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Hospice care, in the home, per diem

HCPCS code

Name of the Procedure:

Hospice Care, in the home, per diem (HCPCS Code: S9126)

Summary

Hospice care at home provides comprehensive care to patients nearing the end of life, ensuring comfort and quality of life. This service is typically offered on a per diem (daily) basis and involves medical, emotional, and spiritual support tailored to the patient's individual needs.

Purpose

Hospice care at home addresses terminal illnesses where curative treatment is no longer effective or desired. The primary goals are to manage symptoms, alleviate pain, and support patients and their families through the end-of-life process.

Indications

  • Terminal illness with a life expectancy of six months or less
  • Significant and uncontrolled pain or symptoms due to the illness
  • Desire to remain in a home setting for end-of-life care
  • Patient and family preference for supportive care over aggressive treatment

Preparation

  • A comprehensive health assessment performed by a healthcare professional
  • Discussions between the patient, family, and healthcare team about goals and care preferences
  • Arrangements for needed medical equipment and medications in the home setting

Procedure Description

  1. Initial Assessment: A hospice nurse visits the home to assess the patient's condition, discuss care plans, and set goals.
  2. Care Plan Development: A personalized care plan is created, including pain management, symptom control, and emotional support strategies.
  3. Routine Visits: Regular visits by trained hospice staff, including nurses, aides, social workers, and chaplains.
  4. 24/7 Support: Access to round-the-clock support for emergencies or urgent needs.
  5. Medical Equipment and Medications: Delivery of necessary medical supplies and medications to manage symptoms.

Duration

This care is ongoing and provided daily as needed, depending on the patient's condition and needs.

Setting

The procedure is primarily performed in the patient's home.

Personnel

  • Hospice nurse
  • Home health aide
  • Social worker
  • Chaplain or spiritual advisor
  • Physician (for oversight and emergency consultations)
  • Volunteers (for additional support and companionship)

Risks and Complications

  • Potential for inadequate pain or symptom control, requiring adjustments in treatment
  • Stress and emotional challenges for family caregivers
  • Risk of infection or complications from medical devices or medications

Benefits

  • Personalized, compassionate care in the comfort of the patient's home
  • Enhanced quality of life through symptom and pain management
  • Emotional and spiritual support for patients and their families
  • Reduction in unnecessary hospital visits and interventions

Recovery

  • No traditional 'recovery'; the focus is on ensuring comfort and quality of life
  • Regular follow-up visits by hospice staff to monitor and adjust the care plan
  • Family education on patient care and what to expect in the final stages of life

Alternatives

  • Inpatient hospice care at a dedicated facility
  • Palliative care, focused on symptom management without hospice enrollment
  • Continued aggressive treatment or hospitalization (if preferred by the patient and family)

Patient Experience

  • Patients and families often feel a sense of relief and support
  • Physical pain and symptoms are managed with appropriate medications
  • Emotional and psychological support helps reduce anxiety and stress
  • Hospice staff provide holistic care, addressing physical, emotional, and spiritual needs

Pain and symptom relief, along with emotional and spiritual support, are central to the hospice care experience, ensuring the patient's and family's needs are met compassionately and respectfully.

Medical Policies and Guidelines for Hospice care, in the home, per diem

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