What service(s) do you provide?
- The UWHC Palliative Care Service collaborates with the primary care team to help develop a comprehensive plan of care for patients and families facing advanced disease. The focus of care is on patients, families, and staff, and ideally begins early in the course of a life-limiting illness.
- Manage complex symptoms related to disease or treatment, including pain, nausea, dyspnea, anxiety, and fatigue
- Assist patients, families, and staff with decision making for treatment options, hydration, nutrition, ventilation, dialysis, code status, advance directives, or treatment withdrawal
- Participate in family meetings, education, and counseling
- Provide emotional and spiritual support
- Review patients being considered for hospice
When is it appropriate to initiate a referral to your service?
- Palliative care is important at all stages of a person's illness and includes pain and symptom management, advanced care planning, emotional support of patients and families, and continuity of patients and families' goals across providers and care settings
Who can initiate a referral?
- Any doctor, nurse, social worker, case manager, patient or family member can request a consult
- The Palliative Care Service always reviews the request with the primary team
What hours are you available?
- The service is available Monday–Friday, 8am-4:30pm
How do we reach you?
- Pager 0500
- Health Link Consult
Is there a separate fee added to the patient's bill for your service(s)?
What is your response time?
- Within 24 hours (not on weekends)
Other things we should know?
- Palliative care is defined by the World Health Organization as the act of total care of patients whose disease is not responsive to curative treatment
- Experts in Palliative Care work within a multidisciplinary team (medicine, social work, nursing, pastoral care) and are available for both inpatients and outpatients through consultation
Hospice Care is available in several settings: home, inpatient hospice units, nursing homes and CBRF's.
- Acutehospice facilities generally admit patients that are not stable and have rapidly changing symptoms.
- There is 24/7 RN staffing.
- The goal is acute symptom management.
- Residential hospice facilities
- Have 24/7 CNA staffing.
- They do not manage IV's.
- There is a daily room and board charge,
- Some Nursing Homes contract with hospice agencies to provide hospice care for their custodial care patients. Insurance will not pay for skilled and hospice at the same time.
- Many Assisted Living facilities contract with hospice agencies. Since care is typically private pay, insurance can cover hospice services.
Clients must have a terminal condition and be certified by a physician to have a life expectancy of less than six months (at times, 12 months). Clients are not discharged from hospice and will not lose their Medicare Hospice Benefit after six months as long as their physician continues to re-certify a six-month prognosis.
Clients must seek palliative—or comfort—care over curative care.
Medicare Part A covers nursing care, social and bereavement support, medications (limited co-payment of no more than $5), laboratory tests, and other services required for the management of the terminal illness and documented as necessary in the hospice plan of care. Palliative chemotherapy and radiotherapy may also be included.
Clients must pay room and board costs when they are residential status in inpatient hospice units. They do NOT have to pay room and board for general inpatient status!
Clients on home I.V. dobutamine therapy for Congestive Heart Failure will be reviewed on a case-by-case basis for eligibility for Hospice.
Hospice Care Inc inpatient hospice can take patients in intermittent (not continuous) CPAP, cannot take patients on BiPAP.
If a client is confused, and does not have a Power of Attorney for Health Care, a close family member may be assigned to make decisions in lieu of pursuing a guardianship.
- Contact a patient's insurance company to check coverage / preferred providers.
- Speak to patient about their preference
- Make referral via ECIN
- DME: Hospice agency will arrange for transportation. If a hospice nurse is meeting the patient at home, the ambulance ride is often covered (Note: Ryan Brothers has Hospice Inc contract). Stretcher or W/C van is not covered.
- Health Link Documentation
- Document your planning in a Progress Note
- Update the DC Plan
- Update the DC Date and Time
- Enter a Suggested Order for DC Face Sheet