Hospice & Palliative Care Flashcards
What is the goal of palliative care
The goal of palliative care is to help patients with serious illnesses feel better. It prevents or treats symptoms and side effects of disease and treatment. Palliative care also treats emotional, social, practical, and spiritual problems that illnesses can bring up. When patients feel better in these areas, they have an improved quality of life.
When can a person have palliative care?
Palliative care can be given at the same time as treatments meant to cure or treat the disease. You may get palliative care when the illness is diagnosed, throughout treatment, during follow-up, and at the end of life.
Who is offered palliative care?
Palliative care may be offered for people with illnesses, such as:
- Cancer
- Heart disease
- Lung diseases
- Kidney failure
- Dementia
- HIV/AIDS
- ALS (amyotrophic lateral sclerosis)
You do not need to give up your doctor or your treatments to get palliative care.
Who can provide palliative care?
Any health care provider can give palliative care. But some providers specialize in it. Palliative care may be given by:
- A team of doctors
- Nurses
- Registered dietitians
- Social workers
- Psychologists
- Massage therapists
- Chaplains
Palliative care may be offered by hospitals, home care agencies, cancer centers, and long term care facilities. Your doctor or hospital can give you the names of palliative care specialists near you.
What is the difference between palliative care and hospice?
Both palliative care and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the patient is not going to survive the illness.
Hospice care is usually offered only when the person is expected to live 6 months or less.
What is palliative care?
A multidisciplinary approach to specialised medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, physical stress, and mental stress of a serious illness—whatever the diagnosis.
What types of treatment may be included in palliative care?
- Medicine
- Nutritional guidance
- Physical therapy
- Occupational therapy
- Integrative therapies
What are some emotional, social and coping problems experienced by people and families dealing with palliative care?
Stress during illness that can lead to fear, anxiety, hopelessness, or depression. Family members may take on care giving, even if they also have jobs and other duties.
Treatments may include:
- Counseling
- Support groups
- Family meetings
- Referrals to mental health providers
When should a decision about entering a hospice program be made and who should make it?
At any time during a life-limiting illness, it’s appropriate to discuss all of a patient’s care options, including hospice. By law the decision belongs to the patient. Most hospices accept patients who have a life-expectancy of six months or less and who are referred by their personal physician.
This does not mean that care will only be provided for 6 months; hospice can be provided as long as the person’s physician and hospice team certifies that their condition remains life limiting
Should a person wait for the physician to raise the possibility of hospice, or should they raise it first?
The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.
Is all hospice care the same?
No. Many communities have more than one hospice. Medicare requires certified hospices provide a basic level of care but the quantity and quality of all services can vary significantly from one hospice to another. To find the best hospice for your needs, ask your doctor, healthcare professionals, clergy, social workers or friends who have received care for a family member. You may want to call or meet with the hospices and ask questions about their services.
Can a hospice patient who shows signs of recovery be returned to regular medical treatment?
Certainly. If the patient’s condition improves and the disease seems to be in remission, patients can be discharged from hospice and return to aggressive therapy or go on about their daily life. If the discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose
What does the hospice admission process involve?
One of the first things the hospice program will do is contact the patient’s physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. (Most hospices have medical staff available to help patients who have no physician.) The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital. The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage.
How many family members or friends does it take to care for a patient at home?
There’s no set number. One of the first things a hospice team will do is to prepare an individualized care plan that will, among other things, address the amount of caregiving needed by the patient. Hospice staff visit regularly and are always accessible to answer medical questions.
Must someone be with the patient at all times?
In the early weeks of care, it’s usually not necessary for someone to be with the patient all the time. Later, however, since one of the most common fears of patients is the fear of dying alone, hospice generally recommends someone be there continuously. While family and friends do deliver most of the care, hospices may have volunteers to assist with errands and to provide a break and time away for primary caregivers.
What specific assistance does hospice provide for home-based patients?
Hospice patients are cared for by a team consisting of a physician, a nurse, social workers, counselors, home health aides, clergy, therapists, and volunteers. Each one provides assistance based on his or her own area of expertise. In addition, hospices provide medications, supplies, equipment, and other services related to the terminal illness.
Does hospice provide care 24 hours a day, 7 days a week?
Hospice staff is on call for emergencies 24 hours a day. Hospice care does not include a nurse in the home 24/7. If you require more care than can be provided in the home, some hospices have their own inpatient facilities. Most communities have nursing homes, inpatient residential centers and hospitals with hospice care options.
Does hospice do anything to make death come sooner?
No- Hospice neither hastens nor postpones dying. Just as doctors and midwives lend support and expertise during the time of child birth, hospice provides its presence and specialized knowledge during the dying process.
Is caring for the patient at home the only place hospice care can be delivered?
No. Hospice patients receive care in their personal residences, nursing homes, hospital hospice units and inpatient hospice centers.
How does hospice “manage pain”?
Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it can address each. Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists can assist patients to be as mobile and self sufficient as they wish, and they are sometimes joined by specialists schooled in music therapy, art therapy, massage and diet counseling. Finally, various counselors, including clergy, are available to assist family members as well as patients.
What is hospice’s success rate in battling pain?
Very high. Using some combination of medications, counseling and therapies, most patients can attain a level of comfort they consider acceptable.
Will medications prevent the patient from being able to talk or know what’s happening?
Usually not. It is the goal of hospice to have the patient as pain free and alert as possible. By constantly consulting with the patient, hospices have been very successful in reaching this goal.
Is hospice care covered by insurance?
Hospice coverage is widely available. It is provided by Medicare nationwide, by Medicaid in 47 states, and by most private insurance providers. To be sure of coverage, families should, of course, check with their employer or health insurance provider.
If the patient is eligible for Medicare, will there be any additional expense to be paid?
The Medicare Hospice Benefit covers the full scope of medical and support services for a life-limiting illness. Hospice care also supports the family and loved ones of the person through a variety of services. This benefit covers almost all aspects of hospice care with little expense to the patient or family.
Would hospice care still be provided If the patient is not covered by Medicare or any other health insurance?
The first thing hospice will do is assist families in finding out whether the patient is eligible for any coverage they may not be aware of. Barring this, some hospices will provide for anyone who cannot pay using money raised from the community or from memorial or foundation gifts.
Does hospice provide any help to the family after the patient dies?
Most hospices provide continuing contact and support for caregivers for at least a year following the death of a loved one. Many hospices also sponsor bereavement groups and support for anyone in the community who has experienced a death of a family member, a friend, or similar losses. (the one we went to provided berevement for the children & grand children at the camp)
What is Hospice?
When medical care cannot offer a cure, hospice provides care, comfort and support for persons with life-limiting conditions as well as their families. The hospice team works to make the person comfortable and relieve their symptoms and pain for the entire length of their illness
Second definition
Hospice care is a type of care and philosophy of care that focuses on the palliation of a chronically ill, terminally ill or seriously ill patient’s pain and symptoms, and attending to their emotional and spiritual needs
What specific services are provided as part of hospice?
The hospice team will provide the following services to individuals in the home, wherever they consider home to be:
- Manage pain and other symptoms
- Offer support with the emotional and spiritual aspects of dying
- Provide medications, medical supplies and equipment
- Teach family members skills to help them provide care
- Deliver special services like speech and physical therapy if needed
- Make short-term inpatient care available when pain or other symptoms become too difficult to manage at home
- Provide support and counseling to family members and loved ones
