Dave K
Distinguished member
- Joined
- Jul 13, 2015
- Messages
- 196
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Myth No. 1: Hospice care is only intermittent.
The truth: There are multiple instances of PALS who have needed and received 8, 16, or even 20 hours per day of in-home nursing shift care. Unless a patient’s insurance plan clearly and specifically limits it, there is no limit to the amount of hospice care to which a patient is entitled, if it is medically necessary to palliate symptoms arising from the terminal illness.
Myth No. 2: The job of a Home Health Aide is to help the patient bathe, make the bed, and leave after one or two hours.
The truth: Home Health Aide functions include the following tasks that should be detailed in the patient’s care plan:
• Assistance with mobility, range of motion, transfers, positioning, exercise as ordered and taught by an RN, physical therapist, or other appropriate health personnel
• Maintenance of a clean and healthful environment
• The performance of simple procedures as an extension of therapy services.
• Household services essential to healthcare at home.
• Assistance with medications that are ordinarily self-administered.
• Laundry.
• Light housekeeping.
• Collect specimens; urine, stool, and sputum
• Shaving
• Oral hygiene
• Toileting
• Nail care (except that which requires a podiatrist)
• Care of glasses, personal equipment and belongings
• Apply non-legend topical ointments, creams, lotions, and solutions to intact skin surfaces
• Take vital signs: temperature, pulse, respirations, and blood pressure
• Measure and record in-take and out-put
• Chart the medical record
"Light housekeeping" is commonly understood to mean sweeping and/or mopping up, taking out the trash, and laundering the patient’s soiled clothes and bed linens.
“Performance of simple procedures as an extension of therapy services” includes such tasks as
• Cleaning and storing reusable equipment and supplies,
• Maintaining the contents of medical supply cabinets, and
• Assembling necessary equipment and supplies for tube feedings, medication, and therapies.
Again, unless a patient’s insurance plan clearly and specifically limits it, there is no limit to the amount of hospice care to which a patient is entitled, if it is medically necessary to palliate symptoms arising from the terminal illness. If aide services are not being adequately provided, PALS and CALS should request that additional aide services be included in the care plan, and the nurse who writes the care plan should include the services in the written care plan.
Myth No. 3: Patients are not eligible for hospice unless their life expectancy is six months or less.
The truth: Many PALS are entitled to hospice benefits when they have a life expectancy of 12 months or less. All PALS should carefully research their individual eligibility requirements.
Myth No. 4: A tracheostomy and/or mechanical ventilation disqualifies an ALS patient from hospice eligibility.
The truth: Hospice does not cover measures intended to extend someone’s life artificially. Hospice care is palliative in nature. Therefore, if a tracheostomy or mechanical ventilation are done to extend life artificially, it is not consistent with hospice care; however, if these measures are performed as comfort measures, they are included in hospice care. For example, if the tracheostomy is done to help manage secretions, and if the mechanical ventilation is used part-time to help the patient sleep, prevent headaches, and reduce fatigue, then the measures are palliative in nature and appropriate for hospice care.
The truth: There are multiple instances of PALS who have needed and received 8, 16, or even 20 hours per day of in-home nursing shift care. Unless a patient’s insurance plan clearly and specifically limits it, there is no limit to the amount of hospice care to which a patient is entitled, if it is medically necessary to palliate symptoms arising from the terminal illness.
Myth No. 2: The job of a Home Health Aide is to help the patient bathe, make the bed, and leave after one or two hours.
The truth: Home Health Aide functions include the following tasks that should be detailed in the patient’s care plan:
• Assistance with mobility, range of motion, transfers, positioning, exercise as ordered and taught by an RN, physical therapist, or other appropriate health personnel
• Maintenance of a clean and healthful environment
• The performance of simple procedures as an extension of therapy services.
• Household services essential to healthcare at home.
• Assistance with medications that are ordinarily self-administered.
• Laundry.
• Light housekeeping.
• Collect specimens; urine, stool, and sputum
• Shaving
• Oral hygiene
• Toileting
• Nail care (except that which requires a podiatrist)
• Care of glasses, personal equipment and belongings
• Apply non-legend topical ointments, creams, lotions, and solutions to intact skin surfaces
• Take vital signs: temperature, pulse, respirations, and blood pressure
• Measure and record in-take and out-put
• Chart the medical record
"Light housekeeping" is commonly understood to mean sweeping and/or mopping up, taking out the trash, and laundering the patient’s soiled clothes and bed linens.
“Performance of simple procedures as an extension of therapy services” includes such tasks as
• Cleaning and storing reusable equipment and supplies,
• Maintaining the contents of medical supply cabinets, and
• Assembling necessary equipment and supplies for tube feedings, medication, and therapies.
Again, unless a patient’s insurance plan clearly and specifically limits it, there is no limit to the amount of hospice care to which a patient is entitled, if it is medically necessary to palliate symptoms arising from the terminal illness. If aide services are not being adequately provided, PALS and CALS should request that additional aide services be included in the care plan, and the nurse who writes the care plan should include the services in the written care plan.
Myth No. 3: Patients are not eligible for hospice unless their life expectancy is six months or less.
The truth: Many PALS are entitled to hospice benefits when they have a life expectancy of 12 months or less. All PALS should carefully research their individual eligibility requirements.
Myth No. 4: A tracheostomy and/or mechanical ventilation disqualifies an ALS patient from hospice eligibility.
The truth: Hospice does not cover measures intended to extend someone’s life artificially. Hospice care is palliative in nature. Therefore, if a tracheostomy or mechanical ventilation are done to extend life artificially, it is not consistent with hospice care; however, if these measures are performed as comfort measures, they are included in hospice care. For example, if the tracheostomy is done to help manage secretions, and if the mechanical ventilation is used part-time to help the patient sleep, prevent headaches, and reduce fatigue, then the measures are palliative in nature and appropriate for hospice care.