that digestion may be uncomfortable/painful
- dying pt do not need, nor can their bodies assimilate the energy provided by food.
- dying pt will not experience hunger or a sense of deprivation
What is terminal restlessness?
- form of delirium/agitation that occurs in the final days, weeks, or hours of life.
- very common up to 85%
- pt can demonstrate this by pulling on sheets, groaning, making random movements, attempt to remove medical devices.
Who covers hospice care and what part of the medical team provides the documentation and what is the patients role?
- Medicare Part A
- MD provides certificate of terminal condition with
The covered services from Hospice care must be available to the family on a __ _____ basis.
24 hour basis
