Healthcare Delivery & Transitions of Care
Ultimately, the care is mainly delivered by families - perhaps immediate families in the home, or new-found families of aides and nurses and volunteers in a variety of settings. One of the most stressful part of facing serious illness is the facing of these decisions: how and where to care for someone.
We know that without thoughtful discussions about these topics, patients often enter into the rapidly rotating doors of hospital-rehab-home-hospital... We also know that thoughtful discussions require us to know something about what we recommend to patients and their families or caregivers.
So we are lucky to have one of our local experts, Wendy Bower, help guide us through the bread-and-butter of healthcare delivery models and how to help ensure smooth transitions of care. Thanks also to Jennifer Reidy for working with Wendy in putting this month's curriculum together, and to Charlie Rosenbaum and Ariadne Miller who will add the hospice medical director perspective to the topics.
Topics to Consider:
We know that without thoughtful discussions about these topics, patients often enter into the rapidly rotating doors of hospital-rehab-home-hospital... We also know that thoughtful discussions require us to know something about what we recommend to patients and their families or caregivers.
So we are lucky to have one of our local experts, Wendy Bower, help guide us through the bread-and-butter of healthcare delivery models and how to help ensure smooth transitions of care. Thanks also to Jennifer Reidy for working with Wendy in putting this month's curriculum together, and to Charlie Rosenbaum and Ariadne Miller who will add the hospice medical director perspective to the topics.
Topics to Consider:
- Explore emotional, practical and economic burdens of caregiving in creating a plan of care for patients & families
- Review hospice philosophy and services based on the Medicare Hospice Benefit
- Compare and contrast hospice with non-hospice palliative care
- Understand how hospice/palliative care is different from home-based or nursing-home-based nursing care
- Introduce the PACE program
- Explain differences in hospice/palliative care benefits for children
- Review nuts-and-bolts of crafting a successful and smooth discharge plan or move from one setting to another
Articles
- Place of Death: Correlations With Quality of Life of Patients With Cancer and Predictors of Bereaved Caregivers' Mental Health Wright et al. Published online before print September 13, 2010, JCO October 10, 2010 vol. 28 no. 29 4457-4464 doi: 10.1200/JCO.2009.26.3863
- The Impact of Serious Illness on Patients' Families Kenneth E. Covinsky; Lee Goldman; E. Francis Cook; Robert Oye; Norman Desbiens; JAMA. 1994;272(23):1839-1844.
- Beyond Polarization, Public Preferences Suggest Policy Opportunities to Address Aging, Dying, and Family Caregiving Byock et al. AM J HOSP PALLIAT CARE June 2009 vol. 26 no. 3 200-208 Published online before print January 9, 2009, doi: 10.1177/1049909108328700
- Understanding Economic and Other Burdens of Terminal Illness: The Experience of Patients and Their Caregivers Ezekiel J. Emanuel, Diane L. Fairclough, Julia Slutsman, and Linda L. Emanuel Ann Intern Med March 21, 2000 132:451-459
- Hospice Care in the Nursing Home Setting: A Review of the Literature Stevenson DG, Bramson JS. J Pain Symptom Manage. 2009 Sep;38(3):440-51. Review. PubMed PMID: 19735904. doi:10.1016/j.jpainsymman.2009.05.006
- Low-Cost Lessons from Grand Junction, Colorado — NEJM Thomas Bodenheimer, M.D., M.P.H., and David West, M.D. N Engl J Med 2010; 363:1391-1393October 7, 2010
- Letting Go of the Rope — Aggressive Treatment, Hospice Care, and Open Access — NEJM Alexi A. Wright, M.D., and Ingrid T. Katz, M.D., M.H.S. N Engl J Med 2007; 357:324-327July 26, 2007
- Understanding Hospice — An Underutilized Option for Life's Final Chapter — NEJM Gail Gazelle, M.D. N Engl J Med 2007; 357:321-324July 26, 2007
- Why Health Care Is Going Home — NEJM Steven H. Landers, M.D., M.P.H.. N Engl J Med 2010; 363:1690-1691October 28, 2010