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Palliative Care: 10 Facts To Know

By News

What Is Palliative Care?

Palliative care is an approach that improves the quality of life of patients (adults and children) and their families who are facing problems associated with life-threatening illness. It prevents and relieves suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual.

This care is a crucial part of integrated, people-centered health services, at all levels of care: it aims to relieve suffering, whether its cause is cancer, major organ failure, drug-resistant tuberculosis, end-stage chronic illness, extreme birth prematurity or extreme frailty of old age.

Fact 1: Palliative care improves lives

Worldwide, only about 14% of people who need care currently receive it. The quality of life of patients and their families who are facing problems associated with life-threatening illness, whether physical, psychosocial or spiritual are greatly improved by palliative care.

Fact 2: Pushing policy will drive palliative care forward

World Health Assembly resolution 67.19 on strengthening palliative care, adopted in 2014, emphasizes the need to create national care policies, to ensure secure access to opioids for pain relief, training for all health care staff in palliative care, and the integration of palliative care services into existing health care systems.

Fact 3: Most people in need of palliative care are in their own homes

Therefore, the most effective models of palliative care link supervised home care and care at community health centres to hospitals with more palliative care expertise.

Fact 4: Palliative care benefits everyone

Patients during treatment for serious illnesses, not only patients at the end of their lives, can take advantage of what palliative care can offer. For example, it can improve the quality of life of patients receiving radiation therapy for cancer or chemotherapy for cancer or drug-resistant tuberculosis.

Fact 5: Oral immediate-release morphine is an essential palliative medicine

Opioid laws and prescribing regulations must balance the prevention of illegal use of opioids with ensuring accessibility to morphine to relieve moderate and severe pain.

Fact 6: Children have little access to palliative care

They are at a higher risk than adults to face inadequate pain relief. For children, 98% of those needing palliative care live in low- and middle-income countries with almost half of them living in Africa.

Fact 7: Palliative care is “people-centered”

For example, it respects the values and confidentiality of patients, seeks to protect patients and their families from financial hardship due to the illness, and provides emotional support both during the illness and for the bereaved.

Fact 8: Palliative care shows global disparity

Lack of access to palliative care and pain control is one of the largest inequalities in global health. Most people in high-income countries have access, but only a small percentage of people in low- and middle-income countries do. Each year an estimated 40 million people are in need of palliative care, 78% of whom live in low- and middle-income countries.

Fact 9: The need for palliative care has never been greater

It continues to grow with the increase of chronic diseases and people living to an older age.

Fact 10: Integrating home care has multiple benefits

Palliative care that includes home care can improve the quality of life of patients and their families while also saving money for health care systems by reducing unnecessary hospital admissions.

Long Term Care

10 Things To Know About Hospice Care

By Uncategorized

Learn what Hospice Care means and contains.

Nurse helping elderly man in hospice careDeath comes in many forms. It may arrive suddenly without warning or approach slowly after a long illness. In the latter case, families have time to prepare for the inevitable. What’s more, they may have access to hospice care, which can simplify life by bringing doctors directly to patients and providing myriad support services.

Unfortunately, not everyone who is eligible makes use of hospice. “The truth is half of patients never get hospice at all,” says Joe Rotella, chief medical officer with the American Academy of Hospice and Palliative Medicine. “What we see is patients either avoid hospice or call it very late.”

Some people may not use hospice because they are unaware or misunderstand it. Other times, people may not want to go into hospice because it means ending all attempts to cure a patient. “A lot of times, doctors are reluctant to give up,” says Ellen Windham, author of “Hospice: The Last Responder,” a guide to hospice care.

When the end is in sight, here are:

10 things hospice experts say seniors and their family members should know.

1. Hospice is not a place but a type of care. While it’s true some hospice organizations operate facilities, hospice itself refers to a type of comfort care that can be provided in any setting. “A team of professionals provide emotional and spiritual support to a patient and family anywhere,” says Richard Fife, president of the Foundation for End-of-Life Care.

2. Medicare pays for almost everything. Seniors who receive Medicare will find their hospice care is covered almost completely. That coverage includes everything from doctors and nurses to social workers and homemakers. Patients must pay a $5 co-payment for prescriptions and 5 percent of the Medicare-approved amount for respite care, should they need it. In exchange for this level of coverage, Medicare stops paying for any medical care outside of hospice.

3. You need to have a life expectancy of six months or less. Under Medicare rules, a hospice doctor and a person’s primary care doctor need to certify a person has a life expectancy of less than six months before hospice care can begin.

4. If you live longer, that’s OK. Six months or less is the life expectancy required to enter into hospice, but estimating a person’s lifespan is an imperfect process. “It’s not always easy to predict for a patient with Alzheimer’s, for example, when they’ve entered their last six months of life,” Rotella says. As a result, it’s possible for some people to remain in hospice long after six months have come and gone. Michelle Riddle, a patient advocate at Complete Dignity in Phoenix, says people don’t need to worry about losing their coverage if they do outlive expectations. “If you haven’t passed in six months, they don’t cut you off.”

5. It isn’t only for those with certain illnesses. Some people might mistakenly believe hospice is only for those with certain diseases, such as cancer. However, this type of care can be used by people of all ages with terminal illnesses of any kind.

6. Hospice is about more than medical care. A critical component of hospice is the support services they provide to family members. “Loved ones don’t have to run out to the drug store to get supplies,” Riddle says.

Hospice organizations are available 24/7 with on-call nurses and doctors who can make home visits at whatever time they are needed. Plus, hospice staff coordinates prescriptions, arranges for respite care and meets other needs families might have. Once people are able to stop juggling appointments or worrying about the logistics of their care, they may find their quality of life increases.

“People equate hospice with immediate death, Windham says. However, she advises people enter into this care as early as possible. “Going into hospice sooner rather than later gives patients and family members more quality time together.”

7. Services continue after someone dies. After a person passes away, hospice typically offers grief counseling or other bereavement services to family members. “Many hospitals have a chaplain, but that doesn’t mean you’re going to get the emotional support you get with hospice,” Fife says.

8. You can choose the hospice you want. Hospice isn’t offered by a single entity, but is a form of care offered by thousands of providers. In 2014, there were 4,000 hospice care agencies in the country, according to the Centers for Disease Control and Prevention. “A lot of nursing homes have a hospice they use, but it’s OK to pick a different one,” Windham says. She recommends families interview at least two hospice providers before making a choice.

During those interviews, the most important question may be to ask whether the hospice is Medicare-certified. If not, Medicare won’t pay for its services. Beyond that, patients and families should ask about the type of services provided, frequency of care and who will serve as the family’s point of contact. “If they are getting irritated with your questions, look at a different hospice,” Riddle says. “Don’t be bullied into a choice you don’t want.”

9. More transparency may be coming to hospice organizations. The government doesn’t publish hospice information for consumers as it does for nursing homes. That may be changing, Rotella says. It could be years before it’s fully implemented, but a move is underway for Medicare to publish quality measures of hospice organizations to make the process of selecting one easier for consumers.

10. Hospice is focused on life, not death. Entering hospice might feel like quitting on life, but those who work in the field say accelerating death is not the focus of this type of care. Instead, it’s intended to help people live fully and comfortably in the time they have left.

“[People] think it’s morbid and focused on giving up,” Rotella says. Instead, he says “it’s focused on quality of life while facing the reality of what’s going on with an illness.” Rather than feeling like they are at the mercy of a medical process that entails countless appointments and tests, people in hospice care may finally feel like they are back in control of how they live.

This article was written by Maryalene LaPonsie and can be found here.

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