Coordinating Care at the End of Life: The Role of Hospice.

Introduction Nine Modules Course Objectives Faculty Approval / CE Certifications Technical Requirements Refund Policy Demo To Order

Introduction

The American Hospice Foundation (AHF) announces a new electronic self-study course for nurses, social workers and other health professionals who provide case management or discharge planning services for people with terminal illness. Available on CD-ROM, the course is designed to help healthcare professionals better understand the role of hospice in providing high quality care in the last stage of life. The course focuses on communication skills to initiate advance care planning and to reach consensus on end-of-life care decisions with patients, families and physicians.

AHF developed this course for clinicians who are strategically positioned to facilitate referrals to hospice and to improve the management of pain and other end-of-life complications. A study reported in the January 7, 2004 issue of the Journal of the American Medical Association shows that “bereaved family members of patients with home hospice services (in contrast to the other settings of care) reported higher satisfaction, fewer concerns with care, and fewer unmet needs.” (Teno et al., pp 88-93) In this study, care provided to patients receiving home hospice services was rated by their family members as “excellent” more than 70% of the time “compared with less than 50% of those dying in institutional settings or with home health services.”

Yet, despite the fact that it is widely available, hospice is under utilized across the country. (Last Acts, Means to a Better End: A Report on Dying in America Today, November 2002) Among the most significant barriers to hospice care are --

1) lack of public awareness and understanding of hospice, and

2) the reluctance of health professionals to discuss end-of-life options with their patients.

• The Need for Hospice
• What is Hospice
• Symptom Management
• Hospice Insurance Benefits
• Planning Ahead
• Discussing Hospice
• Comprehensive Assessment for Hospice
• Cultural Issues
• Looking Forward

1. Cite specific study results that demonstrate the need for hospice.
2. Describe how the length of stay is decreasing while the number of hospice programs is growing.
3. Identify common misperceptions about hospice.
4. List and discuss the principles of hospice care.
5. Describe historical patterns of illness and goals of care.
6. Explain the goals of hospice care and why early intervention is desirable.
7. Identify common end-of-life symptoms.
8. List effective drugs and other therapies.
9. Identify common misconceptions about drug therapies.
10. List Medicare covered services.
11. List services that are not covered by Medicare.
12. Compare typical commercial insurance coverage with the Medicare hospice benefit.
13. Distinguish the types of advance care planning and the associated documents.
14. Explain how to use advance care planning as an opportunity to introduce hospice to patients and families.
15. Describe when and how to introduce the idea of hospice care to

• patients,
• family members,
• physicians and
• other healthcare team members.

• Hospice medical director for 19 years
• Nationally recognized EPEC trainer (Education for Physicians on End-of-Life Care)
• Past President of the American Academy of Hospice and Palliative Medicine
• Founding Chairman of the American Board of Hospice and Palliative Medicine
• Formerly the Chief of Staff at the Amarillo, TX, Department of Veteran’s Affairs (VA) Medical Center, where he was involved with the A’s National Hospice Initiative
• Certified by the American Board of Hospice and Palliative Medicine, the American Board of Pediatrics, the American Board of Pediatric Endocrinology, and the American Board of Human Genetics (Clinical Genetics)