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Skirball Patient Handbook.Pdf Skirball Hospice A Program of the Los Angeles Jewish Home Committed to Quality of Life PATIENT INFORMATION HANDBOOK Skirball Hospice 6345 Balboa Boulevard, Suite 213 Encino, CA 91316 818-774-3040 (24 Hours) Information Handbook Contents SECTION 1: HOSPICE OVERVIEW 2 • Criteria for Admission 2 • Hospice Concept 2 • Services 2 • Your Hospice Team 2 • Revocation of the Medicare Hospice Benefit 3 • Transfer 3 • Payment for Services Not in the Hospice Plan of Care 3 • Emergency Room/Facility Admission 3 • Respite Care 3 • Aggressive Treatment 3 • Medicare Hospice Benefit 4 • Problem Solving Procedure 5 SECTION 2: PATIENT RIGHTS AND RESPONSIBILITIES AND 6 NOTICE OF PRIVACY PRACTICES 8 SECTION 3: YOUR RIGHT TO MAKE DECISIONS ABOUT 12 YOUR MEDICAL TREATMENT SECTION 4: BASIC SAFETY AND INFECTION CONTROL • General Safety 15 • Environmental Safety 15 • Bathroom Safety 16 • Kitchen Safety 16 • Electrical Safety 16 • Medical Equipment Safety 16 • Medication Safety 17 • Proper Body Mechanics 17 • Techniques with a Walker 17 • Safety Tips for Using Hospital Bed and Wheelchair 18 • Moving the Patient from the Bed to the Wheelchair/Commode 18 • Fire Prevention and Responsibilities 18 • Earthquake/Disaster Preparedness 19 • Infection Precautions 20 SECTION 5: PATIENT CARE INFORMATION 21 • Pain Management 21 • Bowel Program 23 • Nutrition/Hydration 24 • Preparing for Approaching Death 26 1 SECTION 1: Hospice OVerVieW CRITERIA FOR ADMISSION: • Referral from your attending physician who makes a recommendation to Hospice. Medical condition with a life expectancy of six months or less, if the illness runs its normal course. • Agree to palliation (control) of symptoms and not cure of illness. • Agree to follow the plan of care established and refined by you, your family, by the physician and the hospice team. • Live within the geographic area served by Skirball Hospice. • Have a place of residence (home, skilled nursing or residential care facility) which is a safe environment for patient, caregiver and hospice staff. • Have a realistic plan for the provision of primary caregiving on a 24-hour basis when needed. HOSPICE CONCEPT: What is Hospice? • Hospice care provides comfort and kindness to those persons nearing the end of life’s journey. • Hospice will help you make decisions about how and where you want to spend the rest of your life. • Hospice is a special kind of caring that includes both the patient and loved ones. Why Hospice? • Hospice treats you, not the disease. The focus is on care, not cure. You and your family’s medical, social, emotional, and spiritual needs are addressed by a team of hospice professionals and volunteers. • Hospice considers your entire family, not just you, as the “unit of care.” You and your family are included in the decision making process. Hospice will help you and your family make choices about end-of-life issues and enable you to have greater control over these choices. Bereavement counseling is provided to your family for 13 months after your death. • Hospice offers palliative rather than curative treatment. Hospice will provide care and comfort when cure is no longer an option. Through advancing technology, pain and symptom control will enable you to live as fully and comfortably as possible. • Hospice emphasizes quality of life. Hospice neither hastens nor postpones your death. It affirms life and regards dying as a normal process. SERVICES: Hospice provides the most effective care-alternative to people who have life-limiting illnesses and decreases the need for hos- pitalization. Skirball Hospice offers the following features for all who receive hospice care: • 24 hours a day, 7 days a week availability of a full team of professionals. • Case Management services. • Aggressive pain control and symptom management. • Extended nursing care at home during short periods of medical crisis. • Respite services for caregiver relief. • Staff who visit the home when the patient dies to assist the family, day or night. • All diagnosis-related services, drugs, supplies and medical equipment are covered under the Medicare and Medicaid hospice benefit and many commercial insurance plans. • Support for family, caregivers and other loved ones. YOUR HOSPICE TEAM: At Skirball Hospice, your care is provided by an interdisciplinary team of professionals in partnership with your physician. The following interdisciplinary team services are available to you: • A Medical Director available for consultation and discussion of the plan of care. • Nursing staff, highly trained in pain management, symptom control and supportive care. • Social Workers who help relieve the emotional and social pain of patients and their families, address family financial concerns and assist with coordination of community resources and funeral pre-arrangements. • Spiritual counselors who offer guidance and support to patients and their families. 