Name of the Procedure:

Common Name: Hospice Routine Home Care
Technical Term: Hospice Routine Home Care, Per Diem (HCPCS Code: T2042)

Summary

Hospice Routine Home Care (T2042) is a type of palliative care service provided to patients who are at the end stages of a terminal illness. This service is delivered in the patient's home and aims to manage symptoms, provide emotional support, and improve the quality of life for both the patient and their family.

Purpose

The main purpose of Hospice Routine Home Care is to provide comprehensive, compassionate care to terminally ill patients. It addresses various conditions including advanced cancer, end-stage heart failure, chronic obstructive pulmonary disease (COPD), and other terminal illnesses. The goal is to ensure the comfort and dignity of the patient during the remaining stages of their life.

Indications

• Advanced, terminal illness with a prognosis of six months or less if the disease follows its normal course
• Recurrent or severe symptoms affecting quality of life
• Patient preference for end-of-life care at home
• Family or caregiver support available for home-based care

Preparation

• No specific medical preparations are necessary for the patient
• An initial assessment by the hospice team is conducted to create a personalized care plan
• Medication adjustments may be made based on the patient's current health status and symptoms

Procedure Description

1. Initial Assessment: Conducted by the hospice team, including a nurse, social worker, and possibly a doctor, to evaluate the patient's medical, emotional, and spiritual needs.
2. Care Plan Development: A tailored care plan is created, covering pain and symptom management, emotional support, and other necessary services.
3. Routine Visits: Regular visits by hospice nurses, aides, therapists, and social workers to provide care and assistance. Frequency of visits may vary based on the patient’s needs.
4. Medication Management: Ensuring the patient has access to necessary medications and managing any changes to improve comfort.
5. Emotional and Spiritual Support: Provided by social workers, counselors, and chaplains to help the patient and family cope with emotional and spiritual challenges.

Duration

Hospice routine home care is ongoing and provided on a per diem basis for the duration of the patient's eligibility for hospice services.

Setting

This care is delivered in the patient's home or place of residence, which may include facilities like assisted living or nursing homes.

Personnel

• Hospice Physician
• Registered Nurses
• Licensed Practical Nurses
• Certified Nursing Assistants
• Social Workers
• Therapists (Physical, Occupational, Speech)
• Counselors and Chaplains
• Volunteers

Risks and Complications

• Possible medication side effects, which are monitored and managed by the hospice team
• Emotional strain on family members and caregivers, who will receive support from social workers and counselors

Benefits

• Enhanced quality of life through symptom management and emotional support
• Comfort of receiving care in a familiar, home setting
• Comprehensive support for both the patient and family, tailored to individual needs
• No hospital visits needed, reducing stress for the patient

Recovery

Since hospice care is for terminally ill patients, traditional recovery is not anticipated. Focus is on maintaining quality of life and comfort during the end-of-life stages.

Alternatives

• Inpatient Hospice Care: For those needing intensive symptom management that cannot be provided at home.
• Palliative Care: Can be received alongside curative treatment, not limited to end-of-life care.
• Home Health Care: For patients who do not have a terminal diagnosis but need medical care at home.

Patient Experience

Patients can expect to experience increased comfort and symptom relief. Emotional and spiritual support will be available to both the patient and their family. Pain management is prioritized to ensure minimal discomfort. The hospice team will be available for any emergent needs, making the experience as serene and dignified as possible.