Bleeding From Medications Given While in Hospital: Acceptable?

Patient Services
When a patient with a severe illness decides that curative measures are no longer appropriate or effective, the option of hospice care is a compassionate, dignified and cost-effective end-of-life care option. When possible, the patient can receive treatment within his or her own home. The hospice team who visits the patient on a regular basis consists of a nurse, hospice aide, social worker, volunteer and chaplain. Staff physicians are consulted and are available when necessary.

The essence of Houston Hospice care is:

* quality of life
* treatment of the patient, not the disease
* the provision of palliative (the alleviation of pain) treatment
* the family as the "unit of care," not simply the patient
* 24 hours a day, 7 days a week available help from the hospice nurses and physicians

Following assessments in the areas of physical pain, emotional needs, spiritual issues, legal concerns and practical arrangements, the patient, family and physician approve a plan of care. Being involved in making the plan helps patients and families face the last stages of life more comfortably and confidently.

Patient care is provided by Houston Hospice in the home, in a nursing home or residential facility or in the Margaret Cullen Marshall Hospice Care Center which is located in the Texas Medical Center.

There are four levels of care that are provided by hospices in the United States. Every patient receiving hospice services will be on one of these four levels. A hospice patient can move from one level to another and back, depending on the services required to fulfill his or her needs. The need of the patient will determine their individual level of care. These four levels are:

* Routine Home Care – patient at home with symptoms controlled
* Continuous Nursing Care at Home – patient at home with uncontrolled symptoms
* Inpatient Care – patient in facility with uncontrolled symptoms
* Respite Care – patient at facility with symptoms controlled

When is Hospice appropriate?

Hospice care becomes an alternative when a patient has reached the last phases of a terminal illness, and has been given a prognosis of six months or less. It can also be an alternative following the discontinuation of treatment, an accident or the sudden onset of a catastrophic illness. The subject can be addressed at any time during the illness, as physician and patient discuss treatment options. When a patient chooses hospice, the decision to give up curative measures is made in favor of comfort care, focusing on pain management and symptom control, psychosocial support for both patient and family and ancillary services that lessen the burden of illness and caregiving.

Should I wait for our physician to bring up the subject of hospice, or can I raise it first?

The decision to choose hospice should be made by patient and family with the input of a physician. Open and honest discussion about treatment options should be held throughout the course of the illness. If a patient or family feels that a physician is reluctant to discuss hospice care, it is always appropriate for one or the other to approach the subject.

What does the admissions process involve?

The admissions process involves an interview with an admissions nurse to discuss what the patient and family can expect from Houston Hospice, how care is provided, services available and information on illness and its effects that help prepare the family for the coming days. Medicare, Medicaid and/or other available benefits will be discussed, although Houston Hospice never denies treatment based on a patient's ability to pay for services.

Where is hospice care provided?

Houston Hospice provides the majority of its care in a patient's home, with family and friends acting as caregivers. If there is no residence, the agency can furnish care in nursing homes, or other types of residential facilities in their own communities. If a patient requires inpatient care in order to address severe symptoms or to provide respite for a caregiver, Houston Hospice has contracts with hospitals throughout its service area as well as in its the Margaret Cullen Marshall Hospice Care Center located in the Texas Medical Center.

What assistance does hospice provide in the patient's home?

Houston Hospice patients are cared for by a team of doctors, nurses, social workers, hospice aides, non-denominational chaplains, therapists and trained volunteers.

How do we pay for hospice care?

Houston Hospice is a Medicare and Medicaid certified hospice, and has relationships with a number of managed care companies. Arrangements may be negotiated to meet specific patient's needs with individual insurance case managers. Charity funds may be available for part or all care if a patient qualifies based on a Houston Hospice financial assessment. No patient is denied services based on his or her ability to pay.

Then get a second opinion from a reputable doctor. If the doctor indicates malpractice then consult a lawyer but I don't know if the new healthcare bill prevents patients from suing their doctors?