Hospice Care vs. Palliative Care: What’s the Difference?

Patients facing a serious or life-limiting illness may sometimes be offered hospice care, palliative care or both. The terms are often confused. A lack of understanding can make the conversation around these topics emotionally fraught. Hospice care and palliative care are different in a few key ways. Here is an overview of the two:

Hospice Care

  • Hospice care may be offered to patients whose prognosis is six months or less assuming their disease follows its expected course.
  • Hospice care is provided only to patients who are no longer pursuing curative care. This might occur when the patient is no longer receiving any benefit from active treatment, or the patient has decided that he or she no longer wishes to undergo treatment.
  • Hospice care is often provided at home or in a nursing home, but there are some residential hospices as well as hospital beds designated for hospice patients.
  • hospice patient, If you no longer want to receive hospice or your prognosis changes you can discontinue hospice care at any time.
  • Hospice care is generally covered by Medicare, Medicaid, and private insurance.

 

Palliative Care

  • Palliative care may be provided to patients at any stage of the disease process, regardless of the prognosis.
  • Palliative care is focused on alleviating the pain and addressing quality of life issues that occur with serious illness. It may be provided to patients who are on hospice, or those who are continuing to receive curative treatment.
  • Palliative care may be provided in the hospital, at home or in a long-term care facility, or in the doctor’s office.
  • Aspects of palliative care, including physician visits and prescription medications, may be covered by private insurance.

 

Both

  • Both hospice and palliative care involve multidisciplinary teams of professionals, often including physicians, nurses, social workers, pain management specialists, and spiritual care personnel.
  • Both hospice and palliative care focus on the patient as well as the family unit.

 

If you or a loved one are facing a serious illness, hospice care or palliative care may be beneficial. Care Answered can help you understand and select the most appropriate care during a stressful time. For additional information, give us a call or contact us via email.

Care to Talk

Gathering with Loved Ones? Talk About Healthcare Decisions this Holiday Season

The words “We have to talk” can fill a person with dread, especially when spoken by a spouse or partner. But it is vitally important to have conversations about healthcare decision-making before we are faced with making those difficult decisions. The holiday season brings family and friends closer together and can present the perfect opportunity to talk about our wishes should we become unable to make healthcare decisions for ourselves.

Benjamin Franklin famously said that only two things are certain in life — death and taxes. While both are unfortunately unavoidable, we can promise that no one has ever died from discussing healthcare decisions. The most important thing you need to do is give your loved ones peace of mind by selecting your health care proxy.

What is a Healthcare Proxy?

The New York Health Care Proxy Law allows you to appoint someone you trust — for example, a family member or close friend – to make health care decisions for you if you lose the ability to make decisions yourself. By appointing a health care agent, you can make sure that health care providers follow your wishes. Click here to learn more.

How do you talk about healthcare decisions?

Once you have selected your proxy, be sure to inform that person about his or her role, and let him or her know about your wishes should an illness or injury leave you unable to make your own healthcare decisions.

It’s not taboo. Just bring it up at the dinner table. Try these opening lines:

“My faith is important to me and I don’t want to have….”

“I’m allergic to …. Please make sure that I don’t receive that medicine”

Talk about what you value, and be as specific as you can. You might say:

“I don’t want to ever be sustained by machines,” or “I have to be able to live independently,” or “There are new health findings every day. I would like to be kept alive until they find a cure.”

Points to remember about healthcare decisions

The discussion with your healthcare proxy can and should be ongoing. You cannot imagine every possible scenario but if the person you select as your healthcare proxy understands your values and knows the types of life-sustaining treatments that you would want, as well as those interventions that you would not want, your proxy will feel confident that they are following your wishes rather than having to decide your fate on their own.

This is not a contest of who loves you the most; rather, it’s about who will be able to carry out your wishes.

It is a tremendous burden to expect your loved ones to make these decisions for you if you have not expressly told them your wishes. Help them be your proxy.

Take time this holiday season to begin your discussion. And fill out your healthcare proxy form. Think of it as a compassionate gift to your loved ones should they ever have to make an important healthcare decision for you.

 

November is National Family Caregivers Month – Recognizing “Caregiving Around the Clock”

Are you one of the 43.5 million Americans who provide care for a loved one – a spouse, parent or in-law with Alzheimer’s disease, or a special needs child? AARP estimates that the economic value of so-called “informal caregiving” is more than $470 billion annually. But that pales in comparison to the physical and emotional toll that caregiving can take.

