Hospice: Proportional Method And Streamlined Method

I first heard about hospice from a co-worker a few years ago when that co-worker was preparing to check her mother in hospice and she was in her forties. As she discussed with me her mother had a drug addiction problem her entire life. At that time I had never heard about hospice and I became interested in learning more about it. “Hospice is a special concept of care designed to provide comfort and support to patients and their families. Patients are referred to hospice when life expectancy is approximately six months or less. Hospice care can continue longer than six months if

When a person is diagnosed with a terminally illness and is given an expectancy of six months or less to live, it is time to concentrate on the type of care will need. Many times a person and their family will turn to hospice care. The meaning of hospice is to provide care to a person who is terminally ill. Hospice does not speed up or postpone death. Hospice is a type of care that provides services to improve the quality of life for the patient and family.

The National Hospice and Palliative Care Organization reported that, as of 2003, there were 3,139 hospice programs in operation in the United States, Guam and Puerto Rico (Wexler & Frey, 2004). The Centers for Disease Control and Prevention National Center for Health Statistics said that, in 2000, there were 11,400 combined home health and hospice care agencies, which served 1.5 million patients. It also reported that, at present, more than 90% of hospice care is delivered at home, although based in medical facilities. Hospital-based programs often provide hospice care in a wing or a

18). This type of spending is not surprising since there are such outstanding research and care facilities in this country. It is important to note, though, that of these expenditures, $50 billion of Medicare expenses are paid during the final two months of patients’ lives (CBS News, 2010). While it is important to provide excellent care during the final days of a patient’s life, many of these costs are for medical technology that does not really extend either the quantity or quality of a person’s life.

Hospice is a philosophy of care. It treats the person rather than the disease and focuses on quality of life. It surrounds the patient and family with a team consisting of professionals who not only address physical distress, but emotional and spiritual issues as well. Hospice care is patient-centered because the needs of the patient and family drive the activities of the hospice team.

Hospice is compassionate care provided to patients facing terminal illness or illness for which there is no cure. These patients are diagnosed with an illness from which they will never recover and usually have a life prognosis of six months or less (Hospice Foundation of America, 2014). The goal of hospice care is improving quality of life and managing the symptoms of disease and the dying process. The care hospice offers is focused on pain management and emotional and spiritual support for both the patient and family (National Hospice and Palliative Care Organization, 2012). Hospice care can be provided in many different settings, often the patient’s own home. Hospice care can also be provided in hospitals, nursing homes, long-term care facilities and free-standing hospice centers and is available to patients of all ages (NHPCO, 2012). A patient receiving care in a hospice program has a team of healthcare individuals that can consist of the patients own physician, nurses, home health aides, clergy, social workers, and speech and physical therapists (NHPCO, 2012). Usually, a care plan is developed by the hospice team and care of the patient is provided by family members with the support of the hospice staff (NHPCO, 2012). Nurses make regular visits to the patient and family and are on call 24/7. Once enrolled in a hospice program hospice covers everything that will be needed to care for you, from medications to manage pain to

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.

I do home health CNA jobs and trying to get in to be a CNA in a hospice home health and later on, I would like to be a visiting nurse to a hospice patients. I conducted an interview to one hospice psychologist I know and the information I’ve learned is intense and I’ve realized that I wanted to know more about this field. So what is hospice? Hospice is a program of care for terminally ill patients and their love ones; it’s a program about life and about living life to the fullest until the end. One professional that can help what’s they are going through is psychologist. They assessed what the patient and family needs and help them to understand and evaluate the options that meet their needs. Many psychologist have compassion working on hospice,

You have made excellent points. I do not believe that health care professionals neglect to treat patients in palliative care in the correct settings. The care one receives is based on what type of locations they are in. Hospitals and hospice centers often have employees with higher education levels and an increased passion for their job. I believe that health care providers want to ensure that one is comfortable at the end of life. I have visited Alive Hospice here in Nashville and was able to see the the great amount of care they provided to their patients. I have attached a link to their website below. I am curious to know your opinion on why you think one would not receive adequate care at the end-of-life phase.

