Palliative Medicine and Supportive Care

Palliative Medicine and Supportive Care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.

Palliative care can be provided during all stages of serious illness, and often serves as an extra layer of support along with curative treatment.

Palliative medicine is based on your needs, not on your prognosis. Our team has specialized doctors, advance practice professionals, nurses, social workers, and chaplains all working together to provide support for you and those you love.

What to expect from Palliative Medicine and Supportive Care

• Expert management of symptoms such as pain, depression, anxiety, fatigue, shortness of breath, constipation, nausea, loss of appetite, and difficulty sleeping.
• Clear and compassionate communication from your medical team.
• Focus on the emotional, social and spiritual needs of you and your loved ones.
• Help understanding what to expect in the future and guidance in making decisions regarding your health and types of care you prefer.

Consultations With Our Team

A palliative care consultation may be desirable when a doctor feels that a patient may need:

• Expert symptom management.
• Help understanding what to expect with his/her diagnosis, treatments and changing medical condition and needs.
• Assistance in determining how aggressive a patient wants his/her treatments to be.
• Assisting patients with deciding in advance what they want to happen in the event of a medical crisis.
• Information about end of life options, such as hospice.
• Emotional support when an illness is advancing.
• Support of families when a patient is on life support or nearing death.

Advanced Illness Management (AIM) Home Health Programs

The purpose of the AIM program is to work with patients and their families who are currently under the care of home health but are dealing with the advanced stages of a serious illness. The AIM Care team provides curative and aggressive treatments with the comfort, peace and dignity of palliative care. Established as a bridge between curative and comfort care, the AIM program seeks to meet the needs of the advanced chronically ill patients who currently “fall between the cracks” of hospital, home health and hospice services.

Not all home health agencies provide AIM home health programs, but many community home health agencies do. Your physician, social worker or palliative care professional can assist you in identifying these services in your community.

Hospice

Hospice care focuses on improving the quality of life for persons and loved ones faced with a life-limiting illness. People become hospice-eligible when it is expected they will die from their condition within 6 months, although many patients live longer than this and can remain in hospice. The primary goals of hospice care are to provide comfort, relieve physical, emotional and spiritual suffering, and promote the dignity of terminally ill persons. Hospice care neither prolongs nor hastens the dying process but assures comfort.

Hospice care is a philosophy or approach to care rather than a place. Care may be provided in a person’s home, nursing home, assisted living, hospital, or independent facility devoted to end of life care. Ochsner LSU Health currently offers hospice services within each of our hospitals based in Shreveport and Monroe.

Who pays for hospice?

Medicare, Medicaid and private insurance generally cover hospice. There are companies/policies that require a co-pay, but this is not the norm. Hospices are paid a daily amount by the insurance provider to take care of the person, and out of this payment, hospice provides all services, including medicine, medical equipment, wound care supplies, professional visits and bereavement support.

Does a referral to hospice mean the person’s doctor has given up on him/her?

On the contrary, a referral to hospice means that a doctor recognizes that the illness is advancing despite every effort to treat it, and the person needs specialized treatment to maximize their comfort and quality of life. It is an important time for a thorough conversation between physicians, patients and their loved ones to understand where they are in the course of their illness, and what the recommended options are for them. It is a time when the health care team may assess that the discomfort of aggressive treatments are no longer beneficial. This often comes as a relief to people who are tired of being in the hospital, tired of going through painful treatments, and tired of the hassle of frequent doctor appointments that accompany these treatments.

What exactly does hospice do for people?

• Hospice care is provided by a team of people, including a doctor, an RN, a nurse’s aid (CNA), a social worker, a chaplain, volunteers and occasionally a physical therapist. You will be admitted (signed up) by a nurse, who will assess your need for medical equipment, review your medicines with you and the hospice doctor, and provide an appropriate medical regimen for your comfort. Depending on what is needed at the time, this regimen will usually include your regular maintenance medicines such as blood pressure or diabetes medicines in addition to comfort medicines.
• The nurse will make sure that caregivers feel comfortable with the medicine and care routine, and are always available for questions or other help. The team is there to guide families through this unfamiliar territory.
• Hospice will provide any medical equipment you need such as a hospital bed, wheelchair or oxygen.
• A CNA will provide help with bathing as needed, whether it’s daily or once a week.
• A social worker will provide visits for emotional support for patients and families.
• A chaplain will visit as desired by patients or family members for spiritual support.
• Wound care supplies, adult diapers, disposable pads, barrier cream, urinals, gloves, wash basins, etc. are all provided by hospice.
• Volunteers may provide companionship for a patient, sit with a patient while a caregiver is away for an afternoon, bring a therapy dog to visit, or other such support.
• Hospice will manage medicines, making sure patients don’t run out.
• Hospices provide a nurse on call 24 hours a day, every day.
• Hospice care includes bereavement support to loved ones for 13 months after a patient has died.

What DOESN’T hospice do?

• Hospice does not provide live-in or all-day care unless the patient’s needs dictate inpatient hospice facility care.
• Hospice does not do routine diagnostic tests, such as X-rays or lab draws.
• Hospice does not use IV medicines or fluids, except in rare cases when pain cannot be managed by any other route.
• Hospice does not require you to go to doctor appointments.
• Hospice does not stop your regular medicine unless you want to stop it.
• Hospice does not pay for any aggressive treatments such as chemotherapy, radiation, hospitalization, or blood transfusions.
• Hospice does not artificially prolong life, but improves quality of life.
• Hospice does not artificially shorten life. It allows natural death, and keeps patients from suffering while at end of life.