Making the Rounds: An End-of-Life Care Blog
World Sepsis Day is September 13: A Day to Rethink Sepsis
September 13 is World Sepsis Day 2019, the perfect opportunity for healthcare professionals and clinicians to update their approach to sepsis.
Sepsis Outcome of Death or Discharge Remain Steady
Incidence and mortality rates of sepsis in the United States appear to have remained constant in recent years based on clinical data, despite the higher incidence and lower mortality suggested by claims-based data.
Sepsis Hospital Readmissions Higher Than Non-Sepsis
Sepsis patients are at a significantly higher risk of hospital readmission and post-acute care use than non-sepsis patients, according to the results of a two-year observational cohort study published in the Annals of the American Thoracic Society.
Why Partner with a Hospice Provider?
When we work as your partner, VITAS leverages our technology, staff and experience to transition your sickest patients from hospital to wherever they call home. Then we provide the support necessary to improve quality of life, manage symptoms and prevent readmissions.
A Hospice Eligibility Checklist for Emergency Department Staff
ED staff: Is your frequent emergency room patient a good fit for hospice care? Read and download our guidelines here to find out if hospice care can help.
Sepsis Develops Frequently in Hospice-Eligible Patients, Yet End-of-Life Care Is Rarely Addressed
New research should convince physicians and administrators to consider how sepsis infections in persons near the end of life impact healthcare value—particularly metrics for patient and family satisfaction, in-hospital mortality, hospital readmissions and Medicare per-beneficiary spend.
Sepsis Hospital Readmissions Found to Be Common and Costly
The striking proportion of sepsis patients who undergo hospital readmissions continues to be common and costly, according to the authors of a study published in CHEST® Journal.
Largely Unpreventable, Sepsis Hospital Deaths Are Prevalent
Despite the prevalent view that most sepsis-based deaths are preventable with better care, the authors of a study published in JAMA Network Open report that it is unlikely that a large proportion of these deaths can be prevented.
Clinicians' Overestimation of Cancer Patient Survival Affects End-of-Life Outcomes
A study that followed advanced cancer patients who engaged in a palliative care consultation found that patients' likely survival time was often overestimated by clinicians.
Physicians' Beliefs Contribute to Geographic Variation in End-of-Life Expenditures for Cancer Patients
Healthcare expenditures in the last months of life are known to vary considerably across US geographic areas, with no link to improved outcomes.
Is It an Emergency? Or Is It Hospice?
What are best practices for terminally ill patients who frequent your emergency department?
Cardiologists Urged to 'Champion' End-of-Life Care for Patients and Their Families
Clinicians caring for patients with advanced heart failure (HF) are encouraged to advocate for changes to improve the overall care of this growing population.
Hospice Cardiac Care Is Aggressive, Palliative Symptom Management
If a Stage D heart failure patient does not choose cardiac surgical options or is not a candidate for surgery, providers, patients and families can and should advance care to the next therapeutic level: hospice.
Longer Survival, Lower Costs, Less Likelihood of Hospital Death Linked to Heart Failure Patients under Hospice Care
Many older adults with heart failure who enrolled in hospice experienced lived longer and didn't die in the hospital, according to a report published in JACC: Heart Failure.
Wound Care in Hospice Settings
Even in the final stages of life, good wound care can contribute to physical, psychological and emotional comfort. Read more from VITAS Healthcare, here.
Pediatric Palliative Care: a Gentle, Individualized Philosophy of Care
Palliative care’s goal is to relieve suffering and enhance quality of life for a child and family facing a serious, life-altering diagnosis. Read more here.
Take a Deep Breath. Are We Talking Invasive or Non-Invasive?
How are mechanical ventilations categorized? Are they reporting mechanical ventilation as invasive (IVS), non-invasive (NIVS) or both? Read more here.
Preventing Falls in Elderly Patients Can Avoid Injury and Save Lives
An older American falls every 17 seconds, making falls a leading cause of injury & the leading cause of injury-related death among people 65+. Read more here.
Dying COPD Patients Receive Increasing Rate of Life-Sustaining Procedures over Time
For patients with COPD who are hospitalized near the end of life, the utilization of life-sustaining procedures showed a significant interval increase from 2010 to 2014.
Important Palliative Care Discussions with COPD Patients: Too Little, Too Late?
Patient-physician discussions of palliative care issues are crucial to ensuring that patients with chronic obstructive pulmonary disease (COPD) get care that reflects their wishes and values. Read more here.
