unity point palliative care services. ipost iowa physician orders for scope of treatment
TRANSCRIPT
Unity Point Palliative Care Services
Ipost Iowa Physician Orders for Scope of Treatment
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Palliative Care
Health Palliative Care Hospice
Who is appropriate for palliative Care
Life limiting disease COPDCHFCancer
Frequent admissions
Goal clarification Symptom
management Support and
education IPOST completion
Services
Provided Goal clarification Ipost development Symptom
management Education/ chronic
disease management
Coordination of care
Not provided Skilled nursing
visits Lab draws Physical therapy
(*can be in addition to home care)
Who pays for palliative care Some insurance pay for palliative care Patients are not billed if service is not
covered Patient would pay a co-pay (same as
clinic visit) if seen by the ARNP
Hospice care Statistically, patients who are hospice
appropriate and elect hospice services live longer. (Journal of pain and symptoms management Vol. 33 No. 3 March
2007) Palliative care offers a seamless
transition into hospice when appropriate and when patient requests.
“I don’t think my patient is ready for palliative care!”
66 year old male 66 year old male patient with ESRD on
dialysis with COPD. Presents to the hospital with respiratory failure. He is in the ICU on Bipap. He is a “full code”.
Is he “ready” for palliative care?
74 year old male patient 74 year old male with diabetes and
obesity. Presents to clinic with intractable pain. Work up identifies multiple metastatic lesions.
Is he “ready” for palliative care?
Hospice Is your patient hospice appropriate? Prognosis of 6 months or less without
aggressive treatment Patients who are not going to continue
with dialysis, chemotherapy, or other life sustaining treatments.
90 year old female 90 year old female with CHF, COPD,
history of lung CA. Oxygen dependent. Symptoms of shortness of breath at rest. Patient reports that it is her goal to stay out of hospital and remain comfortable.
Is she hospice appropriate?
66 year old male 66 year old male patient with morbid
obesity, COPD, and CAD. Multiple hospital admission in last 3 months requiring mechanical ventilation. He is now refusing further intubation.
Is he hospice appropriate?