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Hospice Flashcards

(48 cards)

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1
Q

definition: a place of rest or shelter for the ill and wearly

A

hospice

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2
Q

What are the goals of hospice?

A
  • QOL
  • self-determined closure of life
  • patient/family-care independence
  • effective grieving and support for the family
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3
Q

How is hospice covered?

A

Medicare A and Private insurance

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4
Q

What are the requirements for hospice?

A

physician certification of a life-limiting illness and prognosis of less than 6 months to live

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5
Q

(true/false) Hospice care cannot exceed 6 months.

A

False (it can)

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6
Q

Can a person graduate from or discontinue hospice and then return at a later time in life?

A

Yes

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7
Q

Where do most patients pass away while receiving hospice?

A

Their place of residene

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8
Q

How many Americans receive hospice each year?

A

1.7 million

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9
Q

Majority of people receiving hospice are > ____ y/o

A

85 y/o (white females are most common)

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10
Q

What are the top diagnoses in hospice?

A
  1. cancer
  2. dementia
  3. heart disease
  4. lung disease
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11
Q

What are the four levels of hospice care?

A
  1. routine
  2. respite
  3. inpatient
  4. continuous
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12
Q

Hospice level:
- traditional hospice in patient home or facility
- intermittent services by the multi-disciplinary team

A

routine level

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13
Q

Hospice level:
- break for families when patient lives at home
- will bring the patient into SNF or a hospice house for short periods of time
- rest for the family

A

Respite level

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14
Q

Hospice level:
- hospice inpatient unit
- short stay
- acute symptom mgmt
- often at very end of life if patient is having severe pain and can not be managed
- needs extensive IV pain medication

A

Inpatient level

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15
Q

Hospice level:
- 24 hours in home or faciity
- combination of SN, HHA, LPN, and MSW
- for short periods of time to manage periods of significant disease exacerbation

A

continuous level

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16
Q

definition:
Legal Document that contains information regarding what care you want at end of life

  • Emergency persons may not follow because it is not a physician order
  • Need to have a copy with patient and in Chart
A

advanced directive

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17
Q

(true/false) advanced directives are a physician order.

A

FALSE

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18
Q

What are the two components of an advanced directive?

A
  • living will
  • POA
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19
Q

definition:
-Legal document that expresses an individual’s care wishes
- Can guide care at end of life but can be overridden by healthcare providers and power of attorney
Outlines life-sustaining interventions such as Ventilation, Feeding tubes, Dialysis

A

living will

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20
Q

definition: person legally assigned to act and make decisions for someone financially and/or medically

21
Q

definition:
Documents what medical care you want at end of life or during an emergency that can be changed any time by you and your physician

  • Will be honored by medical facilities
  • Meant for individuals with serious illness or at the end of their life
Study These Flashcards
A

POLST (physician orders for life-sustaining treatment)

22
Q

(true/false) POLST documents are not a physician order

Study These Flashcards
A

FALSE (it is)

23
Q

POLST documents are (medical/legal) documents.

24
Q

(true/false) POLST documents are available in every state.

25
Are POLST documents available in PA?
yes
26
(true/false) The 5 wishes can act as a living will completed by the patient AND family.
True
27
definition: multidisciplinary and holistic assessment and management of physical, psychosocial and spiritual symptoms, with the goal of alleviating suffering
palliative care
28
What is the goal of palliative care?
pain and symptom management
29
Palliative care (is/is not) paid for by hospice benefit
is not
30
(true/false) Palliation of symptoms is part of hospice but the program entitles "palliative care" is different.
true
31
Who covers palliative care program costs?
Medicare A or B (depending on location) --> some private insurances (EX: highmark includes this as a member benefit)
32
Where is palliative care provided?
- hospital - outpatient facility - home health - nursing homes
33
What is considered as a bridge to hospice for patients?
Palliative care
34
Who makes up the hospice team?
Physician RN MSW Therapy HHA Spiritual and Bereavement support Volunteers
35
Who makes up a palliative care team?
Medical Model Lead by physician or NP
36
What is the description of cancer trajectory for functional decline?
Steady decline over time w/ aggressive intervention and then has a sharp decline
37
What is the description of organ failure trajectory for functional decline?
Long term limitation with short severe periods of exacerbations followed by recovery to a lesser extent
38
What is the description of frailty/dementia trajectory for functional decline?
Slow steady decline with intermittent social and medical complications triggering more decline
39
definition: Palliative Care/Hospice documentation of patient decline over time that includes: - Ambulation - Evidence of the disease - Self care - Food Intake - Level of Consciousness
Palliative Performance Scale (PPS)
40
What is the most common assessment tool in hospice that can bbe used with ALL patients at ALL stages?
Palliative Performance Scale (PPS)
41
(true/false) You can move in multipe directions on the PPS scale
true
42
(true/false) you can move in multiple directions on the Functional Assessment Scale (FAST)
False
43
definition: Assessment scale that was developed in 1984 to help identify Alzheimer’s/dementia patients at end of life: Seven Stages of development: - Normal without decline - Normal with mild memory loss - Early stage dementia - Mild dementia - Moderate dementia - Moderately severe dementia - Severe dementia
Functional Assessment Scale (FAST)
44
definition: Examines patient symptoms - Valuable in determining effectiveness of interventions - Nine symptoms assessed on scale of 0-10
edmonton symptom assessment scale (ESAS)
45
definition: Reliable and valid tool for assessing the impact of care giving that can be helpful for goal setting especially in case management brief and easy to use Measures strain in 5 major domains: Financial Physical Psychological Social Personal
caregiver strain index
46
(true/false) The end of life disease trajectory for functional decline is predictable for several diagnoses
True
47
_____ tools play a role in managing patients at the end of life
Evidence based tools
48
The ____ model provides a model of intervention based on disease trajectory.
Briggs Palliative Care Model

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