Hospice & Palliative

Community College of Denver **We aren't endorsed by this school
NUR 3667
Jul 1, 2023
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HospicerPalliativecaren what patients Families want GOALS pain symptom control Avoid prolongation of dying Acheive a sense of control relieve burden on family strengthen relationships w loved ones 90 of terminally ill adults prefer to be cared for in theirown home Palliative Care Hospice Care Patient family centered care that optimizes A type of palliative care or by anticipating preventing Tx suffering medicare Hospice Benefit eligibility life expectancy camo pallium to cloak must waive further therapies affording relief w out cure most hospice care 851 is delivered at home To ease or relieve patients are routinely re evaluated re certified as To mitigate or alleviate appropriate our challenge finda cloak that fits Hospice does not mean giving up hope specallized medical care for people w serious illness Hospice is compassionate whole pressureaggressive care at the end of life Focused on RELIEF from symptoms pain stress focused on relief of physical paint personal distress Goal to improve Qa for pts family Delivered by a team tothe persons home comprised of consultation team private practitioner A medicare benefit hospice agency team some Barriers lack of right information at right time Appropriate at any age stage of illness cultural religiousemphasis on gift of life can be provided along with curative care Doctorsreluctant to refer problem of prognosis Medicarefences changes in dying process How to ask reminders about Hospice Enrollment Medicare hospice Benefit us may extend past Gmo physician nursing a social work services may re enroll at any time Dme supplies if enteria is met medications for symptom control covered physical occupational therapies Bereavement nursing home or inpatient facility RB not covered medical care for diagnosis other than primary hospicediagnosis Patients Appropriate for inpatient Palliative Care consultation Advanced illness Unmetneeds physical emotional spiritual practical Team support re complex decisions conflict Examples any to male w advanced colon ca refractory pain 65g to male wi CHFcred unsure reHDor status Improved patient care Qu Yin Ying Pn not eating Outcomes of Palliative care conditions addressed by PC communication Lung disease Agar a unwanted Tx or disease Quality Quantity Alzheimer's fifer disease Dementia improved adjustment of family after death Ms saves 8 CKD
Communication Difficulty of Eoc communication patients scared vulnerable unsure of wishes often too ill or unable to communicate Families struggling w distressing emotions a tendency towards denial difficulty understanding lack of preparedness physicians trained to save lives rather than manage death stakeholder decisions Look for triggers Growing patientsfamily needs physical emotional practical despite optiminal care Failed Tx hospitalizations Er visits invitations from family isnt there something more you can do im worried about my wife im not sure she can keep going like this when will this get better EOC discussions change care studies show er discussions associated w no r in patient depression or worry Better patient caregiver Qu a ventilation resuscitation Icu admissions costs Earlier hospice admissions less depression in bereavement caregivers more aggressive therapies associated wt no difference in mortality worsepatient Qa
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