Lancaster Physician Fall 2019 - 25

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here are many misconceptions
about hospice care, such as: it's a
sign of giving up, it means being
unable to keep your own doctor,
and it doesn't allow you to get other medical
care. All of these are false. In reality, hospice
care is not about dying; it's about receiving
quality care to live for every last moment.
Benefits of an Early Referral
"There is fear and concern about being
referred to Hospice too early," commented Dr.
Maria Hayes of Hospice & Community Care.
"Fear that not all things have been tried. Fear
that someone has given up hope. Being referred
to Hospice at the appropriate time, allows the
patient and family to be taken care of by a team
of well-trained individuals whose focus is on
what is important to the patient and family at
a very vulnerable time in their lives. The team
provides guidance through the many facets of
their journey-symptom management, disease
process, emotional support, spiritual support,
and financial stress."
Benefits include:
* Goals - When a patient has days or hours
to live, emotions are high for everyone
involved. When physicians are able to meet
with the patient and family in the early
stages of an illness, the conversation is easier
and ensures that patient's wishes are heard.
* Avoid Emergency Rooms - Let's face it; no one
enjoys being admitted to the hospital. When a
patient is receiving end-of-life care they want
to be in the comfort of their own home and
surrounded by caregivers with whom they have
relationships. When an individual is referred
to hospice care early, they and their caregivers
are given the tools and resources needed,
including access to a nurse 24/7, to avoid an
emergency room visit or hospital admission.
* Help with Quality and Performance Metrics
- In today's demanding health care environment, medical professionals feel pressure

Indicators for a
Referral to Hospice
* An increase in pain, nausea,
or breathing distress
* Repeated hospitalizations or trips
to the emergency room
* Failure to "bounce back" after
medical setbacks
* Decrease in function requiring
assistance walking, eating,
bathing, dressing, and/or going to
the toilet
* Decreased alertness - Patient is
emotionally withdrawn, sleeping
more, or having increased difficulty with comprehension
* Significantly decreased appetite
and weight loss

to meet quality metrics. Referring a patient
early to hospice care can help them to exceed
these goals. By providing personalized care to
improve patient quality of life, hospice care
can help them meet the medical, spiritual,
and emotional needs of their patients. By
offering high levels of care for acute symptom
management, it can reduce 911 calls as well as
readmissions, mortality rates, and the overall
length of stay in the hospital setting.
"We are proactive in getting Hospice &
Community Care as early as possible," commented Dr. R. Scott DeLong of Penn Medicine
Lancaster General Health Physicians Geriatrics.
"They are great at supporting the patient, family,
and staff. Our staff are not always comfortable
with end-of-life care, and Hospice helps as an
extra layer of support and education."
Physician Collaboration
"Understanding the changes that occur during
the dying process is complex, and Hospice &

Community Care helps us walk this journey,"
shared Dr. DeLong. "I have seen an improvement in our staff's knowledge because of Hospice
& Community Care's early involvement."
When an individual seeks hospice care,
their family doctor or specialist is encouraged
to remain engaged in their care. The Hospice
physician works closely with the patient's
doctor-who knows them better (medically)
than anyone else-to determine the specific
medical needs that will be addressed in their
individual plan of care.
"I especially like it when I can meet the
patient and family along with the Hospice &
Community Care staff," shared Dr. DeLong.
"These mini team meetings show the patient
and family that we are all on the same page and
helps to put them at ease."
Making a Referral
Often, a physician is the first to mention the
possibility of hospice care; however, some
physicians hesitate to bring it up because they
sincerely want to preserve hope for a cure.
Frequently, physicians will continue to pursue
treatment because they think that is what the
patient and family want. Hospice is an option
for comfort, and it is important that patients
and their doctors talk openly and share the same
goals for maintaining quality of life.
"I disagree with some of my colleagues who
think they can do hospice and palliative care
on their own," commented Dr. DeLong. "I
find that Hospice & Community Care staff
are very easy to work with, and I feel supported
in knowing that they are advocating for my
patients' plan of care."
Because hospices consistently hear from their
patients and families that they wish they would
have sought them out sooner, it is a good idea
for patients to let their physicians know at the
time of diagnosis that they are open to discussing end-of-life care at the appropriate time. It's
important to know that patients and families
have a choice in their hospice care provider.

Find out more about the variety of options available for patients living with serious illness or how to
request an assessment by visiting Hospiceprofessional.org or by calling (844) 422-4031.
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http://www.Hospiceprofessional.org

Lancaster Physician Fall 2019

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