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Palliative Care

 

Palliative Care focuses on relieving and preventing the suffering of patients. Unlike hospice care, palliative medicine is appropriate for patients in any stage of disease, including those undergoing treatment for curable illnesses and those living with chronic diseases, as well as patients who are nearing the end of life. Palliative medicine utilizes a multidisciplinary approach to patient care, relying on input from physicians, pharmacists, nurses, chaplains, social workers, psychologists, and other allied health professionals in formulating a plan of care to relieve suffering in all areas of a patient’s life. This multidisciplinary approach allows the palliative care team to address physical, emotional, spiritual, and social concerns that arise with advanced illness.

 

Prognosis Guidelines

Hospice is for patients who have been diagnosed as being in the last six months of life, but some patients stay on for years if their disease process is slow. In a 2010 study published in the New England Journal of Medicine, metastatic non-small-cell lung cancer patients receiving early palliative care lived 2.78 months longer than those who delayed palliative treatment. The authors concluded that: “Early palliative care led to significant improvements in both quality of life and mood… (the patients) had less aggressive care at the end-of-life but longer survival.”

 

It is important that a conversation is had before the patient begins to decline or is admitted repeatedly to the hospital

Patients are more comfortable having these conversations with their own physician rather than hospital staff

Don’t be afraid to call upon Hospice of Kona to assist with the conversation:—Determine eligibility—Explain hospice services—Offer counseling and support to both patients and family

 

Eligibility

Anyone facing life-limiting illness who wants to focus on comfort rather than curative care and meets the eligibility guidelines may enter into hospice care. Cancer accounts for 40% of hospice admissions followed by debility unspecified, heart disease, dementia, and lung disease (NHPCO 2010 data). Additionally, there are many ‘not so obvious’ illnesses that can make a patient qualify. Hospice of Kona can assist in determining the diagnosis.

 

A Person May Be Eligible And Admitted Into Hospice Of Kona Care If:

     • It is verified that the patient’s prognosis is 6 months or less.

     • They elect no further curative treatment.

     • The patient is 18 years or older, or has a legal guardian available to sign consent forms for care.

 

Hospice of Kona may need access to medical records necessary for admission purpose, diagnosis confirmation, and other relevant history that may influence care. Hospice of Kona may need access to medical insurance information or other plans (i.e. long term care plans, supplementary insurance).

 

Advance Directives

An Advance Directive (AD) is a written statement about your future medical care. It is a gift to family members and friends so that they won’t have to guess what you want if you no longer can speak for yourself.

 

Why do I need an Advance Directive? Medical technology makes it possible for patients with little or no hope of recovery to be kept alive for months or even years. This makes it important for you to discuss what kind of care you want before illness occurs. Now is the time to talk about these important issues, while you can still make your own decisions and have time to talk about them with others. If you don’t have an advance directive, and even one person interested in your care disagrees, your doctor may not honor your wishes for end of life care.

 

What do I put in my advance directives? The kind of medical treatment you want or don’t want. You can say whether or not you want to be kept alive by machines that breathe for you or feed you even if there is no hope you’ll get better. The person you want to make decisions for you when you cannot. This person (or agent) does not have to be an attorney. Unless you limit your agent’s authority, your agent has the right to accept or refuse any kind of medical care and testing, discharge or select doctors, and see all medical records. Your wishes for comfort care. You can indicate whether you want medicine for pain or where you want to spend your last days. You can also give spiritual, ethical and religious instructions.

 

How can I ensure that my advance directive is honored? Share copies and talk with people who will be involved in your care. Ask your doctor to make your advance directive part of your medical records.

 

Patient Referral

Who Can Make A Referral?

     •A patient may refer themselves.

     •A physician may refer a patient/family.

     • A nurse, discharge planner, social worker, spiritual leader, friend, family member or another member of your community.

 

The Cost Of Care

Hospice of Kona is a non profit organization which receives reimbursement from Medicare, Medicaid and most commercial insurers. Patients are accepted solely on the basis of medical need and not on the basis of their ability to pay.

 

Too often referrals for hospice care are not made until the patient has uncontrolled symptoms or is near death. Although hospice care can do much to assist and provide care at this time, the patient and family can benefit much more from hospice services if referred earlier. Many symptoms (i.e. pain) can be anticipated and prevented from becoming severe. Symptoms that might otherwise require a hospitalization or an emergency room visit can be successfully managed by the hospice team in the patient’s home. The patient’s and family’s quality of life can be greatly enhanced by early intervention.

 

Please do not hesitate to call us, even if you don’t immediately need our services. We are here to answer any questions or concerns you may have.

 

Caregiver Tips

A very important aspect of being a caregiver is to take good care of yourself physically, emotionally and spiritually. This will provide you the opportunity to give the best possible care to your loved one. This may be difficult to accomplish, but can be done in a number of small ways.

 

Find Someone To Talk To: Being a caregiver for an ill loved one can isolate us from the rest of the world. However, caregivers need others with whom they can share their frustrations and dreams. Times spent individually with family members, friends, a therapist or group support members may be a vital way to remember that their feelings are normal and shared. Caregivers need to have this outlet for them on a regular basis.

 

Keep a Journal: Write down those thoughts that might initially be too scary to share with someone else, or say out loud. The act of putting down words on paper makes the problems seem more manageable. This does not have to be shared with anyone or permanently kept.

 

Say It Out Loud: If you are a caregiver who does not like to write, you may occasionally find moments to verbalize your frustrations. This can make them feel a little more manageable. (Walls keep secrets.) Wide open, private spaces like beaches or forests also may be places for strong voices.

 

Maintain Creative Outlets: Crocheting, singing, drawing or other forms of creative expression can give you a break emotionally from the demands of your role as caregiver. Doing something creative reminds you that you have talents beyond your role as caregiver.

 

Engage in Physical Activity: One of the best ways to take a break from emotional or mental stress is to do something physical. Even if it’s just walking to the Post Office, the act of switching gears from mental to physical activities helps you take a ​“mini vacation” from your worries and stress. Another benefit of a short break is that it will help you to solve problems more efficiently.

 

Take Time Off: You have been chosen by family or circumstances to be your loved one’s primary caregiver. However, it is important for your well-being to take a few hours, a day, or even a week or two off. Check with your Hospice Care Team about respite care.

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