patient questions and hospice myths
DESCRIPTION
Patient Questions and Hospice Myths. Presented by: XXX. Introductions. Local Project Hospice Lead(s). Insert from Speaker Notes. Stratis Project Team. Stratis Health Staff Janelle Shearer, RN, MA, CPHQ, Program Manager Laura Grangaard, MPH, Research Analyst Subject Matter Experts - PowerPoint PPT PresentationTRANSCRIPT
Patient Questions and Hospice Myths
Presented by: XXX
Introductions
Local Project Hospice Lead(s)• Insert from Speaker Notes
Stratis Project Team
Stratis Health Staff Janelle Shearer, RN, MA, CPHQ, Program
Manager Laura Grangaard, MPH, Research Analyst
Subject Matter Experts Barry Baines, MD Lores Vlaminck, RN, BSN, MA, CHPN
Objectives• Overview of the TRUE project• Explore strategies for discussions with your
physician regarding your serious illness• Describe the Medicare hospice benefit and
services
Targeting Resource Use Effectively (TRUE)
Goals:– Increase appropriate referrals to hospice– Increase the length of stay of hospice patients
(days of care)
How: By forming multidisciplinary community based teams to implement strategies to address barriers to optimal hospice use in the XXXXX community
THE REALITY, THE PROBLEM, AND THE RESULT
Is There an Elephant in the Physician’s Exam Room?
The Gap: Having The Talk
• Patients and their families think that if they have a serious illness, their doctor will start the talk about hopes and goals for care
• Doctors say that they will have these talks if their patients bring up the topic first
• Doctors and their patients both think that having these talks are important
Reality
Persons have a Serious illness
Problem
Neither the patient nor the physician are talking about it
Result
Frequently, these talks aren’t taking place or they happen in a crisis situation
Opportunities: Having “The Talk” Sooner
•For Patients:– Encourage patients to ‘ask their doctor’ if they
have a serious illness
– Provide a list of specific questions to initiate “the talk” (see patient brochure)
Patient Questions:
• Do I have a serious or life-limiting illness?
• Can my illness be cured?• If my illness can’t be cured, are there
treatments that can slow down my illness?
• What kind of care is available to focus on making me comfortable?
Patient Questions:
• If my illness keeps getting worse, when is it a good time to think about getting supportive and comfort focused care?
• Will you be the one to tell me when to contact hospice?
• Will you stay involved with my care even when I am no longer looking for treatment for my disease?
Shared Decision-Making
Between Physician and Patient:• Physician’s Responsibility: Inform
and recommend best treatment option(s)
• Patient’s Responsibility:
To choose or refuse treatment option(s)
MYTHS AND REALITIES ABOUT HOSPICE
Myth
• I have to give up my primary physician upon hospice enrollment
Reality
• Hospice encourages you to keep your primary (usual) physician
Myth
• All my medications and treatments will be discontinued
Reality
• The hospice team, along with your primary physician reviews all medications and treatments to meet your wishes for comfort.
Myth
• I have to pay for hospice
Reality
• For those that meet the hospice eligibility criteria for Medicare, Part “A” covers hospice at 100% without a co-pay or deductible. Most health plans do the same..
Myth
• Hospice is a place I must go to.
Reality
• Hospice is a team of professionals and volunteers that come to the place you call “home.” They bring their expertise, care and supplies to you.
Myth
If I enroll in hospice, I will die sooner.
Reality
Actually, research shows people with some diseases live longer if they are enrolled in hospice than if they aren’t.
Who Qualifies for Hospice Care?• Terminally ill persons whose life
expectancy is six months or less given the current progression of their disease process (any age-any diagnosis)
• Patient is seeking palliative care rather than curative treatment
Hospice Team Members
Core Team Members•Medical Director/Attending Physician
•Nurses (RN on-call 24/7)
•Social Worker
•Chaplain/Counselor
•Volunteers (Active and Bereavement)
Hospice Team Members
• Hospice Aide
• Therapies (PT/OT/ST)
• Registered Dietician
• Pharmacist– Ancillary/Complimentary Therapies
Medical Supplies
Supplies related to the terminal illness are covered
Examples may include:•Wheelchair•Walker•Oxygen•Wound care•Incontinent products•Dressings•Ostomy supplies•Other
Medications and Treatments
• All medications and treatments related to the terminal and “related” conditions are covered as approved by hospice
Who Pays for Hospice Care?
• Medicare• Medical Assistance• Most Insurance
Plans• Private Pay• Several Long Term
Care Insurances
The Reality as Expressed by Many Patients
• “I wish I had enrolled in hospice sooner”
• “I didn’t realize all the support hospice offered”
• “Why didn’t my doctor tell me about hospice?”
• “Why didn’t I know about hospice?”
The Reality as Expressed by Many Families• “ I didn’t realize all the support hospice
could offer me”
• “The value of being able to contact a nurse 24/7 was such a comfort”
• “I had no idea hospice would provide my family with grief support”
Questions
Contact Information
• XXXXXXX
• XXXXXX
Stratis Health is a nonprofit organization based in Minnesota that leads collaboration and innovation in health care quality and safety, and serves as a
trusted expert in facilitating improvement for people and communities.
This template was prepared by Stratis Health, the Quality Improvement Organization for Minnesota, under a contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the US Department of
Health and Human Services. The contents presented do not necessarily reflect CMS policy. 10SOW-MN-SIP TRUE HOSPICE-14-30 031114