Patient Questions and Hospice Myths
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Transcript of Patient Questions and Hospice Myths
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Patient Questions and Hospice Myths
Presented by: XXX
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Introductions
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Local Project Hospice Lead(s)• Insert from Speaker Notes
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Stratis Project Team
Stratis Health Staff Janelle Shearer, RN, MA, CPHQ, Program
Manager Laura Grangaard, MPH, Research Analyst
Subject Matter Experts Barry Baines, MD Lores Vlaminck, RN, BSN, MA, CHPN
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Objectives• Overview of the TRUE project• Explore strategies for discussions with your
physician regarding your serious illness• Describe the Medicare hospice benefit and
services
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Targeting Resource Use Effectively (TRUE)
Goals:– Increase appropriate referrals to hospice– Increase the length of stay of hospice patients
(days of care)
How: By forming multidisciplinary community based teams to implement strategies to address barriers to optimal hospice use in the XXXXX community
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THE REALITY, THE PROBLEM, AND THE RESULT
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Is There an Elephant in the Physician’s Exam Room?
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The Gap: Having The Talk
• Patients and their families think that if they have a serious illness, their doctor will start the talk about hopes and goals for care
• Doctors say that they will have these talks if their patients bring up the topic first
• Doctors and their patients both think that having these talks are important
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Reality
Persons have a Serious illness
Problem
Neither the patient nor the physician are talking about it
Result
Frequently, these talks aren’t taking place or they happen in a crisis situation
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Opportunities: Having “The Talk” Sooner
•For Patients:– Encourage patients to ‘ask their doctor’ if they
have a serious illness
– Provide a list of specific questions to initiate “the talk” (see patient brochure)
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Patient Questions:
• Do I have a serious or life-limiting illness?
• Can my illness be cured?• If my illness can’t be cured, are there
treatments that can slow down my illness?
• What kind of care is available to focus on making me comfortable?
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Patient Questions:
• If my illness keeps getting worse, when is it a good time to think about getting supportive and comfort focused care?
• Will you be the one to tell me when to contact hospice?
• Will you stay involved with my care even when I am no longer looking for treatment for my disease?
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Shared Decision-Making
Between Physician and Patient:• Physician’s Responsibility: Inform
and recommend best treatment option(s)
• Patient’s Responsibility:
To choose or refuse treatment option(s)
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MYTHS AND REALITIES ABOUT HOSPICE
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Myth
• I have to give up my primary physician upon hospice enrollment
Reality
• Hospice encourages you to keep your primary (usual) physician
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Myth
• All my medications and treatments will be discontinued
Reality
• The hospice team, along with your primary physician reviews all medications and treatments to meet your wishes for comfort.
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Myth
• I have to pay for hospice
Reality
• For those that meet the hospice eligibility criteria for Medicare, Part “A” covers hospice at 100% without a co-pay or deductible. Most health plans do the same..
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Myth
• Hospice is a place I must go to.
Reality
• Hospice is a team of professionals and volunteers that come to the place you call “home.” They bring their expertise, care and supplies to you.
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Myth
If I enroll in hospice, I will die sooner.
Reality
Actually, research shows people with some diseases live longer if they are enrolled in hospice than if they aren’t.
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Who Qualifies for Hospice Care?• Terminally ill persons whose life
expectancy is six months or less given the current progression of their disease process (any age-any diagnosis)
• Patient is seeking palliative care rather than curative treatment
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Hospice Team Members
Core Team Members•Medical Director/Attending Physician
•Nurses (RN on-call 24/7)
•Social Worker
•Chaplain/Counselor
•Volunteers (Active and Bereavement)
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Hospice Team Members
• Hospice Aide
• Therapies (PT/OT/ST)
• Registered Dietician
• Pharmacist– Ancillary/Complimentary Therapies
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Medical Supplies
Supplies related to the terminal illness are covered
Examples may include:•Wheelchair•Walker•Oxygen•Wound care•Incontinent products•Dressings•Ostomy supplies•Other
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Medications and Treatments
• All medications and treatments related to the terminal and “related” conditions are covered as approved by hospice
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Who Pays for Hospice Care?
• Medicare• Medical Assistance• Most Insurance
Plans• Private Pay• Several Long Term
Care Insurances
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The Reality as Expressed by Many Patients
• “I wish I had enrolled in hospice sooner”
• “I didn’t realize all the support hospice offered”
• “Why didn’t my doctor tell me about hospice?”
• “Why didn’t I know about hospice?”
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The Reality as Expressed by Many Families• “ I didn’t realize all the support hospice
could offer me”
• “The value of being able to contact a nurse 24/7 was such a comfort”
• “I had no idea hospice would provide my family with grief support”
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Questions
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Contact Information
• XXXXXXX
• XXXXXX
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Stratis Health is a nonprofit organization based in Minnesota that leads collaboration and innovation in health care quality and safety, and serves as a
trusted expert in facilitating improvement for people and communities.
This template was prepared by Stratis Health, the Quality Improvement Organization for Minnesota, under a contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the US Department of
Health and Human Services. The contents presented do not necessarily reflect CMS policy. 10SOW-MN-SIP TRUE HOSPICE-14-30 031114