Hospice Nutrition and Hydration for Your Patients
If a terminal patient wishes to forgo food and water, is it ethical to honor their wishes? In this article we'll examine all aspects of ethical and medical issues surrounding nutritional support and hydration for patients near the end of life.
Deprescribing: Discontinuing Medications at the End of Life
Deprescribing is the process of discontinuing drugs when the risks outweigh the benefits in terms of a patient's care goals. Learn more about deprescribing and how it can help your hospice patients at the end of life.
Identify Symptom Burden, Manage Symptoms, Improve Patient Experience and Save Money
Palliative care & hospice services can be the win-win solution for many of these declining, chronically ill patients and their overutilization of healthcare.
Suggesting Hospice to Your Seriously Ill Patients
Talking about options near the end of life while the patient still enjoys quality of life is a priceless gift from the healthcare professional to the patient and the family.
High Symptom Burden Among Hospitalized Patients with Advanced Cancer Linked to Longer Stays, Risk of Readmission
A heavy physical and psychological symptom burden is experienced by hospitalized patients with advanced cancer; are at risk of unplanned readmission. Read more here.
New Clinical Guideline Urges Early Hospice Discussion for Advanced Cancer Patients
The American Society of Clinical Oncology has issued a consensus guideline for patient-clinician communication in cancer care, with a focus on consideration of end-of-life care.
Guidelines to Advance Care Planning
Voluntary ACP, which is reimbursed by the CMS, enables certain clinicians to engage in conversations about preferences at the end of life with patients.
Social Workers Play Critical Role in Hospice & Palliative Care
March is social work month. VITAS social workers are front-line healthcare professionals, serving as sounding boards & confidantes of their patients.
Homebound Status May Predict Mortality Among Older Adults
Among adults 65 years+ living in the community, homebound status is associated with greater risk of death, according to the Journal of the American Geriatrics Society.
Hospice Referrals for Advanced Dementia Patients Increase
The rate of hospice referrals for hospitalized patients with advanced dementia transferred from nursing homes increased over the past decade.
Helping Oncologists Treat the Disease While Palliative and Hospice Services Treat the Patient
Cancer treatment, palliative & hospice care can and should go hand-in-hand, for the benefit of the patients, their families, and those who treat them.
Quality of Life: Ask the Right Questions. Then Listen.
The goal of hospice is to make life as good as it can for as long as it can. But we have to ask the right questions & listen very carefully for each patient.
Why Don't More Healthcare Professionals Have End-of-Life Directives?
Studies & surveys show the general public embraces advance directives at rates greater than HCP's. In one Kentucky ICU, only 13% of the HCP's have EOL plans.
4 Levels of Hospice Care For Your Patients with End-of-Life Care Needs
Read how VITAS has services and resources to provide care for your patient at all 4 levels of hospice care.
ED Physicians Have the Tools—and the Mandate—to Identify Hospice Patients
The CARING tool helps identify patients with advanced disease, citing criteria to identify those likely to die within a year. Learn more from VITAS.
Hospice Enrollment Linked to Symptom Burden, But Care May Often Begin Later Than Needed
As restricting symptoms increase and the functional status of older adults as end of life declines, the likelihood of hospice referral rises, researchers found.
Palliative Care Improves Quality of Life, Well-Being for Advanced Heart Failure Patients
Patients with advanced HF who receive ongoing, palliative care in the outpatient setting following hospital discharge show greater improvement in quality of life.
How Hospice Workers Can Overcome Compassion Fatigue
Empathy is an important quality for any hospice provider, but compassion fatigue can often be a cost of caring. Here are VITAS' tips for self-care for healthcare professionals.
The Hospice Transition: How Medications Change
The transition of a patient from curative care to palliative or hospice care brings changes in treatment philosophy. One of those involves medications.
Advanced Disease Management: Helping Patients Cope with Serious Illness
Advanced Disease Management (ADM) bridges the gap between curative care and hospice. Learn more about helping patients cope with serious illness fro VITAS.
How to Spiritually Care for Your Patients Near the End of Life
Spiritual care is valuable at any time, but it’s particularly essential for hospice patients as they struggle with apprehensions about their own death.
10 Ways to Reduce Patient Readmissions
Communication and collaboration are the keys to reducing patient rehospitalization. Learn more about the ways to reduce patient readmission with VITAS.
Care Coordination: A New Challenge in Healthcare Reform, an Old Standard in Hospice
Care coordination has been at the foundation of hospice care since it was signed into law in 1982. Learn more about care coordination with VITAS.
How We Help Our Healthcare Partners Achieve the Triple Aim
CEO Nick Westfall shares insights on how VITAS can help healthcare organizations meet the Affordable Care Act's Triple Aim, by improving the patient experience, improving the health of populations and reducing the per-capita cost of health care.
