Version June 2024
| Hospice staff understand the patient's goals of care, medical issues, and care plan. Hospice is responsible for the patient's medical costs related to the terminal illness. |
| Pay attention to both distressing signs and symptoms and to any emotional and psychosocial issues. Get help as needed: social service, chaplaincy, and palliative care team. |
| Refer to appropriate UpToDate topics and tables. |
| If rapid decisions are required regarding the use of life-sustaining treatments (eg, intubation for respiratory failure), whenever possible, the goals of care must be clarified first:
|
| Assess the cultural and spiritual needs of the patient; ensure privacy; identify the patient or family's preferred location for the dying process (eg, return home with support; private hospital room; private area in the ED). |
| Whenever possible, testing should not be performed until after discussion with the hospice care team. Testing should be based on patient-defined goals of care. If testing is necessary, low-burden, noninvasive methods that may reveal reversible pathology or clarify prognosis should be performed first. |
| Treatment should be based on patient-defined goals of care. Established ED protocols (eg, antibiotics for pneumonia) may be inappropriate and should only be used if they are consistent with patient goals. |
| Disposition should be planned after discussion with hospice staff and should be based on the patient's goals. Returning home or direct admission to an inpatient hospice facility may be preferable to hospital admission. If the patient wishes to return home, hospice may be able to arrange 24 hours of support for the treatment of symptoms that are difficult to manage. |
| The inpatient palliative service (if available) and hospice should be notified if the patient is to be admitted to the hospital. The patient and caregivers should be aware of all next steps. |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
