Name of the Procedure:

Hospice Care in a Long-Term Care Facility (HCPCS: Q5007) Common names: Long-term facility hospice care, Skilled nursing facility hospice care.

Summary

Hospice care provided in a long-term care facility involves comprehensive end-of-life care for patients residing in nursing homes or other extended stay facilities. The focus is on comfort and quality of life rather than curative treatments.

Purpose

This service aims to address the complex medical, emotional, and spiritual needs of terminally ill patients. The primary goal is to provide comfort, relieve pain, and support the patient and their family during the end-of-life phase.

Indications

• Advanced terminal illnesses with a prognosis of 6 months or less
• Unmanageable symptoms that require specialized care
• Inability of family caregivers to provide adequate home care

Preparation

• Assessment of the patient's medical history and current health status
• Discussion of the patient's preferences and goals for care
• Coordination with the long-term care facility staff

Procedure Description

1. Initial Assessment: A hospice care team evaluates the patient's needs, symptoms, and personal preferences.
2. Care Planning: A personalized care plan is developed involving pain management, emotional support, and spiritual care.
3. Symptom Management: Ongoing treatment to manage symptoms such as pain, nausea, and anxiety.
4. Regular Visits: Hospice team members, including physicians, nurses, social workers, and chaplains, make regular visits.
5. Family Support: Providing counseling and guidance to family members.

Tools and Equipment:

• Medical supplies for symptom control (e.g., medications, oxygen therapy)

Anesthesia or Sedation:

• Typically not required, as treatments aim for comfort using routine symptom management techniques.

Duration

Ongoing, with regular reassessments until the patient passes away.

Setting

Long-term care facility, which includes nursing homes, skilled nursing facilities, or other extended care environments.

Personnel

• Hospice physicians and nurses
• Social workers
• Chaplains or spiritual care providers
• Hospice aides
• Volunteers

Risks and Complications

• Adverse drug reactions
• Pressure ulcers due to immobility
• Emotional distress for family members

These risks are managed with continuous monitoring and a responsive care plan.

Benefits

• Enhanced quality of life in the patient's final months
• Relief from pain and other distressing symptoms
• Emotional and spiritual support for both the patient and their family

Benefits are typically realized almost immediately as symptom management begins.

Recovery

• Not applicable, as hospice care is intended for end-of-life comfort.

Alternatives

• Curative treatments: Often inappropriate for terminally ill patients with a prognosis of 6 months or less.
• Home hospice care: Suitable for patients who prefer to remain at home.
• Palliative care: Focuses on improving quality of life but not specifically for end-of-life care.

Patient Experience

Patients can expect a compassionate approach focused on comfort rather than cure. They might experience relief from pain and receive emotional and spiritual support. Pain management is tailored to the individual’s needs, and comfort measures are prioritized to ensure a peaceful end-of-life experience.