November is National Family Caregivers Month, recognizing “Caregiving Around the Clock.” One month hardly seems like enough time to acknowledge the many sacrifices inherent in providing care for a loved one. The average age of the informal caregiver is 49, which means that very often these individuals define the sandwich generation, caring for both aging parents and children under 18. Family caregivers spend about 24 hours each week providing care, often on top of full- or part-time jobs. No wonder they are exhausted!

Nathan Anderson

Most caregivers live within 10 miles of the care recipient. But long distance caregivers live an average of 450 miles away from care recipients, and studies show that emotional distress for the caregiver increases with distance from the recipient.

If you are a family caregiver, you know that support is essential. In particular, support communities and groups can help by providing you with a safe space to share feelings, frustrations and victories.  Here are some tips:

  • Find others (a friend, family member, or paid aide) who can provide you with a weekend, day, or even an hour off.
  • Find a caregiver’s support group in your community or online.
  • Take time for you. Exercise, read a book, take a walk, or do something that makes you happy, even if only for a few minutes each day.
  • Remember to take care of yourself, or you will not be able to take care of your loved ones who are depending on you.

The Caregiver Action Network is an excellent online resource which is offering tips for family caregivers all month long. Care Answered is also here to help. We can answer your questions and assist you in navigating the healthcare bureaucracy, identifying your options, helping you understand insurance coverage, and enabling you to obtain the most appropriate care for your loved ones.  Then YOU can spend more time being a husband, wife, daughter or son, and less time as a caregiver.

References:

https://www.caregiver.org/caregiver-statistics-demographics

http://www.caregiveraction.org/national-family-caregivers-month

Who’s Who in the Hospital?

Who are All These People in the Hospital?

A trip to the hospital can be stressful and overwhelming. Adding to the confusion is the parade of medical professionals with different roles and functions. Who should you talk to when you want information, or to voice concerns? Here is a rundown of some of the people you are likely to meet in the hospital:

  • In the Emergency Room
    • Triage nurse – This is a registered nurse who will perform an initial assessment, learn about the symptoms that have brought you to the hospital, and determine the level of acuity – or how serious – your condition may be. This information will affect how quickly you are seen by the doctor. Patients who arrive after you but who are in more serious condition will be seen sooner.
    • Emergency physicians – Their primary job functions are to resuscitate or stabilize you and refer you to the next appropriate level of care. They may decide that you require admission to the hospital, or that you may safely be sent home for follow-up with your personal physician, a referral to a specialist, or surgery.
    • Registered nurses – Nurses will monitor your condition in the emergency room, administer any medication ordered by the doctor, and participate in the care you are receiving. They can answer questions about your condition and your treatment plan.
    • Technicians – These individuals may draw your blood or perform x-rays, electrocardiograms or other diagnostic testing that has been ordered by the physician.
    • Aides – Aides can assist you with comfort needs such as providing you with a pillow or blanket. You may also see aides restocking supplies, cleaning the room, or performing other supportive tasks.
  • In the hospital
    • Hospitalists – These are physicians whose primary focus is the general medical care of hospitalized patients. They will oversee your care, coordinate with any specialists brought in to evaluate or treat you, prescribe medication, and monitor your condition. They are also responsible for deciding when you may go home and for writing your discharge orders. Because they are based in the hospital, they are often available to provide information on your progress to you or your loved ones.
    • Registered nurses – The job of the registered nurse is to monitor your condition and to provide the care that has been ordered by the physician. This includes administering medication, checking wounds and changing dressings, helping you with mobility, and making sure that you are making steady progress toward your goals. Nurses can often answer questions about your medications, treatment plan, and progress.
    • Nurse manager – The nurse manager oversees the nursing staff on a unit. If you are unhappy with your care or wish to discuss any concerns regarding staff or your treatment, you may ask to speak with the nurse manager.
    • Dietitians – Your diet during your hospital stay is often prescribed by your physician. Dietitians make sure that the food you are provided meets any restrictions necessary to speed your recovery.
    • Phlebotomists and technicians – You are likely to undergo multiple medical tests during your hospital stay. Phlebotomists will draw your blood and technicians will perform other medical exams.
    • Social workers and case managers – These individuals are there to assist with non-clinical aspects of your hospitalization. As soon as you are admitted to the hospital, they will begin to work on a plan for your discharge, including any after-care arrangements such as skilled nursing facility, rehabilitation, or durable medical equipment that you may need. They are also available to assist you with financial, social or emotional concerns related to your illness and hospitalization. They can make referrals to resources to assist you with a wide range of issues that may impact on your well-being.

