Latest / One on One With a Professional / ONE-ON-ONE: Gentiva Hospice 8-27-24

Transcript

ONE-ON-ONE: Gentiva Hospice 8-27-24 · One on One With a Professional

• 0:09
  Speaker 1: And good morning on this Tuesday, I'm Nathan Thompson nine
• 0:13
  Speaker 1: forty nine. Now it's time for us to go one
• 0:16
  Speaker 1: on one with our good friends at Gentiva Hospital. Michelle
• 0:20
  Speaker 1: Farley is in today. Michelle, Good morning, how are you today?
• 0:24
  Speaker 2: Good morning, I'm doing well, doing well. Good to see you.
• 0:27
  Speaker 1: Good to see you too. And you know, besides traffic problems,
• 0:31
  Speaker 1: I'm hoping you're having a good day today.
• 0:32
  Speaker 3: It's been a really good morning so far. Other than
• 0:35
  Speaker 3: the train. You know, you never do, never do, know
• 0:38
  Speaker 3: when to expect.
• 0:39
  Speaker 1: Those absolutely absolutely so again Gentiva Hospice, this is again
• 0:45
  Speaker 1: dealing with end of life care as we get into
• 0:48
  Speaker 1: that point. And the really good thing. We've talked about
• 0:51
  Speaker 1: this before. Gentiva, you're not only local, but you are.
• 0:54
  Speaker 3: We are nationwide. Yeah, we cover all fifty states, well
• 0:57
  Speaker 3: all forty eight, you know, Cotton It will say, I
• 1:00
  Speaker 3: don't even I guess that's all that really matters right now,
• 1:03
  Speaker 3: but in Hawaii and Alaska. But anyway, we are nationwide.
• 1:08
  Speaker 3: We're the largest provider of hospice care in the nation.
• 1:11
  Speaker 3: We are more than twice the size of the number
• 1:13
  Speaker 3: two competitor out there. But for some reason, we don't
• 1:16
  Speaker 3: have a large presence in Oklahoma, so we're trying to
• 1:18
  Speaker 3: just build our brand and let people know that we're here.
• 1:21
  Speaker 3: We can cover your people that need houspice care just
• 1:24
  Speaker 3: about anywhere in the stake. There are a very few
• 1:27
  Speaker 3: remote locations, one being around the Grand Lake area that
• 1:30
  Speaker 3: we're not able to cover right now, but you know,
• 1:33
  Speaker 3: we will find someone who can take care of you
• 1:34
  Speaker 3: if we're not able to meet your needs in your location.
• 1:37
  Speaker 3: So yeah, we're everywhere. So if you can hear my voice,
• 1:41
  Speaker 3: we can probably take care of you.
• 1:42
  Speaker 1: Right And you know, again we've had this discussion, Michelle.
• 1:47
  Speaker 1: Sometimes it's an uncomfortable topic to discuss end of life
• 1:52
  Speaker 1: hospice compassionate care, and I think that's one of the
• 1:56
  Speaker 1: differences really that Gentiva has is that aspect of really
• 2:01
  Speaker 1: making sure that your client is taking care of the
• 2:04
  Speaker 1: family of the client is also getting the support services
• 2:08
  Speaker 1: in a compassionate way as one.
• 2:10
  Speaker 3: So hospice care it is a full team approach to
• 2:13
  Speaker 3: not only patient care, but also the family care. Our
• 2:16
  Speaker 3: team we make care may make sure that you know
• 2:19
  Speaker 3: the wife or the spouse, the children, anybody that lives
• 2:22
  Speaker 3: in the home, anybody that is a caregiver or a
• 2:24
  Speaker 3: family member to that patient on our services gets their
• 2:28
  Speaker 3: needs met as well. So it really is all encompassing,
• 2:31
  Speaker 3: not just for the patient specifically.
• 2:33
  Speaker 1: Sure. Sure, And a lot of the time when we
• 2:35
  Speaker 1: think about hospice care, we think about, you know, I
• 2:40
  Speaker 1: must I have to be really sick to even think
• 2:44
  Speaker 1: about making arrangements or contacting and moving it through. Sometimes
• 2:50
  Speaker 1: hospice care is just for those who are getting older
• 2:54
  Speaker 1: in age.
