Hospices are increasingly challenged with enrollment of patients with advanced care needs. Often these care needs are in conflict with the hospice philosophy where patients are expected or required to forego all disease modifying treatments. These treatments include chemotherapy, radiation, surgery, dialysis, pulmonary ventilation, enteral and parenteral feeding. This presents a significant decision making dilemma for patients and their families who may not be ready to give up on treatment. Patients with a prognosis of 6 months or less are entitled to elect the hospice benefit, yet many hospices will not accept these eligible patients unless their treatment plan is changed.
Hospices are increasingly opening their hearts and minds to enrolling patients with advanced care needs. Yet there is a need for hospice clinicians who will manage the care of patients with these therapies. This care involves:
- Intimate knowledge of standards of care for the terminal illness
- Relationship building skills with patients, families, the interdisciplinary team and the primary care team
- A process for approval of therapies
- A way to deliver the care efficiently and effectively keeping all the parties involved informed and happy with the plan.
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