Proposed Definition of Palliative Care
Until a US National Consensus can be reached, CAPCManual proposes that the following definition of palliative care be used to guide palliative care program development:
Brief Definition (8 second sound byte):
Palliative Care aims to relieve suffering and improve the quality of living and dying.
Elaborated Definition:
Palliative Care is appropriate for any patient and/or family living with, or at risk of
developing a life-threatening illness
- due to any diagnosis
- with any prognosis
- regardless of age
- at any time they have unmet expectations and/or needs, and are prepared to accept care
It aims to address:
- physical, psychological, social, spiritual and practical expectations and needs
- loss, grief and bereavement
- preparation for, and management of, self-determined life closure, the dying process, and death
It is most effectively delivered by an interdisciplinary team.
It may complement and enhance disease-modifying therapy, or it may become the total
focus of care (see Applicability of Palliative Care).
It may also be applicable to patients and families experiencing acute illness and/or chronic
illness.
Background:
Proposed by the Authors of CAPCManual.
Adapted from the National Consensus-building Process to Establish National Norms of Practice,
Canadian Palliative Care Association.
Accepted by The National Hospice Work Group.
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CAPCManual Attribution:
von Gunten CF,
Ferris FD,
Portenoy RK,
Glajchen M, eds.
CAPCManual: How to Establish A Palliative Care Program.
New York, NY: Center to Advance Palliative Care, 2001.
©
Center for Palliative Studies, San Diego Hospice & Palliative Care, San Diego, CA
and
The Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY, 2001
Permission to reproduce for non-commercial educational purposes with display of
attribution and
copyright is granted.
Last updated: February 20, 2002
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Elements
Select section:
Basis, Context, Components,
Case Examples
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Basis of Palliative Care Practice
Palliative Care Definitions
Historical Definitions
WHO
Oxford Textbook
ABHPM
NHPCO
Palliative Care
Applicability
Application to Patients at Risk
Differences–Hospice & Palliative Care
Values, Ethical Principles
Values
Ethical Principles
Conceptual Framework
Square of Care
Square of Organization
Square of Care & Organization
Norms / Standards of Practice
Guidelines
Policies, Procedures
What are They?
Developing, Implementing, Evaluating
Measures
Definitions of Common Terms
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Context
Tensions
In Therapeutic Relationships
Within Host Organizations
Within Healthcare System, Community
Who's the Customer
US Healthcare
Acute Care Hospitals
Long-term Care Facilities
Home
Hospice Care
Financing US Healthcare
Expenditures for EOL Care
Overview by Settings, Revenue Sources
Medicare
Medicaid
Commercial Insurers
Managed Care
Government (VA, Military)
Financing
Community Hospitals
Academic Hospitals
Subacute, Skilled Care
Custodial Care
Ambulatory Care
Home Care
Hospice Care
Eligibility
Covered Services
Reimbursement Rates
Unintended Consequences
Financing Physicians
Coding
Procedure / Service Codes
Coding Based on Time
Frequently Used E/M Codes
Example
Addition of Procedure Codes
Diagnosis Codes
ICD-9 Codes for Palliative Care
Avoiding Concurrent Billing Problems
Example
Documentation
Example
Physician Reimbursement
Medicare
Medicare Hospice Benefit
Non-hospice Physicians
Associated with a Hospice
Medicaid
Commercial Insurers
Managed Care
Government (VA, Military)
Financing Non-physician Providers
Hospital–Hospice Relationships
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Program Components
1º, 2º, 3º Model of Palliative Care Delivery
Interdisciplinary Care
Members of Interdisciplinary Team
Core Competencies
Physician
Nurse
Social Worker
Chaplain
Volunteer
Specialized Environments
Types of Services
Consultation Services
Consultation Etiquette
Consultation Documentation
Sample Note
Inpatient Units
Developing an Inpatient Unit
Staffing
Acuity
Nursing Model
Unit Size
General Ward vs. Palliative Care Unit
Roles
Decisions
Case Example
Nursing Staff
Physician Staff
Other Staff
Advice
Home Care
Eligibility, Medicare Home Health Benefit
Covered Services
Usually Not Covered
Hospice Care at Home
Ambulatory Outpatient Care
Respite Care
Financing Palliative Care Programs
Acute Hospital
Skilled Care Nursing Home
Hospice
Home Health
Ambulatory Outpatient
Managed Care
Financing Physicians in Palliative Care
Financing Non-physicians in Palliative Care
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Case Examples
CAPCManual Case Examples
Pioneer Program Case Examples
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