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It's a situation case managers encounter with agonizing frequency: Physicians who keep pumping medication into patients who are terminally ill, or families who insist on continuing treatment when the clinical picture indicates that the patient's condition is terminal.
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Hospitals need a pharmacist who specializes in pain management on board, although this model hasn't taken off as a trend as quickly as many experts in the field believe it should.
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There are a number of reasons pain management should include pharmacy input, including the following:
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Phase I oncology trial participants often are excluded from hospice services. However, a recent study shows that although they do suffer the same symptoms of patients undergoing traditional cancer therapy, they are less likely to indicate a need for hospice or palliative care-related services.
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As the U.S. population ages, it makes sense that hospice patients will be older as well. Results of the hospice data collected by the National Hospice and Palliative Care Organization (NHPCO) show a 3.4% increase in patients older than age 85 between 2006 and 2007, with 36.6% of all hospice patients older than age 85.
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Hospice managers admit that the most reliable referral network is comprised of relationships developed with other providers in the community who can recommend hospice to appropriate patients. For this reason, hospices frequently develop relationships with hospitals, physician practices, home health agencies, and nursing homes.
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Although partnering with a nonmedical caregiving agency does give a hospice an additional way to help families meet their caregiver needs that are not covered by the Medicare hospice benefit, it is important that proper training be provided to the nonmedical caregivers.
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Managers don't normally keep a crystal ball in their supply closet, but the ability to predict, or at least guess, at the future of health care as our country faces economic and political changes could be helpful.
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A shrinking work force, expanding patient base, and sicker patients are challenges that many agencies are meeting with technology.
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United Kingdom's Baroness Mary Warnock, considered an expert on medical ethics, created a stir in late 2008 with her suggestion that those in the UK with dementia have a duty to die, so as not to strain public health resources.
