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Flashcards in Hospice/Palliative Care Deck (20):
1

what is an advance directive

written instructions before need of med trt
allows informed consent when no longer able to give
refusal/agreement of trt

2

types of advance directives

living will
durable power of attorney
DNR
DNI
DNH (hospitalize)
Tissue/Organ Donation

3

advance directives - 1 approach, 5 wishes

person i want to make decisions if i cant
kind of med trt i want or don't want
how comfortable i want to be
how i want people to trt me
what i want loved ones to know

4

what is POLST

physicians orders for life sustaining treatment, began in91

5

is POLST a living will

no

6

what is palliative care

decreased severity of symptoms, not cure
trt symptoms not the disease
doesn't hasten or postpone death - regards dying as normal process
beyond the hospital - spreading to the community

7

primary goal of palliative care

optimal quality of life - comfort (physical, mental, emotional, spiritual)

8

secondary intention of palliative care

quantity of life

9

can you still receive curative trt while receiving palliative care

yes

10

is hospice a form of palliative care

yes - more supportive than palliative

11

focus of hospice

caring, not curing - quality of life

12

hospice requires

physician certifies terminal illness (less than 6 mos)

13

hospice team

interdisciplinary

14

benefits of hospice

pain/symptom mgmt
less hospitalizations
fewer procedures
increased care
bereavement support up to 13 months

15

eligibility for hospice

weight loss (sudden, progressive)
infection (freq)
hospitalizations (freq)
chg in mental status
decline in ADL
poor endurance (increasing)
cxr dx w/o trt
profound weakness/fatigue
difficulty swallowing
inability to take food/fluid
pt wants no more trt

16

most hospice care is received

in the home

17

benefit period for hospice

90 days, 90 days, unlimited 60 days

18

4 levels of hospice care

routine - not in crisis, conventional type
inpatient - controlled environment for monitoring
respite - provides caregiver breaks
continuous care - adjustment to crises period in home

19

hospice documentation for medicare

document to the decline - why services are needed, why they are paying for services
care planning

20

who must certify patient at terminally ill

attending and hospice medical director - BOTH