Name of the Procedure:

Hospice Care in Skilled Nursing Facility (SNF)
Commonly referred to as Hospice Care in a Nursing Home, Technical term Q5004.

Summary

Hospice care provided in a skilled nursing facility (SNF) involves a comprehensive approach to end-of-life care for patients residing in a nursing home. This type of care focuses on palliative treatment to enhance quality of life, manage pain, and provide emotional and spiritual support.

Purpose

Hospice care in an SNF addresses terminal illnesses where curative treatment is no longer effective or desired. The primary goals include:

• Alleviating pain and other distressing symptoms.
• Offering emotional and spiritual support to both the patient and their family.
• Ensuring the patient has a dignified and comfortable end-of-life experience.

Indications

• Patients diagnosed with a terminal illness with a prognosis of six months or less if the disease follows its normal course.
• Frequent hospitalizations or emergency room visits for the terminal illness.
• Patient's or family's decision to forego curative treatments in favor of comfort care.

Preparation

• There are no specific fasting or medication adjustments required.
• A thorough evaluation by the hospice team, including a review of medical history and current health status.
• Coordination with the patient's current healthcare providers and the skilled nursing facility staff.

Procedure Description

• The hospice team, comprising doctors, nurses, social workers, chaplains, and volunteers, collaborates with the SNF staff.
• The nursing team provides around-the-clock medical care and pain management.
• Social workers and chaplains offer emotional and spiritual support.
• Regular assessments to adjust care plans according to the patient's needs.

Tools and Equipment:

• Medical supplies for symptom management (e.g., pain medications, oxygen).
• Mobility aids if required (e.g., wheelchairs, walkers).

Anesthesia or Sedation:

• Typically not required, unless for specific medical interventions for comfort care.

Duration

Hospice care continues as long as the patient is eligible, typically up to six months or longer if necessary, based on continuous eligibility assessments.

Setting

Provided within a skilled nursing facility (SNF), which is a specialized healthcare facility offering high-level nursing care.

Personnel

• Hospice physicians
• Registered Nurses and Licensed Practical Nurses
• Social workers
• Chaplains or spiritual care providers
• Trained hospice volunteers
• SNF staff (nurses, aides, etc.)

Risks and Complications

• Potential for medication side effects, such as sedation or nausea.
• Emotional stress for patient and family.
• Managing complex symptoms or advanced care directives can be challenging.

Benefits

• Improved quality of life through effective pain and symptom management.
• Emotional and spiritual support for patients and families.
• Reduction in unnecessary hospital visits and invasive treatments.
• Enhanced patient dignity and comfort during the end-of-life phase.

Recovery

• Post-procedure care focuses on continuous symptom management and support.
• Regular visits and phone check-ins with the hospice team.
• Coordination with SNF staff for consistent care.
• No recovery time as this care pertains to end-of-life.

Alternatives

• Home-based hospice care: suitable for patients wishing to remain at home, involving similar services but in a non-institutional setting.
• Palliative care: different from hospice, this can be provided alongside curative treatments earlier in the disease course.

Patient Experience

• The patient might experience relief from pain and symptoms through medication.
• Emotional and spiritual support might provide comfort and peace.
• Any pain or discomfort is addressed promptly by the hospice team.
• The environment is focused on making the patient as comfortable as possible during their remaining life.