Caring : National Association for Home Care magazine
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When the Medicare hospice benefit was enacted 20 years ago, many hospices greeted the news with great relief. This benefit helped many fledgling hospices start up and survive. ⋯ Thus, volunteer hospices filled that need, supporting and advocating for people who did not fit the hospice benefit criteria, but who wanted hospice support. Since volunteer hospices and Medicare-certified hospices play two very different roles in the hospice care delivery system, there are many opportunities for the two types of hospices to partner to meet patient care needs.
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The psychiatric nurse can play a vital role on a palliative care team. Psychiatric nurses can work with patients to sort out the intense and conflicting feelings that affect patients and their families facing terminal illness and death. Patients can be guided through "life reviews," or nurses can craft interventions to reduce patient anxiety, assist with pain management, or promote physical and psychological comfort.
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Family satisfaction is one of the most important outcomes for hospice care. A survey conducted in 2001 by Press Ganey Associates found overall high levels of family satisfaction with hospice care, but also highlighted areas needing improvement. Hospices need to pay more attention to ancillary care services, logistical issues, and the problem of late-timed referrals.
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While following the same approach to care as hospice, palliative care reaches patients who do not necessarily have a terminal diagnosis or a life-threatening illness, and/or are seeking curative treatment. Reimbursement methodologies and requirements for palliative care differ from hospice, and are not explicitly covered by federal and state regulations. In the first article of a two-part series, the author reviews licensing issues, reimbursement requirements, fraud and abuse pitfalls, and cost report requirements for home health agency palliative care programs.