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The healthcare continuum
Published in Edward M. Rafalski, Ross M. Mullner, Healthcare Analytics, 2022
At the end of the healthcare continuum we find palliative and hospice care. Palliative care is specialized medical care that focuses on providing patients relief from pain and other symptoms of a serious illness, no matter the diagnosis or stage of disease. Palliative care teams aim to improve the quality of life for both patients and their families. This form of care is offered alongside curative or other treatments you may be receiving. Like palliative care, hospice provides comprehensive comfort care as well as support for the family, but, in hospice, attempts to cure the person’s illness are stopped. Hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course.22 In the experience of some health systems, the nature of end of life care for COVID-19 patients was such that hospice care was not an option given the rapid nature of the progression of the disease and the highly critical acuity.
Evaluation of the Transprofessional Model of Home Health Care for HIV/AIDS
Published in David Alex Cherin, G. J. Huba, AIDS Capitation, 2021
David A. Cherin, G. J. Huba, Diana E. Brief, Lisa A. Melchior
However, overall research on hospice-care costs continues to show that the most substantial reason for cost savings of hospice over conventional care results from the substitution of services. This substitution of services may, in fact, be the reason that, according to Scitovsky (1994), hospice services only are used by a small percentage of those who die each year. Physicians and families wait until all possible active/curative treatment is exhausted and then seek hospice care when only a few weeks, or even days, of life remain for the patient. As currently configured and regulated, hospice services and cost savings seem only to be responsive to the timing of hospice admissions.
The NHO Medical Guidelines for Non-Cancer Disease and Local Medical Review Policy: Hospice Access for Patients with Diseases Other Than Cancer
Published in Inge B. Corless, Zelda Foster, The Hospice Heritage: Celebrating Our Future, 2020
Medicare Hospice Benefit legislation legitimized end-of-life care, making hospice equivalent to other reimbursable medical services. For the first time, care of the dying was institutionalized and publicly supported. However, the new law also placed restrictions on patient eligibility for hospice unlike any other segment of the US health care system. Other Medicare-covered services, even those financed under specialized benefits, i.e., dialysis for End-Stage Renal Disease (ESRD), were provided to patients throughout the course of illness. Eligibility for hospice patients, on the other hand, was restricted to those with “a life expectancy of six months or less, assuming the disease runs its normal course.”
Candidates and candidacy: Patient, carer and staff perceptions of referral to a specialist palliative day unit
Published in Progress in Palliative Care, 2021
This qualitative study uses a constant comparative analysis25 to explore staff, patient and carer experiences of referral to SP day care. Data collection took place during 2014–2015 at the local specialist palliative day care unit located within a hospice in the North of England, which has established links with the local University and research team. The hospice is a well-established service providing specialist palliative care through inpatient and day centre facilities as well as via specialist community hospice teams. The SP day care unit provides a range of interventions including; medical support; physiotherapy; occupational therapy; hairdressing and personal care, complementary therapy and psychosocial support. Patients usually attend for one day per week over approximately six to twelve weeks (depending on assessment and condition). Family carers can access a weekly hour-long support group if required. Patient referrals are generally via the General Practitioner (GP), acute hospital services (particularly oncology), community nursing teams including specialist hospice community nurses and patient self-referrals.
Addressing the Gap: Occupational Therapy in Hospice Care
Published in Occupational Therapy In Health Care, 2021
Emily Mueller, Paul Arthur, Mack Ivy, Loree Pryor, Amber Armstead, Chih-Ying Li
Hospice care is a benefit for individuals certified to be terminally ill with a medical prognosis including a life expectancy of six months or less, should the illness run its traditional course (Centers for Medicare & Medicaid Services (CMS), 2018). Occupational therapy is one of the hospice care services that can assist the patients to maintain independence in meaningful activities of daily living and functional skills (CMS, 2018, section 40.1.8). CMS indicates that occupational therapy, along with other services such as physical therapy and speech-language therapy, must be provided in hospice settings, either directly or arranged, to address and meet the patient or family’s needs (CMS, 2018, section 40.5). To date, the number of individuals needing hospice care services has grown to nearly 20 million worldwide. However, only 14% of those individuals actually receive the end of life care they need (Von Post & Wagman, 2019).
Live discharge from hospice care: psychosocial challenges and opportunities
Published in Social Work in Health Care, 2020
Stephanie P. Wladkowski, Cara L. Wallace
The hospice movement was designed as a comprehensive model of care to provide medical care to individuals with a terminal disease. The full scope of hospice care services available to patients and caregivers includes medical care for the patient and psychosocial support for both the patient and their caregiver. Specifically, an interprofessional team is available including, a nurse and physician care; access to physical, occupational, or speech therapy; social services; certified nursing aide services; and a chaplain (National Hospice and Palliative Care Organization, 2019). Additionally, durable medical equipment, medications, and supplies that support the hospice diagnosis and accompanying pain symptoms are provided (National Hospice and Palliative Care Organization, 2019). Hospice care is focused on pain and symptom management, available 24 hours a day, and is provided wherever the patient lives. This holistic model has expanded to include grief and bereavement support for families and caregivers, which includes attending to the anticipatory grief and bereavement post-death. Eligibility for hospice requires a patient to forgo any curative treatment of his or her terminal condition and a physician to certify a life expectancy, or prognosis, of six months or less.