Name of the Procedure:

Common Name: Hospice Care
Technical Term: Palliative and Supportive Care Services during the Measurement Period (HCPCS Code G9707)

Summary

Hospice care is a type of care designed to provide comfort and support to patients who are in the final phase of a terminal illness. The focus is on quality of life, rather than curative treatment, and aims to help patients live as fully and comfortably as possible.

Purpose

Hospice care addresses the physical, emotional, and spiritual needs of patients with terminal illnesses. The primary goal is to manage symptoms and pain, provide emotional support, and ensure that the patient's remaining time is as comfortable and meaningful as possible.

Indications

• Terminal illness with a prognosis of 6 months or less if the disease follows its usual course
• Patient and family preference for comfort-focused care instead of aggressive disease-directed treatment

Preparation

• Patients and families usually meet with a hospice team to discuss goals and preferences for care.
• Advanced care planning, including discussions about do-not-resuscitate (DNR) orders and other advance directives.
• Coordination of medication management and discontinuation of non-essential treatments.

Procedure Description

1. Assessment: Initial evaluation by a multidisciplinary team including a physician, nurse, social worker, and spiritual counselor.
2. Care Plan: Development of an individualized care plan focusing on symptom management, emotional support, and necessary medical equipment.
3. Implementation: Regular visits from hospice team members to provide medical care, monitor symptoms, and offer support.

4. Support Services: Counseling, volunteer services, and assistance with daily activities as needed.

   Tools/Equipment: Medications for pain and symptom control, medical supplies, and equipment like hospital beds and oxygen.

Anesthesia/Sedation: Not typically required, as the focus is on non-invasive comfort measures.

Duration

Hospice care continues for as long as the patient meets the criteria for hospice eligibility, typically up to 6 months, with extensions possible based on ongoing assessments.

Setting

Hospice care can be provided in various settings, including the patient's home, dedicated hospice facilities, nursing homes, or hospitals.

Personnel

• Hospice Physician
• Nurse Practitioner
• Registered Nurses
• Social Workers
• Spiritual Counselors/Chaplains
• Hospice Aides
• Volunteers
• Bereavement Counselors

Risks and Complications

• There are minimal risks, but patients might experience emotional difficulty as they transition from curative to palliative care.
• Families may need additional support to manage stress and grief.

Benefits

• Enhanced quality of life through comprehensive symptom management and emotional support.
• Tailored care that respects patient autonomy and dignity.
• Relief from the burden of aggressive medical treatments.

Recovery

• There is no typical "recovery" in hospice care; the focus is on comfort and support until end-of-life.
• Families might need continued bereavement support after the patient's passing.

Alternatives

• Continuing with aggressive, curative treatment approaches.
• Palliative care, which can be given alongside curative treatments but is not as intensive as hospice care.

Pros/Cons of Alternatives:

• Pros: May extend life, potential for disease remission.
• Cons: Higher physical and emotional burden, possible reduced quality of life due to intensive treatments.

Patient Experience

Patients can expect regular visits from the hospice team, effective pain management, and supportive care tailored to their needs and preferences. Emotional and spiritual support is readily available to both patients and their families, ensuring a compassionate and dignified end-of-life experience.