Hospice and Palliative Care Brief Overview January 10th 2017 Peggy Budai, MS, RN, CNS, NP-C Geriatric and Palliative Care - UCHealth

Hospice and Palliative Care Hospice and Palliative Care both focus on helping a person and family facing serious illness be comfortable by addressing issues causing physical or emotional pain or suffering. Hospice and palliative care providers have teams of professionals working together to provide care. The goals are to improve the quality of a seriously ill person’s life and to support that person and their family.

Primary Differences Palliative care is appropriate at any age and at any stage in a serious illness, and can be provided together with curative treatment. Hospice care is appropriate if there is a limited life expectancy of 6 months or less and the focus of care shifts from curative to focus on comfort.

Hospice Care Overview Paid for by Medicare, Medicaid, 3rd Party insurance, HMO’s, etc. Care for patients at home, hospital or long- term care facilities Most pay at 100% with no patient co-pays

Hospice Philosophy Treats the whole person-Body, Mind and Soul Switches focus of care from curative to comfort Considers the family as the unit of care Uses an Interdisciplinary Team model of care Aggressively manage symptoms – pain, nausea etc Hospice affirms life - neither hastening nor postponing death Hospice is about living life to the fullest with dignity and comfort

Hospice Care Provides Staff – Nurses, Social Workers, Chaplains, Physicians, Nurse Practitioners, Nurse Aides, Music Therapy, Volunteers Medications Treatments Medical Equipment Respite care Bereavement

Aging and How we Die First Steps Second Steps Final Steps Age in Years https://aspe.hhs.gov/basic-report/framework-identifying-high-impact-interventions-promote-reductions-late-life-disability Final Steps Age in Years

Advance Care Planning Steps First Steps - all healthy adults 18 years or older Medical Durable Power of Attorney Goals of Care for unexpected brain injury Conversations with family

Advance Care Planning Steps Second Steps - all adults with chronic/serious illness Durable Medical Power of Attorney Living Will More Conversation with family and friends about goals of care Consider completing a MOST form or a CPR Directive

Advance Care Planning Steps Final Steps – all adults who we would not be surprised if they died in the next 12 months Durable Medical Power of Attorney Living Will More Conversation with family and friends about goals of care Complete a MOST form or a CPR Directive