For Patients & Family
Hospice Overview
About the services we provide
Grief Support
Individualized grief and spiritual support for patients and families
Dementia Capable Care
Our clinical specialty program is built around understanding the unique challenges of memory loss and advanced decline.
For Providers
Overview
With you as your partner in care
Hospice Care
Providing medical and emotional support for patients
Hospice is an important and beneficial end-of-life service that provides care for the patient and family. But half of all patients who require hospice are on service for less than 21 days out of a six-month benefit. Learn more about how early intervention promotes better care and prevents crisis, and see what signs providers should look for.
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Patient meets Medicare administrative contractors disease-specific guidelines to help determine if a patient meets the clinical criteria for the Hospice Medicare benefit.
If a patient experiences acute symptoms that cannot be safely managed in the home or other residential setting, they may require a higher level of care called general inpatient (or GIP) care. GIP care may be provided in a contracted skilled nursing facility or a hospital. Once symptoms are under control, the patient may return to their home under the routine level of care.
Patients who meet most of the LCD guidelines may still be eligible for Hospice if they have a terminal illness with a prognosis of 6 months or less and have significant life limiting co-morbidities
Patients who do not meet all the LCD guidelines but who still have a terminal illness with a prognosis of six months or less may still be eligible if their disease follows the normal course. An attending physician may consult with a Medical Director to review the patient’s status to determine eligibility.
A terminal illness condition not related to a single diagnosis is difficult to determine a primary reason for hospice eligibility. The following guidelines will assist you through determination:
This documentation of structural/functional impairments and activity limitations facilitate the selection or intervention strategies (palliative vs. curative) and provide objective criteria for determining the effects of such interventions. The documentation of these variables is thus essential in the determination of reasonable and necessary Medicare Hospice service.
The BMI is an attempt to quantify the amount of tissue mass (muscle, fat, and bone) in an individual, and then categorize that person as underweight, normal weight, overweight, or obese based on that value. Commonly accepted BMI ranges are underweight : under 18.5, normal weight: 18.5 to 25, over weight: 25 to 30, obese: over 30.
The Palliative Performance Scale Version Two (PPSV 2) is a tool for measurement of performance status in palliative care. The PPSV2 allows common language about performance status that is more relevant in palliative care than the Karnofsky Performance scale from which it is based.
A standard way of measuring the ability of patients to perform ordinary tasks. The Karnofsky Performance Scale scores range from 0 to 100. A higher score means the patient is better able to carry out daily activities. KPS may be used to determine a patient’s prognosis, to measure changes in ability to function or to decide if a patient could be included in a clinical trial.
Registered nurse: will assess pain and other symptoms and implement ordered pain control measures Social worker: will assess psychological, financial and emotional needs related to illness Spiritual care counselor: will counsel, support and intervene related to spiritual care needs and wishes; will support with listening and presence Home health aide: will support with activities of daily living and homemaker services Volunteers: will support with companionship, errands and other activities
Doctors usually classify patients’ heart failure according to the severity of their symptoms. The table below describes the most commonly used classification system. It places patients in one of four categories based on how much they are limited during physical activity.
No limitation of physical activity. Ordinary physical activity does not cause undue breathlessness, fatigue or palpitations.
Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in undue breathlessness, fatigue or palpitations.
Marked limitation of physical activity. Comfortable at rest, but less than ordinary physical activity results in undue breathlessness, fatigue or palpitations.
Unable to carry on any physical activity without discomfort. Symptoms at rest can be present. If any physical activity is undertaken, discomfort is increased.
Registered nurse: will assess respiratory status, medication efficacy and symptom management related to the pulmonary diagnosis; safety consideration with oxygen usage will be addressed Social worker: will assist with optimal coping strategies and assist with support related to terminal illness Spiritual care counselor: will support through listening, presence and prayer based on the patient and family’s needs and beliefs Home health aide: will perform safe and effective assistive homemaker services Volunteers: will support with companionship, errands and other activities
Registered nurse: will manage signs and symptoms of renal failure due to discontinuation of dialysis; comfort and pain management will be obtained Social worker: will assist patient and family with end -of- life planning to assure wishes are met Spiritual care counselor: will support based on the patient’s and family’s needs and belief system Home health aide: will maintain patient’s personal hygiene and assist with activities of daily living Volunteers: will support with companionship, errands and other activities
Registered nurse: will manage signs and symptoms of liver disease; targeted comfort and pain management techniques Social worker: will provide support for the patient and family with advanced liver disease; assess discomfort and symptom control of ascites pain management and malnutrition Chaplain: will evaluate end-of-life issues and assist with solutions related to the patient’s belief system Home health aide and volunteer: will assist with increasing need for assistance with activities of daily living and homemaker chores Volunteers: will support with companionship, errands and other activities
Registered nurse: will provide comfort and care for the patient with abnormalities who is terminally ill Social worker: assesses psychosocial issues facing patients with terminal neurological disease; identify illness-related psychiatric conditions
Registered nurse: will assess for pain and symptom control including new onset infections, nausea and vomiting Social worker: will provide psychological assessment of patient and family to include adjustment to illness and its complications Spiritual care counselor: will provide counseling, intervention and support related to that dimension of life Home health aide and volunteer: will assist with hygiene and comfort maintenance Volunteers: will provide support and respite as defined by the patient and family
Registered nurse: will assess the patient’s pain or other symptoms related to dementia Social worker: will assist with caregiver role strain and will facilitate communication with the patient, family and hospice team Spiritual care counselor: will assist in psychological and spiritual support for the patient and family Home health aide and volunteer: will assist with personal care and homemaking chores Volunteers: will assist the family and caregivers to offer relief and respite
FAST score of 7C or greater may be necessary to qualify someone for hospice with diagnosis of dementia. FAST focuses more on the individual’s level of functioning and activities of daily living versus cognitive decline. A person may be at a different stage cognitively (GDS stage) and functionally (FAST stage)
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