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Pulse Home Health Care practices skilled health care procedures firmly rooted in the latest research and best practice policies. We routinely mail bulletins to physicians and other medical referral sources to highlight how we help patients and to explain the scientific basis for different services. On our home health website we share selected physician bulletins about Pulse's Home Health Services. If you have questions about how home health could help you, please contact us today.

Bridging the Gap in Palliative Care


Palliative CareIn the world of Medicare defined home care programs, there exists a gap between the traditional home health program and the traditional hospice program.  To qualify for hospice, a doctor must provide a prognosis of six months or less, and a patient cannot concurrently receive treatments that are curative in purpose.  Many patients who might benefit from in-home palliative care cannot enter the hospice program because they are pursuing curative treatments, a prognosis of six months or less cannot be confirmed, or they are not ready for the hospice program for personal reasons.  The result is that doctors discuss palliative care with 46% of cancer patients, 10% of COPD patients, and 7% of heart failure patients, according to one study. 1  Pulse Home Health Care has a palliative care solution that will overcome the usual barriers to palliative care and make important care more available to your patients with advanced stage diseases.

Pulse Home Health Care’s palliative care program uses your patient’s Medicare home health benefit to deliver psychiatric nursing support, general nursing support, occupational therapy, home health aide support, and other services at no cost to your patients.  With Pulse’s palliative care program, prognosis is not an admission criterion, and your patients in our palliative care program are free to pursue any medical treatment they choose, including curative treatments. 

Important Palliative Care services include:

  • Pain and symptom management from qualified registered nurses (especially the symptoms of dyspnea, nausea, fatigue, constipation, loss of appetite, and difficulty sleeping);
  • Nutritional support and counseling;
  • Caregiver training;
  • Skilled and supportive home health services including skilled nursing care, rehabilitative therapies, and home health aides;
  • Counseling, for patient and family, around anticipatory grief, coping with the difficulties of treatment, and similar issues;
  • Education and support regarding end of life planning and advance directives.

When patients get better, they are discharged from services.  If palliative care patients worsen, doctors may refer patients to a hospice program at any time.

Receiving additional in-home palliative care services such as pain management, symptom control, nutrition, counseling, ADL support, and advance care planning assistance has been connected with important benefits.  The benefits of palliative care include improved survival of patients,1-8 greater survival of widowed spouses,9 greater emotional health of widowed spouses,10 increased family satisfaction,11 decreased financial burden on patients, and decreased healthcare spending in terms of emergency visits and unplanned hospital admissions.12,13   

References

  1. Thomas J, O’Leary J, Fried T. Understanding their options: determinants of hospice discussion for older persons with advanced illness. J Gen Intern Med. 2009; 24(8): 923-8.
  2. Keyser E, Reed B, Lowery W, et al. Hospice enrollment for terminally ill patients with gynecologic malignancies: impact on outcomes and interventions. Gynecol Oncol. 2010: 118 (3): 274-7.
  1. Connor S, Pyenson B, Fitch K, et al. Comparing hospice and nonhospice patient survival among patients who die within a three-year window. J Pain Symptom manage. 2007 Mar; 33(3): 238-46.
  2. Christakis N, Iwashyna T, Zhang J. care after the onset of serious illness: a novel claims-based dataset exploiting substantial cross-set linkages too study end-of-life care. J Palliat Med 2002; 5: 515-529.
  3. Christakis N, Predicting patient survival before and after hospice enrollment. Hosp J 1998; 13: 71-87.
  4. Connor S. Hospice: Practice, pitfalls, and promise. Philadelphia, PA: Taylor and Francis, 1998. 118-119.
  5. Forster L, Lynn J. the use of physiologic measures and demographic variables to predict longevity among inpatient hospice applicants. Am J Hosp Care 1989; 6: 31-34.
  6. Azoulay D, Jacobs J, Cialic R, et al. Opioids, survival, and advanced cancer in the hospice setting. Journal of the American Medical Directors Association. October 16, 2010; (available online ahead of print publication at http://www.jamda.com/article/S1525-8610(10)00242-2/abstract )
  7. Christakis NA, Iwashyna TJ. The health impact of health care on families: a matched cohort study of hospice use by decedents and mortality outcomes in surviving, widowed spouses. Soc Sci Med. 2003;57:465-75.
  8. Bradley E, et al. Depression among surviving caregivers: Does length of hospice enrollment matter? Am J Psychiatry 2004; 161: 2257-2262.
  9. Teno JM, Clarridge BR, Casey V, Welch LC, Wetle T, Shield R, et al. Family perspectives on end-of-life care at the last place of care. JAMA. 2004;291:88-93.
  10. Pyenson B, Connor S, Fitch K. “Medicare cost in matched hospice and non-hospice cohorts.” J Pain Symptom Manage 2004; 28: 200-210.
  11. Harrison J, Ford D, Wilson K. “The impact of hospice programs on US hospitals.” Nurs Econ. 2005; 23 (2): 78-84.

 

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2325 Severn Ave, Ste 5 Pulse Home Health CareMetairie LA 70001 Pulse Home Health Care(504) 831-7778

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