Continuum of Care Presentation final Essay Sample

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What is hospice care?

Hospice care focuses on improving the quality of life for persons and their families faced with a life-limiting illness.
The primary goals of hospice care are to provide comfort, relieve physical, emotional, and spiritual suffering, and promote the dignity of terminally ill persons.
Hospice care neither prolongs nor hastens the dying process.
Hospice care is a philosophy or approach to care rather than a place.
Care may be provided in a person’s home, nursing home, hospital, or independent facility devoted to end-of-life care.

NHPCO (The National Hospice and Palliative Care Organization.) (Torpy, Burke, Golub (2015)

Affirms life
Regards dying as normal process
Neither hastens nor postpones death
Relives pain and other symptoms
Integrates medical, psychological, and spiritual aspectsof care
Offers a support system to patients and families

(Torpy, Burke, Golub (2015)

When is Hospice Care Appropriate?
A referral to hospice is appropriate when the patient and family have opted for palliative treatment for life-limiting or “terminal” illness.
Medicare guidelines further require that the physician has determined that life expectancy is six months or less if the disease follows its normal course.
(Hospice Association of America) The Hospice Association of America Nov. (2010  Hospice core services

Hospice core services must be routinely provided by the hospice, and cannot be delegated to the facility.
Hospice core services include:
Physician services
Nursing services
Social work services
Counseling services

Bereavement and spiritual
 Dietary

The hospice team is an interdisciplinary team (IDT) and together, they coordinate the patient’s plan of care.

The National Hospice and Palliative Care Organization.(2015)

Where is hospice care provided?
Hospice care is a philosophy or approach to care rather than a place.
Care may be provided in a person’s home, nursing home, hospital, or independent facility devoted to end-of-life care.
Hospice was originally designed to be a non-institutional benefit. However, it is possible to receive Medicare covered hospice care while residing in a nursing home.

(Torpy J.M., Burke A., Golub R.M.. (2015)

Hospice care diagnoses

Other hospice diagnoses include:
End stage heart disease and End stage pulmonary disease
End stage renal disease
End stage liver disease
Dementia due to Alzheimer’s Disease and Related Disorders Stroke & Coma and more!

(The National Hospice and Palliative Care Organization.(2015)

Payment for hospice care
The patient’s primary physician and hospice team evaluate the patient’s eligibility for hospice care on a regular basis.

The first and second certification periods are 90 days; subsequent periods are 60 days.
If a patient no longer meets criteria for hospice care, they may be discharged and readmitted at a later

There is a Medicare hospice benefit for Medicare part A beneficiaries
All but one state (Oklahoma) have a Medicaid hospice benefit
Many commercial insurances also cover hospice care as well
Most hospices are committed to caring for all patients, regardless of an individual’s ability to pay.

(The National Hospice and Palliative Care Organization.(2015)

The steps to choosing long term care then making the right choice is challenging!

There are physical, social, and emotional factors an individual and/or his or her family must consider, not to mention cost, payment, and simply breaching the subject to initiate the process.
Set up a plan……..
Assess your needs
Research financing and care choices
Find what is right for you
Visit your available options
Meet with family to discuss
Meet with health care
Meet with the Care Choice representatives
Know the rights for family members & patients

( – Steps to Choosing Long-Term Care 2015)

Attitudes towards death and dying
 Each person has his or her

 American society tends to deny own view of death and attitude towards it
 Society as the main influencer has a huge impact on people’s perception of death
 The attitudes of the society towards death have been changing over the time
 Fear has always been one of the most common attitudes towards death
 Attitudes towards death change over the lifetime of the person the reality of death.
 Previous experiences with death
 Circumstances of death
 Some medical professionals view death as a failure
 Cultural factors can significantly influence patients’ reactions to their illness and the dying process.
 There are many different religions and belief systems across the world. Each holds an individual view of death and mourning.

(Levine C, Halper D, Peist A, Gould D A, (2010)

Smoothing the Transition
 Clear communication and cooperation between both types of caregivers is a must.

Both family and professional full communication is the key to a smooth transition.  Improved transitional care depends on family caregivers’ and the involvement. It is true that explicit attention to family caregivers is absent.  In order for the ability to develop strong relationships with the family caregivers and provide necessary training, the support throughout the continuum of care should be defined as a core competency for all health care professionals and built into the educational tools provided.

(Levine C, Halper D, Peist A, Gould D A, (2010)

The Hospice–facility Partnership Means Respite Care
Successful partnerships between families and a Hospice nursing facility can be long term or short for a respite time. There should always be consistent communication, coordination, and documentation.
These are keys for the success that will give the provision of high quality and coordinated end of life care!

(The National Hospice and Palliative Care Organization.(2015)

from one whole
to the loss of a
leaves an
empty spot.

Bereavement after patient death…..

Every hospice program offers bereavement services to family and loved ones for a minimum of 12 months following the death of a patient.

Bereavement Services are available to Family and More!
(Oliver, (2006)


Harrington C., Carrillo H, Woleslagle B B, O’Brian T, 2010 Nursing Facilities, Staffing, Residents and Facility Deficiencies, (2004 Through 2009), Table 4., Retrieved from

Harrington C., 2008 State Data Book on Long Term Care retrieved from
Hospice Facts & Statistics (Hospice Association of America) The Hospice
Association of America Nov. (2010) retrieved from Levine C, Halper D, Peist A, Gould D A, (2010) Bridging Troubled Waters: Family Caregivers, Transitions, And Long-Term Care, Health Affairs, 29, no.1 – Steps to Choosing Long-Term Care (2015)Retrieved from
Oliver, D.P. (2006). Inside the Interdisciplinary Team Experiences of Hospice Social Workers. Retrieved from %3dpubmed#.VVFnlsJ_nIU

Pereira J., Bruera E (1998), The Internet as a Resource for Palliative Care and Hospice. Journal of Pain and Symptom Management, Retrieved from

Report to the Congress: Medicare Payment Policy, March 2014 Retrieved from

The National Hospice and Palliative Care Organization.(2015) retrieved from Hospice Care . (2015). Retrieved from
Torpy J.M., Burke A., Golub R.M.. (2015). Hospice Care. Retrieved from

Washington, K.T., Bickel-Swenson D., Stephens N.(2008). , Barriers to Hospice Use among African Americans: A Systematic Review ,Health Social Work . Retrieved from

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