Shepherd’s Cove Palliative Care

What is palliative care?

Palliative care is compassionate care focused on comfort. “To palliate” means to relieve. Palliative care allows patients to seek curative treatments but provides relief from pain and other distressing symptoms. It also utilizes a team approach to integrate emotional and spiritual aspects of care for those living with a life limiting illness. The goal is to allow patients to live as actively and comfortably as possible, and to help families and caregivers cope with the patient’s illness.

The patient creates a plan of care outlining their needs with the help of a board certified physician. The plan will allow patients to receive curative treatments for their illness while achieving comfort from distressing symptoms.

Who is a part of the palliative care team?

• Patients and Families: Patients and family caregivers are the primary palliative care team.
• Doctors: Palliative doctors are trained in comfort care. They work with patients and primary caregivers to create a plan of care based on the goals of the patient and family.
• Nurses: Nurses will work closely with the patient and family to implement and support the care plan. They will communicate with patient and family to help manage medications.
• Social Workers: Social workers will help with practical matters such as confusing paper work to access resources when needed. They are also available to provide emotional support and to explain and access community resources.
• Chaplains: Chaplains provide spiritual and emotional support based on the patient’s value system. They listen with compassion and without judgment. They can guide meaningful conversations about hope and emotional growth.

How does it work?

Referral: If you or a loved one is facing a life-threatening illness and struggling to manage the distressing symptoms, ask about palliative care. Anyone can recommend palliative care. It doesn’t matter the stage of your illness, palliative care can be provided at any time and the sooner the referral is made, the more the patient will benefit from palliative care services.

Eligibility: Palliative care can be provided to anyone with a life-threatening illness whose symptoms are worsening. Care can be given at any stage of an illness and can be provided at the same time the patient is receiving curative treatment.

Payment: Talk to your care team about costs and payment options.

The Plan of Care: Once the patient is accepted into the palliative care program, the care team will meet with the patient to determine the plan of care based on the patient’s needs. Treatments and care will be determined based on the patient’s values, beliefs, needs and goals.

The goal of palliative care is to allow the patient to live as actively and comfortably as possible while facing their life-threatening illness. The care team will assist in educating the patient about their illness and treatment options, help the patient to define what they want their quality of life to be and guide them in determining the type of care the patient prefers.

Delivery of Care: The Shepherd’s Cove Palliative Care makes visits to the patient’s home as needed. The care team prescribes medications and therapies and provides instruction on how to manage syptoms of the illness.

What is Shepherd’s Cove Palliative Care?

A voluntary Board of Directors representing each partner governs SCPC. Through SCPC, an interdisciplinary palliative care team bridges the gap between hospital care and community care for those living with life threatening illnesses. The focus of the team is comfort, addressing not only physical symptoms, but emotional and spiritual suffering while assisting the patient and their family to gain access to care most aligned with their personal goals of care. It is the goal of the SCPC and the interdisciplinary team to improve the patient’s quality of life, as well as to avoid unnecessary hospital readmissions or unwanted treatments or procedures.

What is Palliative Care?

Palliative care

• allows patient to seek curative treatments while addressing comfort issues;
• provides relief from pain and other distressing symptoms;
• integrates psychological and spiritual aspects of care;
• offers support to help patients live as actively as possible;
• helps families cope with the patient’s illness; and
• advocates for patient and family to access community resources

Why should I consult SCPC?

SCPC consultation team has the ability to assist the attending physician by:

• Improving pain and symptom management.
• Helping patients and families clarify goals of care in order to:
  • match the personal goals of care with physician’s orders;
  • set realistic expectations;
  • reduce ER visits; and
  • identify hospice referrals earlier.
• Reducing ICU lengths of stay.
• Reducing 30-day readmission.
• Improving communication between physician and patient.
• Reducing hospital cost.

The difference between palliative and hospice care:

Palliative Care

• Care is provided in hospital and patient’s home.
• Patient can pursue curative treatments.
• Board certified palliative care physician consults and develops palliative treatment plan.
• CRNP trained in palliative care coordinates with physician to develop and implement the palliative treatment plan.
• Patient’s goals of care are clarified.
• RN follows up 1-2 times per month in patient’s home to assist with compliance to the palliative treatment plan.
• Social workers provide psychosocial support and assist in accessing community resources.
• Chaplains provide spiritual support.
• Consults are available Monday-Friday, 8:00 a.m. to 4:30 p.m.
• Medicare coverage is available for physican or nurse practitioner consultation only.

Hospice Care

• Care is provided anywhere a patient calls home including a contracted SNF, hospital, or hospice IPU.
• Hospice care is appropriate after completion of curative treatment.
• A team of healthcare professionals–including RNs, social workers, personal care aides and nurse practitioners–visit the patient weekly or more often.
• On-call RNs are available 24/7.
• Personal care aides and volunteers meet patient and family needs.
• Assistance with personal care and activities of daily living are provided.
• Social workers provide psychosocial support and assist in accessing community resources.
• Chaplains provide spiritual support.
• Volunteers provide companionship and support the family.
• Medications, equipment and/or supplies related to terminal illness are provded.
• Short term inpatient care is available.
• Short term respite care is available.
• Bereavement services are available to the grieving for one year.
• Services are covered by insurance.
• Indigent care is available.

How will palliative care help my patient?

Palliative care:

• provides symptomatic care, allowing the patient to be comfortable, enhancing their quality of life;
• bridges the gap of support with other healthcare providers;
• increases patient’s time in their home—not in hospital;
• implements earlier interventions and treatment compliance with the support of a RN following up in the home environment;
• provides ccess to community resources;
• provides the patient with a support team to help them navigate the physical, emotional and spiritual challenges of facing a life-threatening illness;
• empowers patients to control their care;
• provides them with a knowledgeable team to provide support and guidance, helping the patient to achieve their preferred goals of care; and
• supports families of patients, allowing them to better understand the patient’s needs and preferred goals of care.

What are the criteria for referral?

Diagnosis of a life threatening illness and any of the following:

• unacceptable level of pain or other symptom distress > 48-72 hours;
• uncontrolled psychosocial or spiritual issues;
• frequent visits to the emergency department for the same diagnosis;
• frequent hospital admissions for the same diagnosis in last 30 days;
• prolonged hospital length of stay (7-14 days) without evidence of improvement;
• prolonged stay in ICU setting without evidence of improvement;
• in an ICU setting with documented poor prognosis;
• dementia or Alzheimers FAST score of < 7 experiencing recurrent aspiration;
• cirrhosis experiencing encephalopathy;
• mechanical ventilation > 10 days;
• CHF—3rd admission in a year;
• COPD—3rd admission in a year; or
• Cancer—distressing symptoms.

How do I refer my patient to SCPC?

Call us Monday through Friday, 8:00 a.m. to 4:30 p.m. at 256-302-1663 for a consultation.

The SCPC office is located at 408 Martling Road, Suite A-105, Albertville, AL 35951.