In my nursing practice, I frequently care for dying patients. Instead of simply providing medication to ease pain during the dying process, I wanted to learn about ways to enhance the comfort of the dying patients and possibly assist their family during a difficult time. This desire led me to examine the conceptual model of comfort. Through my research of the concept of comfort care at end of life, I discovered Katherine Kolcaba’s theory of comfort. I found her theory to be useful in describing the concept of comfort care and decided to further analyze it for a more thorough understanding of its usefulness and applicability to nursing practice. Nurses are the ones in direct contact with their patients, providing relief from certain discomforts, continuously assessing, monitoring and providing care that will ensure the patient is at ease. According to Kolcaba, “Comfort is the desirable state that nurses would want for their patients.” (Kolcaba, 2003). With its fundamental emphasis on physical, psychospiritual, sociocultural, and environmental aspects of comfort, the Theory of Comfort care will contribute to a proactive and multifaceted approach to care. This paper aims to describe the origin of Comfort Theory, its primary concepts and relational statements, review of the literature, critique describing its strength and limitation as a middle range theory

Unlike long-term care, Medicare will pay for hospice care if the care is received from a Medicare-approved hospice program (Peden, 2015, p. 484). However, once hospice care is chosen, Medicare will no longer pay for treatment to cure the terminal illness or care for anyone that is not set up by the patient’s hospice group (Peden, 2015, p. 484). Four levels of hospice care are provided by The Conditions of Participation (COP). These include routine home care, general inpatient care, continuous care, and inpatient respite care. These levels relate to the way hospice is reimbursed. Medicare Part A, Medicaid, and most commercial insurance companies reimburse hospice care on a day to day basis (per diem) (Peden, 2015, p. 492-493). Each level of hospice care is reimbursed at a different rate (Peden, 2015, p. 493). Reimbursement also depends on the COP’s benefit period. The benefit period begins with one 90-day period, followed by another 90-day period, then an unlimited number of 60-day periods (Peden, 2015, p. 493). At the end of each benefit period, the patient must be evaluated by hospice to determine if the patient still qualifies for hospice care. If so, the patient must be recertified (Peden, 2015, p. 493-494). Although other insurance companies do provide coverage for hospice patients, Medicare is the primary

In the hospice rotation of my clinical experience, I had the opportunity to observe the care for a ninety-seven year old female patient whose intitials were BA. BA has many medical diagnoses, but the most visible ones during my time there were: systolic and diastolic heart failure, stage four chronic kidney disease, primary osteoarthritis, and malignant neoplasm of skin. At the time of the visit, there were no family present however, I did notice many pictures of family members in her room.

My biggest take away from the movie and our conversations in class is that it's best to be honest with your patients and open. Yes, the conversations about end of life are difficult discussions for everyone involved. However, it is unfair of a nurse or doctor withhold or postpone these tough talks on account that they are uncomfortable with facilitating the conversation.

In 2009, Medicare paid $55 billion dollars for doctor and hospital bills of patients during the last two months of life. Inpatient Hospital charges were over $6,200 dollars per day, and $10,000 per day to maintain the patient in an ICU. Reimbursements at an average of $622 per day at skilled nursing facilities. Although Medicare spending in 2010 was $13 billion dollars for hospice, costing approximately $10,700 on average per patient. Payments made to hospice from Medicare is not limited, although it does enforce an aggregate cap for agencies, per beneficiary of $24,500 dollars. (Hospice end of life care, 2011. Bill Fay).

While sadness plays a big role in hospice…it is also true that there is happiness, positive reflection as well as wisdom. This month we want to recognize our two volunteers Connie and Paul Steber who have been volunteers for Hospice since June and considered it a true blessing to share the stories and experiences of patients who are living through a very emotional and difficult time. They are honored to be making a difference and to be able to share the stories of the patients like James Ellis best known as the Coach, who enjoys their company but most of all watching a football game, especially if his favorite team is on the winning end. The Stabers enjoy conversing with James and listening to his stories. There are also times when James and