2 HOSPICE OVERVIEW (continued) • A Registered Dietician to assess the nutritional needs of patients and to provide education education and information. • Trained volunteers who provide companionship, respite care and support to patients and their certified caregivers. (See services listed below.) • Home health aides who provide personal care to patients. • Physical, occupational and speech therapists who provide palliative modalities to enhance quality of life. • Bereavement Counselors who provide grief support for hospice families and coordinate grief support groups for the general community and hospice caregivers. REVOCATION OF THE MEDICARE HOSPICE BENEFIT: The patient may revoke(stop) the Medicare hospice benefit any time by contacting us and requesting discharge and benefit revocation. The patient and caregiver should know that as soon as a patient does revoke the hospice benefit, he/she gives up the remainder of that benefit period. Should the patient come back on a hospice program, he/she will enter the program in the next benefit period. TRANSFER: A patient may transfer to another hospice program once during each benefit period. The change will be coordinated between the two hospice programs involved and Medicare will be notified. PAYMENT FOR SERVICES NOT IN THE HOSPICE PLAN OF CARE: Skirball Hospice does not pay for services outside the hospice plan of care (that is services for other than the admission diagnosis) or for services that have not received prior approval from us. You may utilize other outside services, but the patient will be financially responsible for these services if they are related to the terminal illness. Medicare, Medi-Cal and commercial insurance will not pay for those services. You may, however, seek medical services for issues not related to the hospice diagnosis and, based on the benefits of your insurance policy, these may be reimbursed. Always check with us or your insurance before seeking such services to ensure payment. EMERGENCY ROOM/FACILITY ADMISSION: We ask you to contact Skirball Hospice at: 818-774-3040 any time you feel the patient needs immediate assistance. Usually these situations can be resolved by Skirball staff, and we can continue to assist in caring for the patient at home. When the patient requires a higher level of care than can be provided in the home, we will help to make the arrangements for that care. Admissions to a facility are arranged by the hospice team when medically necessary, e.g.: for acute symptom management. Once the team feels the reason for admission has been resolved, the patient can return home. It is our aim for patients to return home as soon as symptoms are stabilized. There is no predetermined length of stay. RESPITE CARE: Respite care is provided by hospice for a period of up to five days to allow a period of rest for the patient’s caregiver. This care is routinely provided in a contracted facility, usually a Skilled Nursing Facility, with support from the Skirball Hospice staff. Should you need this option, we will make all arrangements, including transportation as needed. AGGRESSIVE TREATMENT: Aggressive treatment is any form of therapy or surgery that is done for the purpose of curing the disease. If a hospice patient chooses to receive any kind of aggressive treatment, he/she can no longer remain in the hospice program. At this time, either the hospice may discharge the patient or the patient may revoke the hospice benefit. The patient/decision-maker should know that if they decide to discontinue this curative treatment or they complete the treatment, they may apply for re-admission to Skirball Hospice. 3 MEDICARE HOSPICE BENEFIT Medicare will reimburse the cost of Hospice care under your Medicare Hospice Insurance (Part A). In general, Medi-Cal covers the same benefits. Commercial insurance plans vary and we will verify your benefits when you decided to come on service. When all requirements are met, Medicare will cover the following: Covered Services Non-Covered Services • Physician services • Treatment for the terminal illness which is not for palliative symptom management and is not within the hospice plan of care • Nursing care • Care provided by another hospice or home health agency • Home Health Aide • Private caregivers/Sitter services • Medical Social Services • Bereavement counseling • Spiritual counseling • Dietary counseling • Dietary supplements unless directly related to terminal illness • Volunteer Services • Physical Therapy, Occupational • Services not authorized by Skirball Hospice. Therapy, Speech Therapy • Medical equipment, services and • Ambulance transportation not included in supplies the plan of care •
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