 

It is important to speak up when you are a patient in the hospital. Do not be afraid to ask questions, make sure that you understand any instructions you are given, as well as any tests being administered and your diagnosis. While the medical team may be busy, it is their responsibility to treat you with respect, tell you their names and job functions, and answer your questions. And it is your responsibility to make sure you have all the information you need, that you provide them with all relevant information about your history and condition, and that you follow their instructions.

Being an active partner in your own healthcare is the best route to recovery.

How to Avoid Being a Victim of a Medical Error

You check into the hospital expecting to receive care that will restore you to health. Yet for up to 250,000 people each year, the care they receive does just the opposite. A study released last year found that hospital errors are the third leading cause of death in the United States, claiming more lives than respiratory disease, stroke, and Alzheimer’s disease [1].

Many more people suffer adverse effects from medical errors. They may face unanticipated complications, worsening of symptoms, and extended courses of illness caused by poor medical decision-making, medication errors, wrong site surgeries, infections, and falls in a hospital.

What can you do to avoid becoming a victim of a medical error? ASK, ASK, ASK! Don’t be afraid to ask questions of your clinicians. Some questions to ask include:

  • What test are you running?
  • What will these tests tell us about my condition?
  • What is my diagnosis?
  • Could my symptoms be caused by anything else?
  • What details and guidelines are being followed for my treatment?

To prevent medication errors while you are in the hospital, take these steps:

  • Have a list of pre-hospitalization medications including supplements (what, why, when, dosage)
  • Ask about any additional medication: what they are for, how/when will they be administered, how will they interact with the current medications and previous diagnosis?
  • Ask to be notified of any change of medication

Additional tips to stay safe in the hospital include:

  • Know your rights! Every hospital is required to provide patients with a copy of the Patient’s Bill of Rights. Request a copy if you have not received one, and read it to become aware of your rights.
  • Contact your primary care provider and any other physicians you are seeing to let them know that you are in the hospital. Ask your physicians to speak to the hospital doctors who are caring for you.
  • Research doctors and surgeons using online resources to learn about their training and experience.
  • Take steps to prevent infections by making sure ALL visitors, clinicians and staff to wash their hands.
  • Research hospital infection rates.
  • HIRE A PATIENT ADVOCATE, because it can be difficult to serve as your own advocate when you are faced with the stress of illness and hospitalization. A patient advocate will work for you and your loved ones to make sure you receive the most appropriate and safest care available.

 

References
[1]
A. E. Cha, “Researchers: Medical errors now third leading cause of death in United States,” The Washington Post, 3 May 2016. [Online]. Available: https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/researchers-medical-errors-now-third-leading-cause-of-death-in-united-states/?utm_term=.cc3d895ac294.

 

 

 

It’s Flu Season – Take a Shot at Staying Well

Flu Season a Good Time to Make Sure Your Vaccines are Up-to-Date

Each year, it is estimated that between 12,000 and 56,000 Americans will die of the flu. Those numbers are staggering, especially when you consider that the flu is largely preventable. Flu vaccine is safe, effective and available. The Centers for Disease Control (CDC) recommends an annual flu shot for all healthy individuals six months and older, including pregnant women.

Older adults are particularly vulnerable to serious side effects from the flu and other vaccine-preventable illnesses. For example, those 60 and over are at increased risk of developing shingles, a painful skin rash caused by the same virus that causes chicken pox in children. Even those who have had chicken pox as a child and those who have had shingles in the past can benefit from receiving the shingles vaccine, which is administered as one single shot and is effective for up to five years.

Adults 65 and over are also encouraged to get a pneumococcal vaccine to prevent infection with the streptococcus pneumoniae bacterium. This infection may cause pneumonia, blood infections, middle ear infections and bacterial meningitis, and the effects can be more severe in older populations. Speak to your healthcare provider about whether you should have a pneumococcal vaccine this year.

Whooping cough was once a deadly illness that declined sharply once children began being routinely vaccinated against it. However, in recent years there has been a resurgence of this serious illness. Experts believe that immunity fades over time. Therefore, the CDC recommends that adults over the age of 19 receive a booster dose of Tdap, which protects against tetanus, diphtheria and pertussis (whooping cough), with additional booster doses given every ten years thereafter. This is especially important for grandparents and other adults who spend time around babies and young children.

