Jeanann,

What I do when I have a hospice resident is to try to see how the palliative
philosophy affects each problem, need or strength addressed on the
resident's care plan.  I look at  my goals and ensure that they are in line
with the hospice approach. For example:  nutritional problems. For a
non-hospice resident, my goals address the need to maintain nutritional
status, avoid significant weight loss, avoid malnutrition or other
complications related to nutritional status.  Well, for the hospice patient,
those goals are simply not appropriate. So my goal for them would be more
like, "Will consume food and/or fluids AS DESIRED or AS TOLERATED (emphasis
added for effect)  to be free from distress or discomfort associated with
nutritional status or hydration.

The approaches are similarly adjusted: instead of "Serve diet as ordered and
encourage to consume at least 75% of food at each meal", it may say, "Serve
food and fluids as desired and encourage intake as tolerated."

I also usually include an approach on each problem/need/strength statement
to contact XYZ Hospice for any changes in status or discomfort/distress not
alleviated by ordered meds/approaches.

Hope this is helpful.

Holly

Holly F. Sox, RN, RAC-C
Clinical Editor
Careplans.com

[EMAIL PROTECTED]      www.careplans.com
----- Original Message -----
From: <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Sunday, May 02, 2004 2:01 PM
Subject: HOSPICE & CAREPLANS


> Hello everyone. I am happy to say that our survey was last week and we did
> wonderful. I have only been doing this job 2 years in August and actually
looked
> forward to our survey so I could see where I stood. The state always has
> something to say about the Mds or careplans. I was so proud when the only
thing
> stated was our careplans are not coodinated enough for them with the
Hospice
> careplans.
> My question is how do you coodinate your careplans with Hospice? Our
facility
> adds that family/res has chosen palliative care....ect...see Hospice book
for
> spicific goals and approaches...ect...Not good enough. Any suggestions
> besides typing for hours.
> We've all seen Hospice careplans and to add all that to ours.....
> Good luck to everyone in the survey [EMAIL PROTECTED]
> /----------------------------------------------------------
> The Case Mix Discussion Group is a free service of the
>  American Association of Nurse Assessment Coordinators
>       "Committed to the Assessment Professional"
> Be sure to visit the AANAC website. Accurate answers to your
>          questions posted to NAC News and FAQs.
>     For more info visit us at http://www.aanac.org
> -----------------------------------------------------------/
>

/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
      "Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
         questions posted to NAC News and FAQs.
    For more info visit us at http://www.aanac.org
-----------------------------------------------------------/

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