Does Where You Live Determine How You Die?
Residents of the state of Oregon are more likely to have their end-of-life wishes honored than residents in the rest of the country. Learn more here.
VITAS and the Assisted Living Facility: A Partnership of Care
VITAS® Healthcare has the expertise, the staff and the specialized services to keep your residents at home—out of emergency rooms, hospitals and nursing homes—as they approach the end of life.
The Medical Ethics of Healthcare Decision-Making
Medical ethics often refers to four principles of healthcare ethics that should be considered when making a decision.
Emergency Physicians Uniquely Placed to Assess Patients’ Hospice and Palliative Care Needs
Because physicians in emergency departments frequently encounter patients with life-limiting illness, they have the opportunity to recommend care.
COPD Patients Need the Support of Proactive Palliative Care
Patients with COPD are frequently under-supported, experiencing significant symptom burden, disability during the last few years of life. Learn more here.
What Does VITAS Do for Patients and Families Coping with Advanced Lung Disease?
VITAS has the resources to keep your high-risk, hospice-eligible ALD patient at home and comfortable during a crisis, and relieve the cost burden to the patient and their insurer.
Complementary Therapies Increase Comfort, Well-Being of Hospice Patients
Spiritual and holistic therapies are being used by many hospices, including VITAS Healthcare, to complement the physical, emotional and spiritual care.
Hospice Keeps Your Patients Safe at Home
VITAS serves to keep your seriously ill patients safe and allows them to live and die at home. Here's what hospice teaches family caregivers about infection control.
Your Role in Hospice as the Attending Physician
As the attending physician for a patient you refer to hospice, you'll remain an integral part of the patient's care team. Learn how hospice can help.
Families Rate Hospice as “Excellent” with Highest Ratings Linked to Longer Lengths of Stay
A new study shows that families of oncology patients rate hospice as “excellent,” with highest ratings linked to longer lengths of stay. Read more at VITAS.com.
Hospice Patients Have Lower Hospitalization Rates, Reduced Medical Costs
Read about how hospice benefits patients with factors like lowery hospitalization rates and reduced medical costs.
Give Your Seriously Ill Patients Quality of Life at the End of Life
Sometimes, hospice gives patients more time. Always, hospice makes the most of the time the patient has. Quality of life is a gift you can give.
How to Help your Seriously Ill Veteran Patient
The VA reports half of the men who die today are military veterans, there are a lot of veterans who would benefit from hospice services. Learn more here.
Guidelines to Submit a Claim for Care Plan Oversight
Care plan oversight is a service for which certain clinicians can bill Medicare in the absence of a face-to-face patient encounter. Learn more here.
Dealing with Stress When You Work with Death and Dying
Stress is a very natural response to living and working so close to dying and death. An honest assessment of your stress levels can help.
7 Things You Need to Know About Advance Directives for Your Patients
Number 3: They're billable. Medicare reimburses you for talking to your patients about end-of-life care. Get the full list and then talk to your patients about advance directives.
Ten Hospice Basics Doctors Should Know
Read the ten hospice questions palliative care doctors should ask provided by VITAS Healthcare, the nations leading provider in end-of-life care.
Antipsychotics and Your Terminally Ill Nursing Home Resident
The goal of VITAS Healthcare is to optimize symptom management; we prescribe antipsychotic treatment only when clinically sustained. Learn more here.
Oncologists Refer Patients Earlier to Hospice after Simple Quality Improvement Project
By treating referral for hospice care as a quality measure, an Ohio healthcare system has seen the doubling of the hospice LOS among cancer patients.
Performance Status Alone Found Effective Tool for Prognostication in Advanced Cancer
A simple prognostic model based on performance status has predictive ability that is similar to more complex models in patients with advanced cancer.
How to Cope when Your Patient Dies
Medical professionals need to be responsible for their own care. An honest assessment of your ability to cope with loss can help determine the right next steps for you.
Areas with High Hospice Use Have 'Spillover Effect' of Lower Rates of 30-Day Rehospitalization
Patients newly enrolled in hospice close to hospital discharge were found to be at low risk for rehospitalization within 30 days. Read here to learn more.
Hospice Referral at Discharge Linked to Lower 30-Day All-Cause Readmissions among Heart Failure Patients
Approximately 25% of patients hospitalized for decompensated heart failure (HF) are readmitted within 30 days of discharge, making HF the leading cause for 30-day all-cause readmissions in the U.S.
Would a Repeal of the Affordable Care Act Affect Hospice?
