I strongly agree with the need to expand hospice criteria for persons with all types of dementia. One of the commenters mentioned expanding to FAST 6 and I agree (there is a long period of complex care needs between stage 6-7) but we also to recognize that the FAST scale was designed only for Alzheimer's type dementia with more predictable progression of disease. Hospice nurses and medical directors must look at the whole picture for evidence of terminal phase of illness, so as not to look at too narrow a set of criteria for dementia clients and plan to re-evaluate appropriateness frequently. #hospice #hospicenurse
The last top story of 2023 we’d like to mention is Vox Media’s “Many Americans with dementia can’t get the hospice care they need.” Hear from NHPCO's Interim CEO Ben Marcantonio, and VP of Palliative and Advanced Care, Rory Farrand. "One way the US could make hospice’s benefits more available to people with dementia is by providing them under an expanded and more generously covered version of palliative care services — what Marcantonio calls 'community-based palliative care.' In this scenario, people would be able to access all of the good things hospice provides at whatever point their disease becomes burdensome to themselves and their families. The Community-Based Palliative Care Act, a bipartisan bill introduced earlier this year, aims to make more of the services typical of hospice available to people who are still receiving curative treatment. It’s worth noting that the US has tried this model, and it works: Several years ago, a handful of sites in the US trialed the Medicare Care Choices model, which allowed people to get hospice services while also receiving curative treatment, and it worked great — there was still plenty of cost savings, and high family and patient satisfaction. Meanwhile, families can do some things to maximize the likelihood that the existing hospice benefit better serves them in the event of life-threatening illness, said Farrand. 'Don’t be afraid of having conversations with your loved ones about what their wishes, goals, and values are as it pertains to their illness,' or how they’d want to live their lives if they were diagnosed with a serious illness. And if they’re in the midst of a serious illness, they should ask for a palliative care consult, said Marcantonio. People sometimes misunderstand palliative care as 'giving up,' said Farrand, but both palliative care and hospice involve 'aggressively ensuring that your quality of life is what you want it to be — that you can live the best you can, even while living with a serious illness,' she said. 'If anything, it’s the absolute opposite of the idea of giving up.'" Access the full story here: https://lnkd.in/gUuGvfvi
