What is “Comfort Care”?

Inquiries have been coming in to the National Hospice and Palliative Care Organization asking for an explanation of what is included in Comfort Care.

FILE PHOTO – Former U.S. first lady Barbara Bush listens to her son, President George W. Bush, as he speaks at an event on social security reform in Orlando, Florida, March 18, 2005. REUTERS/Jason Reed

It has been widely reported in a statement from the Bush family that former First Lady Barbara Bush has decided to forgo further hospitalizations and curative-focused medical treatments and has chosen to receive comfort care. Questions have come in to NHPCO asking for further details about what makes up comfort care.

Comfort Care refers to care plan for the patient that is focused on symptom control, pain relief, and quality of life. Often support is provided to family members to help them understand the care plan and to address needs and concerns they might have.

There are different forms of comfort care. Two of the best known are hospice and palliative care.

Under hospice care, a person receives medical care as well as emotional, psycho-social, and spiritual care delivered by an Interdisciplinary team of professionals that includes a physician, nurse, social worker, allied therapists, counselors, home health aides, spiritual and grief support and trained volunteers. Each person’s care plan would be tailored to his or her specific needs with some patients requiring services that others might not need.

Palliative care means patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information, and choice.

“Under the philosophy of hospice and palliative care, the goal is care and not cure,” said Edo Banach, President and CEO of NHPCO. “The same principles would apply to comfort care.”

Under the Medicare hospice benefit, a person must have a prognosis of six months or less within the doctor’s best estimation; however, hospice can be provided for as long as the patient needs it and is not limited to six months. Palliative care provides care and services without the required six month prognosis and can be provided alongside curative or life-prolonging treatment.

Hospice care serves people coping with cancer, dementia, heart disease, COPD, renal disease and other illnesses. The majority of hospice care is provided in the home, yet hospice care also is provided in nursing homes, assisted living facilities, and in-patient settings.

Comfort care would reflect the principles of hospice and palliative care, specifically designed to meet the needs of the individual patient and family caregivers. Hospice care provides the most comprehensive array of covered services.

In the U.S., hospice organizations are the primary providers of community-based palliative care and comfort care services.

“If a family is struggling with a serious or life-limiting illness, it is never too early to reach out to your local hospice and ask about care they offer and if it might be right for a loved one,” Banach said.

While more than 1.5 million patients avail themselves of hospice care every year, nearly 30 percent of Medicare beneficiaries received care for seven days or less, which hospice professionals consider too short a time to fully take advantage of all that hospice offers.

“One of the biggest misconceptions about hospice is that it’s giving up,” said Lori Bishop, NHPCO Vice President of Palliative and Advanced Care. “Hospice provides high-quality care and support to the whole person and to family caregivers with the goal of quality of life.”

“It seems appropriate to share this information on April 16, National Healthcare Decisions Day, a day of national outreach to raise awareness of the importance of talking about one’s health care wishes and taking steps to share those preferences,” noted Banach.

Learn more about hospice and palliative care at NHPCO’s Caringinfo.org.

 

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Contact:

Jon Radulovic

Vice President, Communications

Ph: 703-837-3139

 

NHPCO is the oldest and largest nonprofit leadership organization representing hospice and palliative care programs and professionals in the United States. NHPCO’s mission is to lead and mobilize social change for improved care at the end of life.

NHPCO Releases Updated Edition of “Facts and Figures: Hospice Care in America”

NHPCO’s 2017 Facts & Figures report has been released! The report reflects data from 2016 and provides an overview of hospice care delivery in the U.S. with specific information on hospice patient characteristics, location and level of care, Medicare hospice spending, hospice provider characteristics, and more!

Check it out here!

UPDATE – Rural Access to Hospice Act

Special thanks goes out to all of the hospice and palliative care advocates who sent over 1,000 emails and jammed the phone lines asking their Members of Congress to support the Rural Access to Hospice Act.  Although the Rural Access to Hospice Act was not included in the Omnibus Package, the good news is that your hard work and support has made our legislative ask heard loud and clear on Capitol Hill.  We are continuing to push for this bill and are currently looking for other opportunities to get it passed in Congress.