Flu season is the perfect time to check in with your healthcare provider and make sure that you are up-to-date with all recommended vaccines. With a busy holiday season ahead, nobody wants to be laid low with a vaccine-preventable illness.

Stay well!

You are in the hospital! Now what?

Nurse Helping Senior Woman To Walk

You are in the hospital! Now what?

You find yourself or your loved one in the hospital. It’s emotional and overwhelming. So what is the first thing you do?

First, make sure that you have a written record including your current diagnosis, any medications/supplements you take (including name, specific dosage, when you take it, how long you have been taking it).

Next, make sure that you are asking the right questions. These include:

  • What tests are being given?
  • What can these tests tell you/me?
  • What medications are being given now?
  • What are these medications for specifically?
  • Have any pre-hospitalization medications been discontinued?
  • Am I being officially admitted into the hospital?
  • What is my diagnosis?
  • Will you contact my primary care physician?

Immediately upon admission to the hospital, you and your caregivers should begin planning for your discharge.

Your safe and healthy discharge should be on your care team’s minds the moment you’re admitted. You don’t want any surprises. You should have input and understanding of your health goals. Yes, you want to get the heck out of the hospital! Make sure you are on track to leave and understand all of the steps required for you to make a full recovery.

MOST IMPORTANTLY, CONSIDER A PATIENT ADVOCATE

An advocate can help you in a variety of ways…

  • Help you understand complicated medical jargon
  • Help you make sense of your insurance coverage and your financial responsibility
  • Help you navigate the medical maze – diagnostic testing, treatment options
  • Help you transition to the next level of care – long or short-term rehabilitation, skilled nursing facility, home care
  • Act as your advocate, looking out for you and your best interests

There is so much more to do and know but this is to get you started and thinking. A professional healthcare coordinator and advocate can ensure that you cover all the bases.

What You Know Can Save a Life: Being Your Best Healthcare Advocate

Do you understand the fine print in your health insurance policy? Are there questions you wish you’d asked during your last office visit with a specialist? Are you struggling to coordinate care for a loved one who lives far away? As healthcare becomes more and more complex, patients and their loved ones need to know how to be their own advocates. Nicole Christenson, CEO of healthcare advocacy firm Care Answered, will provide tips and strategies for navigating the healthcare system at “What You Know Can Save a Life: Being Your Best Healthcare Advocate.” This informative presentation will be held at the Smithtown Public Library on Tuesday, August 29, at 7:00 pm.

The lecture is sponsored by the League of Women Voters of Smithtown and the Smithtown Public Library. Attendance is free, but pre-registration is required. To register, please call 631-360-2480 or visit www.smithlib.org.

Advocacy in the Hospital- Webinar 4/27/17-Register Today

Advocating in the Hospital-Webinar 4/27/17 Register today
When
Thursday, April 27, 2017 from 1:00 PM to 2:00 PM EDT
Where
This is an online event.

Family First Home Companions hosts their next webinar- Advocating For a Family Member in the Hospital.  This webinar will feature guest speaker, Nicole Christensen, patient advocate and CEO of Care Answered.  Nicole will provide tips and tricks to give you the information you need to be ready if/when your loved one is hospitalized.  The presentation will include the following:
  • Key things to watch our for to prevent medical errors
  • Communicate your loved one’s needs without alienating the medical team
  • Who to turn to for support in the hospital
  • How to interpret your hospital bill and catch mistakes
Attendees will leave this webinar fully equipped to handle the next hospitalization.
Click on the link below to register or RSVP.
About The Speaker:
Nicole Christensen is the CEO of Care Answered, a healthcare coordination and advocacy organization specializing in older adults and their families.  Care Answered expertly navigates the healthcare system for clients and helps remove the strenuous obstacles common place in the healthcare process.  Holding a Master of Science in Urban Affairs, Ms. Christensen has over 15 years of professional advocacy experience.  In her work, she had the opportunity to develop and strengthen advocacy programs in Washington DC, NYC and Long Island.  In addition to her professional experience, she has personal knowledge of the challenges of healthcare coordination and advocacy from assisting her own parents. Ms. Christensen’s expert opinions and presentations are requested by Feeding America, news outlets, businesses, civic organizations, congregations, and legislators.