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A new scoring system that can more accurately predict the life expectancy of a patient with advanced cancer in terms of "days," "weeks," and "months" is described in an article published in BMJ.
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Understanding your own cultural beliefs and biases about pain is an important first step in accurately assessing a hospice patient's pain levels, says Mary Curry Narayan, MSN, RN, HHCNS-BC, a clinical education and transcultural nurse specialist and owner, Narayan Associates in Vienna, VA and author of "Culture's Effects on Pain Assessment and Management."
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All of the accountable care principles that are integrated into the Affordable Care Act (ACA) require a clinical approach to the sickest, most complex, and costliest patients, says Diane E. Meier, MD, FACP, director of the Center to Advance Palliative Care at the Mount Sinai School of Medicine in New York City, because they all begin to move the system away from the fee-for-service model.
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Bilingual staff, cultural diversity education, and community presentations designed for specific populations are efforts that hospices throughout the country have implemented to increase access and improve care to hospice patients of all backgrounds.
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Language and cultural beliefs can affect the accuracy of pain assessment tools regularly used by hospice staff members, says Hank Willner, MD, medical consultant for Hospice Foundation of America and hospice medical director and palliative care consultant for Capital Caring in Falls Church, VA. Interpretation of visual and numeric scales may differ according to culture, he explains.
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Palliative care isn't just for hospice patients it is also used to manage the symptoms of those with chronic or advanced illnesses.
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A program that sends geriatricians and nurse practitioners into the homes of high-risk, frail elderly patients has resulted in a 195% return on investment (ROI) for Fallon Community Health Plan in Worcester, MA.
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Although implantable cardioverter-defibrillators (ICDs) improve survival in patients at risk for recurrent, sustained ventricular tachycardia or fibrillation, the device can add to a patient's discomfort at the end of life.
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Medicare spending on hospice care for nursing facility residents has grown nearly 70% since 2005. Additionally, hundreds of hospices had a high percentage of their patients residing in nursing facilities, and most of these hospices were for-profit.
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A new study from the Dartmouth Atlas Project seems to indicate the "report card" for Medicare patients at the end of their lives is a mixed bag of pluses and minuses.
