Health Care Systems

Describe Hospice care: Who provides it? Who receives it? Where is it delivered (what are the levels)? What is the philosophy? How is it related to/different from palliative care? Hospice Care: ● Provided by: ○ Personal physician, hospice physician/medical director, nurses, hospice aids, social workers, bereavement counselors, spiritual counselors, speech/physical/occupational therapists, volunteers ● Provided in: ○ Hospice center, hospital, nursing facility, home ● Received by: ○ A person that is expected to live 6 months or less ● Levels of Hospice: ○ Routine Hospice Care ■ is the most common level of hospice care. With this type of care, an individual has elected to receive hospice care at their residence. ○ General Inpatient Care ■ is provided for pain control or other acute symptom management that cannot feasibly be provided in any other setting. GIP begins when other efforts to manage symptoms are not sufficient. GIP can be provided in a Medicare certified hospital, hospice inpatient facility, or nursing facility that has a registered nurse available 24 hours a day to provide direct patient care. ○ Continuous Home Care ○ Inpatient Respite Care ● Palliative Care ○ Specialized treatment for discomfort, symptoms and stress of serious illness ○ Relief from: pain, fatigue, nausea, shortness of breath, loss of appetite, sleep problems ○ Always use in hospice care ● Philosophy of Hospice ○ Hospice is focused on the dying process and helping individuals who are terminally ill (and their family and friends) pass through this process more comfortably. ○ During course of terminal illness the patient should be able to live life as fully and comfortably as possible but without artificial or mechanical efforts to prolong life Define advance directives, what are the different types and what do they outline? ● legal documents that allow you to plan and make your own end-of- life wishes known in the event that you are unable to communicate ● Power of attorney – Who will make your decisions? ○ Physician declares the person unable to make medical decisions ○ Power of attorney-appointed person will make decisions for the patient based on the living will ● Living will – what care do you want/not want? ○ Outlines decisions you would like to be made regarding your medical care ○ What types of treatment do you want to be given in medical situations? ○ Most common treatments discussed: ■ Cardiopulmonary Resuscitation (CPR) ■ Do Not Resuscitate Order (DNR) ■ Do Not Intubate Order (DNI) ■ Artificial Nutrition and Hydration

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