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Palliative Care,
Hospice
and Advance Care
Planning
Leah Hamel, LCSW
Share Cancer Support
Community
“We can’t plan for everything, but we can talk
about what is most important—in our life, and
in our health care—with our loved ones before
the situation becomes critical.”-Dr. April Krutka
What is Advance Care Planning?
• Advance health care planning helps individuals make decisions about their health and
wishes while they have capacity to do so.
• It can help improve quality of life.
• Aide in communicating with medical teams.
• Helps family and friends make future decisions about your medical care when you are
no longer able to.
• Is not set in stone and can be changed when needed.
• Can be completed at any stage of life or disease.
The Importance of Advance Directives
• An advance directives are tools/forms that can include a health care proxy,
durable power of attorney, living will, a medical directive and code status
orders.
• These can vary from state to state.
• Advance directives are not financial forms.
• Your wishes are important to discuss with both your family and friends as well
as your medical team.
• Can give the patient and family peace of mind regarding future decisions.
POLST
• A Physician Order for Life Sustaining Treatment (POLST) Medical Order
for Life Sustaining Treatment (MOLST) are forms that are available
throughout the country. They can vary state to state.
• Completed primarily by a physician (NP or PA depending on the state).
• The forms outline a patient’s code status, their decision maker, contact
information and nutritional wishes.
POLST cont.
In California:
POLST - Physician Orders for Life-Sustaining Treatment
Website:http://www.polst.org/California
In New York
MOLST - Medical Orders for Life Sustaining Treatment
Website:http://www.polst.org/newyork
Advance Directives (examples)
Palliative Care
“Effective palliative care offers a support system
that helps optimize the quality of life and dignity
of patients.”
-World Health Organization
What is Palliative Care? (cont.)
• Palliative Care is not hospice care.
• It can be prescribed at any point of a diagnosis.
• The goal is to provide comfort and symptom management through an interdisciplinary
team approach (including spiritual care and social work).
• Collaborates with your primary medical team.
• Services can be provided in both an outpatient and inpatient setting. Sometimes at
home depending on insurance.
• The goal is to treat symptoms that are causing a patient distress (pain, nausea,
depression, anxiety, sleep etc.).
Hospice Care
“Palliative care allows us to make decisions now for
‘then.’ Hospice helps us live through the ‘then.’
-Susan E. Mazer, Ph.D.
What is Hospice Care?
• The mission of hospice is to keep the patient comfortable as they approach end of life.
• Patients must have a prognosis of 6 months or less and a physician order. This is often determined when
there are no additional treatment options.
• Can be offered in the home, hospital or facility. It is important to check with insurance to determine the
location disposition and exact services provided.
• If at home, durable medical equipment and home oxygen can be provided.
• Includes a multidisciplinary team: a physician, nurse practioner, home health aides, spiritual care,
pharmacist and a social worker.
• Often provides respite care for caregivers depending on needs.
• Provides 12-13 months of grief support after a loved one dies.
Case Examples…
Questions???
• And “thank you!”

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Let's Talk About It: Uterine Cancer (Advance Care Planning)

  • 1. Palliative Care, Hospice and Advance Care Planning Leah Hamel, LCSW Share Cancer Support Community
  • 2. “We can’t plan for everything, but we can talk about what is most important—in our life, and in our health care—with our loved ones before the situation becomes critical.”-Dr. April Krutka
  • 3. What is Advance Care Planning? • Advance health care planning helps individuals make decisions about their health and wishes while they have capacity to do so. • It can help improve quality of life. • Aide in communicating with medical teams. • Helps family and friends make future decisions about your medical care when you are no longer able to. • Is not set in stone and can be changed when needed. • Can be completed at any stage of life or disease.
  • 4. The Importance of Advance Directives • An advance directives are tools/forms that can include a health care proxy, durable power of attorney, living will, a medical directive and code status orders. • These can vary from state to state. • Advance directives are not financial forms. • Your wishes are important to discuss with both your family and friends as well as your medical team. • Can give the patient and family peace of mind regarding future decisions.
  • 5. POLST • A Physician Order for Life Sustaining Treatment (POLST) Medical Order for Life Sustaining Treatment (MOLST) are forms that are available throughout the country. They can vary state to state. • Completed primarily by a physician (NP or PA depending on the state). • The forms outline a patient’s code status, their decision maker, contact information and nutritional wishes.
  • 6. POLST cont. In California: POLST - Physician Orders for Life-Sustaining Treatment Website:http://www.polst.org/California In New York MOLST - Medical Orders for Life Sustaining Treatment Website:http://www.polst.org/newyork
  • 8. Palliative Care “Effective palliative care offers a support system that helps optimize the quality of life and dignity of patients.” -World Health Organization
  • 9. What is Palliative Care? (cont.) • Palliative Care is not hospice care. • It can be prescribed at any point of a diagnosis. • The goal is to provide comfort and symptom management through an interdisciplinary team approach (including spiritual care and social work). • Collaborates with your primary medical team. • Services can be provided in both an outpatient and inpatient setting. Sometimes at home depending on insurance. • The goal is to treat symptoms that are causing a patient distress (pain, nausea, depression, anxiety, sleep etc.).
  • 10. Hospice Care “Palliative care allows us to make decisions now for ‘then.’ Hospice helps us live through the ‘then.’ -Susan E. Mazer, Ph.D.
  • 11. What is Hospice Care? • The mission of hospice is to keep the patient comfortable as they approach end of life. • Patients must have a prognosis of 6 months or less and a physician order. This is often determined when there are no additional treatment options. • Can be offered in the home, hospital or facility. It is important to check with insurance to determine the location disposition and exact services provided. • If at home, durable medical equipment and home oxygen can be provided. • Includes a multidisciplinary team: a physician, nurse practioner, home health aides, spiritual care, pharmacist and a social worker. • Often provides respite care for caregivers depending on needs. • Provides 12-13 months of grief support after a loved one dies.