Toward that end, our advocates will be heading to Capitol Hill to reiterate this request in person on Wednesday April 25th! Make sure you check #HAN18 on social media that day to see how they’re doing and share in their experience. Do you want to join them on Capitol Hill? Learn more about the Advocacy Intensive here!

Additionally, don’t forget to check out our new Advocacy Toolkit which provides tip sheets, webinars, letter templates, and a wealth of other information that will help you become a better advocate of hospice and palliative care. Feel free to share this at your next IDT meeting!

Again, thanks for all of the help and support and rest assured, we are still working hard to get this passed! Stay tuned and we will keep you updated as to the next plan going forward. Thank you!

Check Out Our NEW Advocacy Toolkit!

The HAN team is always creating resources that will make it easier for hospice and palliative care advocates to make their voices heard in the Congressional arena.  If you’re the new kid on the block, you may be wondering where to start and you may even have a few questions about how the legislative process works. If you’re a seasoned advocate, you might just need to dust off your shoulders a little bit with a quick refresh on some of our policy initiatives.

Either way, fret not my fellow advocates – we gotcha covered! Our new Advocacy Toolkit is the perfect resource for you and your constituents to become more engaged in the political process.

Our Advocacy Toolkit:

  • Provides an overview of the legislative process as well as our policy initiatives.
  • Helps you discover who your legislators are.
  • Offers resources that will help connect you with your legislators (including email templates and webinars).
  • Enables advocates to write to their members of Congress on issues of importance to the hospice and palliative care community.

Check it out and let us know if you believe this is a helpful tool or if you find areas that need improvement.  Feel free to contact us at info@nhpcohan.org.

As always, the HAN Team is monitoring activity in Congress and the Administration and will continue to keep you in the know!  We’ll do our part, now we need you to get ready to advocate!

 

Data and the Opioid Crisis

A recap on a Senate hearing about data and the opioid crisis
by Lenka Vanova:

As the fifth one in a series of hearings on the opioid crisis, on Tuesday February 27th, the U. S. Senate Committee on Health, Education, Labor and Pensions held a hearing on The Role of Technology and Data in Preventing and Treating Addiction. Chaired by Sen. Lamar Alexander and co-chaired by Sen. Patty Murray, the hearing presented an opportunity to explore the intricate issue from various perspectives.

Snezana Mahon, Vice President Clinical Product Development of Express Scripts, presented results of the Advanced Opioid ManagementTM Program. The program can be inspiring in its combination of prescriber engagement, patient education and outreach, as well as engagement of pharmacies in its effort to reduce opioid consumption and potential misuse and abuse. Sherry L. Green of Sherry L. Green & Associations, LLC and a co-founder of the National Alliance for Model State Drug Laws called primarily for the standards which technology and data solutions are to facilitate to remain clear and consistent. This is not only essential for all parties to be able to comply with these but also to allow data sharing across various systems. Snaket Shah, Clinical Assistant Professor of Health Informatics at the University of Illinois, Chicago stressed that data sharing is crucial to any analysis and also to the possibility  to identify individuals who are at risk of becoming opioid dependent.  With all this in mind, H. Wesley Clark, Dean’s Executive Professor of Public Health Program at Santa Clara University urged all parties to remain cautious about patient privacy and data protection.

In all the testimonies, the Prescription Drug Monitoring Programs (PDMP) tended to be one of the most often mentioned weapons in the opioid overdose epidemic combat. It is also one that has been implemented in almost all states in a hope to identify potentially harmful behavior and prevent opioid misuse and abuse among patients. A tool which is currently not as widely established but one that is believed to complement PDMPs to prevent further spread of the opioid epidemic is electronic prescribing (e-prescribing). Currently, increasing numbers of states require its use for controlled substances in order to prevent pharmacy shopping, to enable better prescription tracking, and to reduce fraud and waste.