Medical Guidelines

Hospice upholds the physician-patient relationship established before the patient’s Hospice admission. Under the patient’s wishes, a continuing collaboration between the patient’s physician and the Hospice medical team will take place throughout the patient’s stay in Hospice.

The primary focus of hospice care is on pain and symptom management along with other supportive measures. Hospice is an alternative to aggressive medical regimes that may no longer be helpful or desired. Hospice care includes optimizing the patient’s ability to participate in activities of daily living.

For a procedure or treatment to be considered appropriate as part of the Hospice care plan, the patient, primary caregiver, physician, and Hospice interdisciplinary team must review the treatment in light of the patient’s life expectancy and quality of life at that moment in time. Treatment decision making is focused on enhancing the quality of the patient’s life.

According to Hospice regulations, and to be covered by insurance, all services, and medical treatments must be reasonable and necessary for the management of the life-limiting condition and pre-authorized by Hospice.

Medications will be ordered for the control of pain and other symptoms to achieve maximum comfort. Diagnostic tests and other assessments may be appropriate when results are needed to obtain additional information in an attempt to try to improve pain and/or symptom management. Testing to evaluate the progression of diseases is usually no longer appropriate unless for the purpose of symptom and pain management.

Hospice works with the patient, family, and attending physician to evaluate the goals and effectiveness of treatments and therapies.

A Do Not Resuscitate Order (DNR) is appropriate for Hospice patients and shall be consistent with New York State regulations. Hospice team members are not obligated to perform heroic measures such as cardiopulmonary resuscitation (CPR) on a Hospice patient for whom a DNR order is not in effect. The hospital medical staff will assume this responsibility when the patient is in the hospital. For Hospice patients at home or in a long term care facility, existing emergency medical services such as 911, and caregivers are instructed or assisted in doing so.

Hospice provides an on-call service that is available to patients and families 24 hours a day, 7 days a week, to handle questions, concerns, and to provide a home assessment of issues that may develop. Ambulance or emergency room services are not covered unless authorized by the Hospice plan of care.

A patient-physician decision to pursue curative or more aggressive therapy through medical intervention will be respected. Patients are free to withdraw from Hospice at any time. Under such circumstances, Hospice will discuss with the patient and their physician the continuing appropriateness for hospice care. Upon the decision to discharge the patient, Hospice will make appropriate referrals and schedule a timely transfer to another health care program or social services if necessary.

HOSPICE REJECTS THE PRACTICE OF ASSISTED SUICIDE OR EUTHANASIA IN THE CARE OF THE TERMINALLY ILL.