Hospice. Ensuring Dignity with Comprehensive Care. Scenario. Cynthia Katzan, MD Visiting Nurse Association of Ohio and HealthNetwork Foundation
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1 Hospice Ensuring Dignity with Comprehensive Care Cynthia Katzan, MD Visiting Nurse Association of Ohio and HealthNetwork Foundation Scenario 1
2 Misconceptions about Hospice Hospice is for when you ve given up. Hospice is for last days/hours of life. The hospice nurse will give morphine, and that will bring death. Hospice is a bad word. Hospice is a concept of care designed to provide comfort and support to patients and their families when life-limiting illness no longer responds to cureoriented treatments 2
3 Hospice is NOT care that prolongs life or hastens death Hospice is a comprehensive holistic approach to managing all the facets of the end-of-life experience * addressing all physical and psychosocial needs * supporting patient and family * customized and fluid *dignity at home 3
4 Needs of the Terminally Ill Physical Psychological Social Spiritual Pain Management Symptom Management Comfort Care Knowledge that they will not be abandoned When is hospice care appropriate? The patient has a life expectancy of 6 months or less The patient/family desires hospice services It is physician approved 4
5 Common Hospice Diagnoses Any diagnosis at end-stage can qualify Cancer Dementia Debility/Adult Failure to Thrive ALS Parkinson s Disease End-Stage Diseases Lung, Renal, Heart Failure, etc. Basic Hospice Expectations Joint Commission accredited Excellent communication skills Timely responses Anticipating & meeting the needs of patients and facilities A cohesive multidisciplinary hospice team Registered nurses with Certified Hospice & Palliative Care Nursing status 5
6 Your Hospice Team: Healthnetwork Foundation Hospice Team Provides Consulting Support Services Your Doctor and Hospice Medical Director Registered Nurse - the case manager 24-Hour Triage Nurse LISW Spiritual Care Provider Hospice Aide Massage Therapist Art Therapist Bereavement Counselor Volunteers Care Delivery Care comes to your home, wherever that is: * Home * Assisted Living Facility * Nursing Home * Hospice house 6
7 Hospice Benefits Availability of: Acute Symptom Management Respite Care Continuous Care Hospice Benefits Also Comfort-related medications Durable medical equipment 7
8 Hospice Benefit Who pays for Basic Hospice Services? MEDICARE Additional Care Available Upon Request please discuss with your Healthnetwork Hospice Team. One Call Starts It All Care is customized and fluid Physical Issues PAIN Toileting Restlessness/ Sleep Breathing Swallowing Psychosocial Issues Depression Worry/ Fear Loss of Control Caregiver Fatigue Logistics of Care 8
9 What do most people want? Don t let me be alone Help me with what s to come Just let me go easy I just don t want to be in pain I just want to be at home What is the first step? Call Lisa - the Healthnetwork Foundation Hospice Coordinator! One Call Starts It All
10 Back to our scenario Alternative paths Her other wishes DNR Medical POA Financial POA Other What if unable to say Hospice Misconceptions Revisited Hospice is for when you ve given up. Hospice is for where conventional treatments leave off. Hospice is for living on in best possible quality. Hospice is for last days/hours of life. Hospice will stay by your side the whole way. The hospice nurse will give morphine, and that will bring death. The hospice nurse will bring morphine, or whatever it takes, to ensure your comfort. Hospice is a bad word. No one should die without the benefit of hospice. 10
11 Questions? Frequently Asked Questions: Do I have to have hospice if my physician recommends it? Do I have to sign a DNR? Do I still go to the hospital for my care? What if I want to have further testing or procedures? Can I receive intravenous fluids in hospice? 11
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