Hospice And Long-Term Care Analysis

Nursing homes and assisted facility homes are all examples of long term care facilities. These facilities are usually targeting individuals who are of geriatric age or need around the clock care (mental health and physical health). The residents in these communities have access to individually-tailored levels of individual or group-centered activities, programs, and assistance whether it is with home or personal care. Long term care facilities are generally for those who are unable to manage independently in the community. Specific types of long-term services include nursing homes, hospice care, home health agencies, and residential care facilities. The goal of these programs is to make sure each patient has a safe and comforting environment

Caring Hospice is a company that will provide nursing care to patients that are terminally ill. The ultimate goal is to insure the patient is kept as comfortable as possible while maintaining dignity during the dying process. This company will send registered nurses to the patient’s home for routine physical assessments, medication teaching and administration, education about terminal diseases and the dying process. The nursing staff will also create and maintain appropriate plans of care for the multi-disciplinary team to provide holistic care to the patient.

Long-term care assists individuals who cannot adequately perform their routine activities of daily living. These activities include dressing, bathing, walking, meal preparation, and taking medications ( Batnitzk,A.,Hayes,D.,& Vinall,P.E. 2014,(c. 5.1). These services are typically for clients over the age of 65 years old and is used to promote independence and security for those who cannot take care of their needs due to illness or debility (c.6.1). The type of provider will depend on the type of care a client needs. For instance, some elderly people that need help with food preparations or everyday activities will request to stay at home and have a family member take care of them. This is one way that long-term care is rendered but is unpaid. Another way is through nursing facilities, skilled nursing facilities and assisted living that will handle more complex or full-time

Medicare, the federal governments health insurance program, finances acute medical care for nearly all elderly Americans over the age of sixty-five. However, very few long-term care services are covered. Medicare finances long-term care only partially through it’s limited skilled nursing facility (SNF) and home health benefits. “Despite recent growth in spending on these benefits, much of the SNF and home-care paid for by Medicare remains short-term rehabilitative care, often related to a hospital stay or outpatient procedure. Medicare covers SNF care for up to 100 days following a hospital stay of at least three days. For homebound persons needing part-time skilled nursing care or therapy services, Medicare pays for home health care, including personal care services provided by home health aides.” (Feder, Komisar, and Niefeld) All that is not covered, the elderly are expected to cover with savings, private insurance policies, and financial support

Hospice—Two caps 1) Number of days of inpatient care are furnished is limited to not more than 20 percent of total patient care days, *The Inpatient Cap*. 2) Aggregate payment amount received in Medicare payments for services provided in the cap year is limited to the cap amount times the number of Medicare patients served, *Aggregate Cap*. There are two different methods for counting the number of Medicare patients; Proportional Method and Streamlined Method.

A survey was conducted in 2000 on more than 9,000 patients discharged from more than 2,000 hospices on the services they received (Carlson, 2007). It revealed that 22% of them received five major palliative care services, which varied among the hospices. These palliative care services were nursing care, physician care, medication management, psychological care, and caregiver support. Approximately 14% of the hospices provided all five services and 33% provided only one or two services. Only 59% of these patients received medication management services. These included administering medication, dispensing correct dosages, and setting and following dosage schedule.

In contrast to the costs of standard medical care, hospice care provides an alternative that is both cost effective and caring. Unfortunately, it is actually difficult to quantify the cost savings associated with hospice care due to the fact that comparing costs during the last year of life are impacted by the variability in the length of hospice use. A study at Duke University went to extensive lengths to provide a comparison that provided an effective method for accurate comparisons. The comparison showed a reduced average Medicare expenditure of $2,309 per person from the time hospice care was initiated in comparison to the same situation handled through standard medical methods (Taylor, Ostermann, Houtven, Tulsky, & Steinhauser, 2007). The amount of cost savings varied depending on the primary health condition and the

Great strides have been made to improve end-of-life care through palliative care and hospice programs, but sometimes that’s just not enough. In America, the care that is offered to the elderly and the chronically ill is less than ideal. Statistics show that an

This essay discusses the core principles of long-term conditions and management. Government guidelines and standards are also discussed in relation to how these will impact the care of the patients who are experiencing long term conditions. The reports, guidelines and plans that play an important role in directing the current nursing system today, are discussed with regard to the management of chronic conditions and lastly, palliative care and outcomes from the publication “Together for Health – Delivering End of Life Care” (2013)

Throughout Unit 6 we reviewed the continuum of care in long-term care facilities and its many aspects. The continuum of care, also referred to as the delivery system of health care, is best defined as a full range of long-term care services increasing in level of acuity and complexity from one end to the other (PowerPoint). This delivery system is comprised of three substantial components. These components are the informal system, community based care, and the institutional system.

Long-term care is a result of people having terminal conditions, disabilities, illnesses, injuries, or being elderly. The purpose of long-term care is to provide services to people and to aid people at a time in their lives when they cannot depend on themselves to maintain daily activities. There are many variations of long-term care available – such as home care, adult day care, and independent and assisted living, personal care facilities, nursing homes, and hospice.

The doctors were pretty sure that Pierre had less than 6 months to live, so he fell well within the guidelines for hospice coverage. Should hospice coverage be limited to those with 6 months or less to live, or should other be covered? 6 months is a random figure and I think that the covering other could help families deal with hospice care a little better; it would give them a better understanding of what hospice-type services is entailed. It also could be too expensive for covering others and how can you know for sure if 6 months is suitable.

Hospice care is a model of care that focuses on relieving symptoms and supporting patients with a life expectancy of six months or less (Altshuler, 2013). For most nurses, caring for a dying elder (individual aged 65 years and above) is a discrete, time-limited experience that begins with first contact, often in a hospital, emergency room, or long term care facility, and ends with the death itself (Phillips & Reed, 2008).

The continuum of institutional long-term care is for patients whose needs are not adequately met in a more community-based setting. It is for individuals who need more dependency. There are two ends of the continuum of institutional long-term care spectrum. On the one end there are the individuals that may only need basic personal or custodial care (Shi & Singh, 2015, p. 399). An example of personal and custodial care can include help with walking, bladder training, or just helping with bathing. On the other end there are the individuals that may need more round the clock care with nursing or specialized services along with the basic needs (Shi & Singh, 2015, p. 399).

Hospice is a component of palliative care. A person does not necessarily have to be dying in order to see a palliative care specialist. This is where the service is often underutilized in the hospital. In the 18 months I have been a nurse, I have cared for many patients with chronic illnesses who have dealt with symptoms that have severely impacted their quality of life. Most of the time, it seems as though the patient’s care providers are interested in treating the patient’s acute problems. My experience has been that the symptoms are often overlooked or are being treated in a manner that is to the dissatisfaction and discomfort of the patient.