Palliative Care / In-home Care

April 16, 2007

Guest Presenter: Joyce Hutchinson, Iowa Health Home Care, 557-3100

Brief History of Health Care:

• People died at home up until about the early to mid 1900’s.
• At that point in time, health care moved to the hospital, CPR and penicillin were introduced.
• Death became equated with medical failure
• People began dying of chronic disease rather than acute diseases of earlier times since those were now treatable. Palliative care will help address this.
• Current law says that resuscitation has to occur in a hospital if no advanced directives are in effect.

Trends:

• It is estimated that by 2020, there will be 70 million elderly in the US.
• People are living longer, and people are living longer with chronic illnesses.
• In 1997, half of all deaths in hospitals were characterized by poor doctor/patient/family communications.
• It used to be that people didn’t want to go to the hospital because they were afraid they would die there. Now people don’t want to go to the hospital because they are afraid they won’t be allowed to die.
• Extended care causes a physical, emotional and financial burden on others.
• Greatest fears of patient: Being a burden and being in pain

Hospice:

• Is available for people diagnosed with chronic illness that will likely take their life within 6 months, though that is not a hard and fast rule.
• Hospice does not determine when a person will die.
• Hospice is about living as long as you can with the best quality of life possible.
• Emotional, physical, spiritual comfort is provided.
• Covered by Medicare and most insurances.
• Available at home, in a nursing home, or at a hospice facility.

Palliative Care:

• Has no time restrains for service
• Purpose is to help you decide how you want the rest of your life to look, such as: do you want repeated hospitalizations, what type of medical help do you want, what type of medical help are you willing to accept.
• Purpose is to help educate both the patient and the family
• No financial help is available at this time from insurance or Medicare, but there is hope that this will change soon.
• Some palliative services are offered at no charge.
• Palliative care staff help with patient setting goals and filling wishes and making decisions for themselves.
• It is family-centered care.
• Goal is to work for freedom from pain.
• Focus is on the quality of life.

Home Care:

• Is an organization that provides medical and nursing care and practical services that are medically oriented to help a person with the tasks that they cannot do for themselves, or that family has trouble doing for them.

Questions to Ask Your Loved One:

• How do you feel about hospitalization?
• How do you feel about dying?
• How do you feel about other people dying?
• How do you feel about someone else making the health care decisions for you?

For more information: Joyce Hutchinson, Iowa Health Home Care, 557-3100