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Myth #7: Hospice requires a doctor referral. Anyone can refer to hospice for a consultation, even the patient or family. ° If the patient is deemed appropriate, an order from a physician is required before care can be performed. Myth #8: Hospice care is expensive. Most people who use hospice are entitled to the Medicare Hospice Benefit. ° This benefit covers virtually all hospice services and requires little, if any, out-of-pocket costs for hospice benefits where services are covered. Myth #9: Patients are required to have a Do Not Resuscitate (DNR) order for hospice care. ° Having a DNR in place is not a hospice requirement. Myth #10: Hospice is for when there is no hope. ° Hospice is a shift in care to focus on comfort. It does not mean there is nothing that can be done; hospice is something that can be done to help the patient maximize their time left.
Conclusion
Resources
This course provided an overview of hospice and palliative care and illuminated the importance and recent growth of this specialty area. It also included a focus on hospice services as defined by the Medicare hospice benefit, quality metrics, and the delivery of care. Increased understanding by nurses and other clinicians is crucial to providing compassionate care. The goal of hospice and palliative care is to reduce the patient’s distressing symptoms (physical, psychological, social, and spiritual), no matter how young or how old they are, and to improve their quality of life. Making appropriate and timely referrals for hospice and palliative care is one way that clinicians can prevent needless suffering for patients with life-limiting conditions.
Aging With Dignity https://agingwithdignity.org
American Academy of Hospice and Palliative Medicine http://aahpm.org American Association of Colleges of Nursing End of Life Nursing Consortium https://www.aacnnursing.org/ELNEC CaringInfo (National Hospice and Palliative Care Organization) https://www.caringinfo.org
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Center to Advance Palliative Care https://www.capc.org
Centers for Medicare and Medicaid Services https://www.cms.gov/Medicare/ Medicare-Fee-for-Service-Payment/ Hospice#:~:text=Hospice%20Levels%20 of%20Care,enrolled%20in%20the%20 hospice%20benefit.&text=A%20patient’s%20 home%20might%20be,patient%20isn’t%20in- %20crisis
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Other barriers to the delivery of hospice and palliative care include both the education and training of healthcare providers in this specialty area. The National Consensus Project for Quality Palliative Care (NCP) aims to formalize and delineate evidence-based processes and practices for the provision of safe and reliable high-quality palliative care in all care settings. 42 The overview and scope of the 4th edition of the NCP Clinical Practice Guidelines for Quality Palliative Care is to • improve access to palliative care for those with serious illness in all care settings by integrating palliative care principles and best practices into routine assessments and care; • formalize evidence-based practices for palliative care for seriously ill adults and children in all care settings; and • provide guidelines to assist in developing palliative care reimbursement mechanisms that are linked to standardized care, as payers (e.g., Medicare Advantage plans) are exploring ways to pay for better access to palliative care. 42
Dignity in Care https://dignityincare.ca/en/
Hospice and Palliative Nurses Association https://advancingexpertcare.org
Hospice Foundation of America https://hospicefoundation.org
National Association for Home Care & Hospice https://www.nahc.org
National Hospice and Palliative Care Organization https://www.nhpco.org
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