According to Medicare hospice regulations, the hospice is required to offer grief services for up to a year after the patient's death to the family and any other people included on the bereavement care plan. Direct family members and other people connected to the sick are treated equally.
The best practice for using the electronic health record in patient care is point of service documentation, which is documentation done during the patient care visit. Due to the interdisciplinary nature of hospice and palliative care, many providers may access the same record to examine collaborative notes on the same day. Inadequate recordkeeping makes it difficult for other healthcare professionals to deliver the best possible care for patients. Point of service documentation has many advantages, including improved patient care record accuracy and reduced staff burnout. Hospice personnel can enjoy personal time for self-care instead of patient care when paperwork is finished during the patient care visit rather than after hours.
A registered nurse must visit the patient's home at least once every 14 days to oversee the hospice aide's care, as required by the Medicare Conditions of Participation for Hospices. If no area of concern has been identified, the hospice aide does not need to be present during the visit.
The best course of action, considering the patient's fatal condition and incapacity to swallow pills, would be to: Hold the levo
thyroxine
Sustaining the patient on medication that they are unable to take could not be very beneficial and might even put them through needless suffering. Prioritizing comfort measures and providing supportive care that is suited to the patient's end-of-life needs is crucial for the nurse.
Family members may experience distress due to changes throughout the end of life, such as the loss of direct communication with the patient. Families should be informed that the patient's behavior—which may include guarding, sobbing, groaning, restlessness, muscle rigidity, grimacing, irritability, diaphoresis, apathy, or aggression—will then be the best predictor of pain. In addition, there is no reason to believe that pain would get worse, so continuous assessment is required. A patient who has experienced agony to the point of being non-verbal is unlikely to stop, therefore the nurse should expect that pain management must remain a priority. It is not proper to start terminal sedation just because someone has stopped speaking.
Sharing any information about your patient's condition would not be appropriate because HIPAA standards safeguard patient privacy in all venues. This not only protects your patient but also assures others that their information will be kept private should they or a loved one ever require hospice care.
To keep the patient/family centered focus, the IDT includes patients and families as members; the patient and family are included in the development of all treatment plans. In IDTs, collaboration between all team members facilitates decision-making; the medical director is not the sole leader. Hospice IDTs—not palliative IDTs—must have a volunteer, per CMS regulations. Professional disciplines are not interdisciplinary when they work individually; rather, they function as a multidisciplinary team, often overlapping in duties and working in dependence on one another.
In general, withholding or withdrawing therapy, commonly referred to as letting natural death, might be morally acceptable and decided by the patient, their legal representative, or both. An ethics committee meeting may be useful to clarify the issue, but it is not necessary for the interdisciplinary team to take the initiative to withhold or withdraw therapy.
When scheduled by the hospice team, the Hospice Medicare and Medicaid Benefit covers outpatient services including ER visits. The benefit does not pay for lodging for hospice patients in private homes or nursing homes, prescription medications, or treatments aimed at curing terminal illnesses. Apart from the patient's regular physician or nurse practitioner who is selected to serve as the hospice care's attending physician, the benefit also stipulates that all care for the terminal disease must be provided by the hospice provider of choice.
Holding the meeting at the patient's bedside would be the most effective way to involve the patient and family in the IDT conversation in the hospice house setting. This would enable everyone to take part in the patient's room's privacy.
The hospice social worker would be the IDT member most qualified to assist a patient and family who are experiencing financial difficulty. Hospice social workers have a special understanding of available community services and the skills to use them.
