Name of the Procedure:

Hospice General Inpatient Care (GIP Care); Per Diem

Summary

Hospice general inpatient care (GIP care) involves providing intensive, short-term medical care in a hospice facility or hospital to manage acute symptoms that cannot be addressed in a home setting. This specialized care is designed to ensure comfort and symptom control for patients with life-limiting illnesses.

Purpose

Hospice GIP care addresses severe symptoms such as extreme pain, difficult-to-manage nausea or vomiting, severe shortness of breath, or complex wound care. The main goals are to provide relief, comfort, and maintain the highest possible quality of life during the last stages of a terminal illness.

Indications

• Unmanageable pain or symptoms in a home setting
• Severe nausea or vomiting needing IV medications or frequent monitoring
• Complex wounds requiring specialized care
• Severe respiratory distress needing medical interventions
• Any other acute symptoms that require continuous medical management

Preparation

• No specific fasting or dietary restrictions are typically needed.
• Coordination with the patient's primary care provider to transfer pertinent medical records.
• Completion of necessary insurance or hospice care documentation.
• Emotional support and counseling for both the patient and their family to understand the transition to inpatient care.

Procedure Description

1. Admission: Patient is admitted to a hospice inpatient unit or hospital.
2. Assessment: Comprehensive assessment by hospice care team, including physicians, nurses, and possibly other specialists.
3. Care Plan: Development and implementation of a personalized care plan, focusing on symptom management and comfort.
4. Monitoring and Intervention: Continuous monitoring of the patient's condition and administration of medications or treatments to manage symptoms.
5. Supportive Care: Provision of emotional and psychological support for the patient and family.

Duration

The duration varies but is generally for short-term stays, often ranging from a few days to a week, depending on symptom control and patient stabilization.

Setting

Usually performed in a dedicated hospice inpatient unit, a hospital, or a skilled nursing facility with hospice services.

Personnel

• Hospice physician or primary care physician
• Registered nurses specializing in palliative care
• Social workers
• Chaplains or spiritual care providers
• Certified nursing assistants
• Counselors or psychologists as needed

Risks and Complications

• Potential for adverse reactions to medications used for symptom control.
• Emotional and psychological stress for patients and families transitioning to inpatient care.
• Possible infections or complications from intravenous treatments or other procedures.

Benefits

• Effective management and relief of severe symptoms.
• Improved comfort and quality of life.
• Dedicated support for both the patient and their family during a difficult time.
• Reduced burden on caregivers at home.

Recovery

• Continuous assessment and adjustment of care plans.
• Emotional and psychological support planning.
• Coordination with home hospice services for transitioning back to home care if condition stabilizes.

Alternatives

• Home hospice care with increased support and frequent nurse visits.
• Palliative care services integrated with regular hospital care.
• Benefits include personalized and intensive symptom management, but drawbacks might involve leaving a home environment and the related emotional impact.

Patient Experience

• Patients often experience significant relief from uncontrolled symptoms.
• Families have direct access to professional support and guidance.
• Emotional responses vary; the hospice team provides psychological and spiritual support to manage stress and anxiety.
• Pain is actively managed with appropriate medications, and comfort measures are a priority throughout the stay.