For caregivers dealing with loved ones with end-stage terminal illness, hospice services provide physical and emotional support for patients, caregivers and loved ones.
Partnering to Keep Hospice Patients Out of the Hospital
Because the role of hospice is to ensure in-home support and the most appropriate care possible for patients and families coping with terminal illness, collaboration between hospice and EMS benefits everyone.
International Study Finds Widespread Use of “Non-Beneficial Treatments” among Terminally Ill
The widespread use of NBTs has repercussions that affect the sustainability of health services and perpetuate unrealistic expectations of survival, note the authors.
Patients, Oncologists Hold Mismatched Opinions on Advanced Cancer Survival Prognosis
More than two-thirds of patients with advanced cancer had survival expectations that did not match the estimates of their oncologists, with most patients being more optimistic.
Hospice Services and the Nursing Home: Collaborating to Care for Residents at the End of Life
Death is a process, not an event. Appropriate care requires ongoing recognition, assessment and response. Hospice can add to a nursing home resident’s end-of-life goals and to its staff’s end-of-life expertise.
Is Hospice Being Used as an Add-On to Increasingly Aggressive Care at Life’s End?
U.S. regions with the highest rates of intensive care for terminally ill patients in the last six months of life also have the highest rate of very short hospice enrollments.
Aspects of a Good Death: Physicians and Families Often Agree with Patients, but Some Divergence Exists
While patients, their family members and healthcare professionals (HCPs) all identify the same three themes of a good death as most important, for some other elements of “successful dying,” the perspectives of these groups tend to diverge.
Is Chronic Overcrowding a Problem for Your Emergency Department?
Hospice, with expanded alternatives such as inpatient units or continuous home care for transitioning end-of-life patients, may better serve your ED while allowing patients and families to regard your facility as efficient and more responsive to their needs.
Functional Decline Can Indicate Hospice Eligibility
In a first-of-its-kind study, older patients from several major U.S. ethnic minority groups identified barriers to the kind of care they would prefer at life’s end.
Hospice Patients Don’t Need to Revoke Benefit if They Visit ED
The Medicare hospice benefit belongs to the patient, who voluntarily signs up for hospice with the understanding that he will receive palliative care in lieu of curative care for his terminal illness. The patient must revoke the benefit if he decides to receive curative care.
Expert Outlines “Splits” Preventing Optimal End-of-Life Care
Studies in recent years reveal an increasing trend in the U.S. toward shorter hospice stays and greater intensity of care in the last months of life.
Earlier Hospice Enrollment Key to Higher Family Ratings of Care Quality
Family members were more likely to rate their loved ones’ end-of-life care as “excellent” when patients were enrolled in hospice for longer than three days, died outside of the hospital and were not admitted to an intensive care unit (ICU) within the final month of life.
Physician Recommendations to Surrogates Crucial to Decision-Making near Life’s End
With the aging of the American population and continuing technological advances in life-sustaining interventions, many patients will be incapacitated when complex end-of-life treatment decisions are called for.
Patients across Ethnic Groups Desire High-Quality End-of-Life Care
In a first-of-its-kind study, older patients from several major U.S. ethnic minority groups identified barriers to the kind of care they would prefer at life’s end.
The H Word
The word 'hospice' is surrounded by mystery and misconception. In reality, it is a natural, gentle, compassionate intervention for a vulnerable population, says Dr. Eric Shaban, VITAS Regional Medical Director.
Break the Cycle; Send them Home
By identifying appropriate patients early in the emergency department cycle and promptly referring them to palliative care or hospice, we offer them better lives.
Strong Presence of Hospice in Nursing Homes Reduces Risk of End-of-Life Hospitalization for All Residents
A report shows that residents in nursing homes with higher rates of hospice penetration have a reduced risk of being hospitalized in the last 30 days of life.
Accurate Understanding of Chemotherapy Does Not Curtail Late-Life Use, But Improves Odds of Entering Hospice Care
Patients with an accurate understanding of chemotherapy are more likely to enroll in hospice, according to a report.
Unpredictable Trajectory and Other Care “Dilemmas” in Heart Failure Make End-of-Life Care Planning Imperative
Uncertainties with heart failure pose an obstacle to ensuring quality end-of-life care for end-stage patients, according to a paper published in the Journal of Geriatric Cardiology.
Quick, Secure and Simple
Refer your hospice-eligible patient easily. The VITAS app features:
- One-touch referral capability
- Immediate access to hospice clinical guidelines
- 1-click access to a VITAS admissions coordinator
- Android and iOS compatibility