Increased Support in the Continuum of Medical Care

Transcription

1 Patient Information Guide Increased Support in the Continuum of Medical Care 8700 BEVERLY BLVD., LOS ANGELES, CALIFORNIA Cedars-Sinai Cancer Program CP

2 Introduction There may come a time in the course of your treatment of cancer that you and your medical team decide to stop attempts at curative treatment. It may be determined that we cannot stop the disease from progressing, and the side effects of treatment far outweigh the benefits. We may not be able to fight the disease, but we can continue to help by providing medical care extended into your home in order to maximize comfort. Hospice provides a direct extension of physician care, increases your medical team's contact with you and enhances what is known as palliative care. Hospice helps to bridge the gap between aggressive medical care and the transition to supportive medical care, which may include symptom management, pain control, nutrition, caregiver support and other in-home care services. In this booklet, we hope to help you understand when it would be appropriate and beneficial to include hospice as part of your ongoing treatment. 51

3 Increased Support in the Continuum of Medical Care Your life undoubtedly changed the day you first heard of your cancer diagnosis. Since then, you have developed a heightened awareness of changes caused by the cancer or its treatment. You, your doctor, and the staff have aggressively fought this disease.yet, despite these efforts, you may feel that the symptoms from cancer are using up more of your time and energy.these efforts at fighting the disease may interfere with the quality of your daily life. You and your family may be very aware of your changing symptoms and the challenge to get through each day. At this point, you may want to think about your future goals and reevaluate the path that you are on. Until this point, the focus of your care has been to fight the disease.you may want to consider having a new goal: a goal focused on comfort and quality of life. Hospice can provide increased supportive services to you and your family.your physician and medical team will continue to be involved in your care. Hospice offers additional support to you in your home.this professional team provides frequent, intermittent visits in your home 24 hours a day as needs arise. Often, the side effects from cancer can be caused by symptoms other than pain. Nausea, fatigue, constipation and anxiety are some of the symptoms that hospice are experts at effectively controlling. In addition, medications and equipment that are related to your illness can be delivered to your home, and in most instances, are paid for by your insurance. Hospice resources include dietitians, physical therapists, home health aides, social workers, chaplains and hospice volunteers. During this most significant time, it is important for you to understand that you and your family are not alone. At this point of your care, there is hope that these symptoms can be eased allowing you greater comfort. There is help available to assist you and your family with the increasing needs that you are experiencing

4 Questions and Answers Q: When will I see my Doctor again? Does that mean I will no longer be seeing him/her? A: Your doctor will continue to be your primary physician and you will also be in contact with the hospice doctor who will be communicating with your healthcare team. Q: Does my insurance cover Hospice? A: The hospice team will contact your insurance company to verify your benefits. Q: Can I discontinue my hospice care? A: Absolutely. There is always a healthcare professional available to assist you with this decision. Q: Can I continue my current regimen of vitamins and/or medications? A: Yes. Your nurse and doctor will help you to evaluate your medications. They will also discuss with you suggestions to make you feel more comfortable. Q: Can I go into the hospital? A: The hospital is available for pain or symptom management if it cannot be handled at home, however, you first need to contact hospice. The hospice team will help you decide whether the home or the hospital environment would be best following an assessment by the hospice team. Q: What if I decide to have chemotherapy or experimental treatment? A: You may discuss with your physician any questions you have regarding treatments. Q: Will a Registered Nurse be with me all of the time? A: A registered nurse will be coordinating your hospice care. Visit frequency will be determined by your needs. There is always a nurse on-call 24 hours a day, 7 days a week. Q: Is a Home Health Aide covered by hospice? A: Home Health Aide visits are available to assist you with your personal care based on your individual needs

5 Psychosocial Services The hospice team will work with you, your family and your medical team to develop a personalized plan of care suited to your needs and desires. Their goal is to bring emotional and spiritual healing as well as relief from physical pain. Hospice services include: N UTRITIONAL C OUNSELING Quality of life can be impacted as a result of barriers to receiving adequate nutrition. As part of the hospice team, the dietitian can offer various symptom management tips for you and your family to address these concerns and help alleviate discomfort. S OCIAL S ERVICES Social workers conduct initial needs assessment and provide emotional support, education and community resource referral. H OSPICE C HAPLAIN The chaplain offers support and guidance as well as prayer during this significant time. R EGISTERED N URSE A nurse specialized in hospice care provides home visits and care coordination. H OME H EALTH A IDE A certified nursing assistant provides personal care and homemaker services. PAIN AND S YMPTOM M ANAGEMENT Hospice care emphasizes relieving your pain and suffering to enhance quality of life for both you and your family. In coordination with your oncologist, the team develops an individualized pain and symptom management program to meet your specific needs. O CCUPATIONAL,PHYSICAL AND S PEECH T HERAPY If indicated, these services maximize physical potential to improve quality of life. B EREAVEMENT F OLLOW- UP P ROGRAM Emotional support for families is provided by grief counselors. VOLUNTEER S ERVICES Trained volunteers offer companionship and support to you and your family through a variety of activities

6 Indications for the Use of: Glossary Chemotherapy, Radiation Therapy, Blood Transfusions and I.V. Hydration in Hospice Care For all hospice patients, the goals of treatment are established at the outset. These goals generally provide for maximum comfort and an avoidance of medical interventions that either cause discomfort or artificially prolong a terminal course. However, all goals are negotiable with the patient, family and physician. C HEMOTHERAPY Combination chemotherapy is almost never indicated because it has stopped being effective and the burdens far outweigh the benefits for hospice patients. Anti-tumor hormone therapy may be continued if it is for comfort. R ADIATION T HERAPY Radiation therapy may be helpful in pain control, provided the course of treatment is brief. Daily transportation should not be an excessive physical or financial burden to the patient or family. B LOOD T RANSFUSIONS Blood transfusions are rarely helpful in providing comfort. They are occasionally indicated for other reasons which may be assessed by the hospice team. I NTRAVENOUS H YDRATION I.V. Hydration (fluids) usually does not relieve symptoms. It can be used to achieve certain clearly defined goals which have been determined by the patient, family and Hospice Team. H OSPICE: A program of palliative care and supportive services that addresses the physical, spiritual, social and economic needs of chronically ill patients and their families. This care may be provided at home or in a skilled nursing facility for hospice care. PALLIATIVE: Relieving or alleviating without curing. An effort that eases a painful or uncomfortable condition. R EGISTERED N URSE: A nurse who has graduated from a state approved school of nursing, has passed the Professional Nursing State Board examination, and has been granted a license to practice within a given state. H OME H EALTH A IDE: An individual who assists nurses by performing patient care procedures that do not require special technical training such as assistance with bathing and feeding and general comfort measures. B EREAVEMENT: friends after the death of a loved one. R ESPITE: and caregivers. A service to provide support for relatives and A program to provide additional help for family 58 59