Hospice and Palliative Care in Colorado

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Hospice and Palliative Carein Colorado
Cordt T. Kassner, PhDExecutive DirectorColorado
Hospice Organization Colorado Palliative Care
Partnership
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Question

• Would you be surprised if you were alive 5 years
  from now?
• 1 year from now?
• Six months from now?

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Colorado Frontier, Rural, and Urban Counties
(N64) Colorados 43 Hospices with 63 Locations
(2/06)
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2004 Colorado HospicePatient Primary Diagnosis
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Standards Quality

• NHPCO Quality Initiative
• Colorado 7th Stateto Sign QualityPledge
• Individual hospicesto join

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Unintended Consequences

• Mean length of stay of 51 days.
• Median length of stay of 18 days.
• 27 of patients admitted died in 7 days or less.
• 5 of patients admitted died in 180 days or more.

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Unintended Consequences

• Misconceptions about enrollment criteria and
  timeframes
• May extend past 6 months
• May revoke at any time
• May re-enroll at any time

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Hospice Palliative Care

• All hospice is palliative care not all
  palliative care is hospice
• Hospice limited by Medicare Benefit to terminal
  phase palliative care for all health problems
• Hospice funded by Medicare, insurance palliative
  care not reimbursed

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What is Palliative Care?

• A philosophy of care
• A program
• A service
• A consult
• A plan of care
• Pre-hospice or hospice care

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Conditions Addressed by P.C.

• CHF
• Cancer
• COPD
• Alzheimers
• Dementia
• Multiple Sclerosis

• Parkinsons
• AIDS
• ALS
• Liver disease
• Diabetes
• Kidney disease

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Current Practice of Hospice and Palliative Care
Curative Treatment
Hospice
Palliative Care
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Current Model of Hospice and Palliative Care
Curative Focus Disease-Specific Treatments
Palliative Focus Comfort / Supportive Treatments
Bereavement Support
Hospice
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Transitions Model of Hospice and Palliative Care
Curative
Palliative

• Transitions are rarely spontaneous
• Effective, ongoing communication vital
• Persons goals transition with time
• Small steps support transitions

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Current Model of Hospice and Palliative Care
Curative Focus Disease-Specific Treatments
Palliative Focus Comfort / Supportive Treatments
Bereavement Support
Hospice
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Where Can I Get Palliative Care?

• Kaiser
• UCHSC
• Exempla hospitals
• Health One hospitals
• Veterans Administration facilities
• Hospice Transition, open access programs
• Consultation through private palliative care
  physician or nursing professional

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Resources

• www.coloradopalliativecare.org
• www.coloradohospice.org
• www.nhpco.org
• www.aahpm.org
• www.capc.org

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For Additional InformationPlease Contact