• 2:55
  Speaker 3: Well, you know, there are some guidelines. The first thing
• 2:58
  Speaker 3: that you mentioned that I want to touch on is
• 2:59
  Speaker 3: that you don't have to be quote unquote sick. A
• 3:02
  Speaker 3: lot of times people are eligible for the hospice benefit
• 3:06
  Speaker 3: and they don't necessarily feel bad. Okay, So today it
• 3:10
  Speaker 3: brought with me some kind of guidelines to let people know.
• 3:15
  Speaker 2: What what are some of the criteria for hospice.
• 3:18
  Speaker 3: So each disease process has their own sort of you know,
• 3:21
  Speaker 3: guidelines and kind of a roadmap. But these these that
• 3:24
  Speaker 3: I'm going to mention today are they're non disease specific.
• 3:27
  Speaker 3: So it's just kind of like these are some basic outline,
• 3:30
  Speaker 3: basic outline of the needs that or the things that
• 3:33
  Speaker 3: somebody may need to have the conditions that they have
• 3:37
  Speaker 3: that would qualify them for hospice care. And the very
• 3:39
  Speaker 3: first one is that they may have a limited life expectancy.
• 3:43
  Speaker 3: So CMS guidelines. Again, these are guidelines. These are not
• 3:47
  Speaker 3: necessarily requirements, but they're guidelines.
• 3:50
  Speaker 2: Okay, uh.
• 3:51
  Speaker 3: CMS requires that a person be within kind of a
• 3:54
  Speaker 3: six month window of lifespan. Now, that doesn't necessarily mean
• 3:57
  Speaker 3: that you're going to pass in six months. So the
• 4:01
  Speaker 3: verbiage is if this patient does not seek treatment for
• 4:05
  Speaker 3: that particular condition and the disease runs its normal course,
• 4:11
  Speaker 3: the person would likely succumb to that disease within six months. Now,
• 4:15
  Speaker 3: when someone does get on hospice care, we have that
• 4:17
  Speaker 3: additional help in the home. We're monitoring their symptoms, their condition,
• 4:21
  Speaker 3: we're really watching everything. So often that doesn't happen. You know,
• 4:26
  Speaker 3: they live longer when they have our care. But that
• 4:29
  Speaker 3: six month guideline is kind of a CMS requirement. Again,
• 4:32
  Speaker 3: it's very hard to determine a six month window. I
• 4:35
  Speaker 3: don't have a crystal ball. Physicians don't, but they kind
• 4:39
  Speaker 3: of know what a disease process generally looks like.
• 4:42
  Speaker 2: So that's the first one.
• 4:43
  Speaker 3: The second one is that we do have to get
• 4:45
  Speaker 3: a physician to sign what is called a COT a COTI.
• 4:50
  Speaker 2: That is a certification of terminal illness.
• 4:52
  Speaker 3: Generally, our medical director will do that once we determined
• 4:55
  Speaker 3: that a patient is eligible, but that can even come
• 4:58
  Speaker 3: from their primary care position. It doesn't really matter which
• 5:00
  Speaker 3: physician signs off on that. The next thing that they
• 5:03
  Speaker 3: need to show is a decline in their Palliative Performance
• 5:07
  Speaker 3: Scale score, and that PPS is it's a chart that
• 5:12
  Speaker 3: they look at and it's increments of ten, so one
• 5:15
  Speaker 3: hundred and ninety eighty seventy sixty, and it's based on
• 5:18
  Speaker 3: things like ambulation, intake, cognition, alert, you know, if they're
• 5:23
  Speaker 3: alert and oriented, lots of kind of just activities of
• 5:28
  Speaker 3: daily living, just things that they do. And one hundred
• 5:30
  Speaker 3: percent would be someone like you and I. We have
• 5:32
  Speaker 3: no issues, We're doing whatever we want, whatever we want,
• 5:34
  Speaker 3: have no problems.
• 5:35
  Speaker 1: I don't know if I'm quite at one hundred percent, So.
• 5:37
  Speaker 2: Maybe you're ninety.
• 5:39
  Speaker 3: But anything above a fifty is probably not hospice eligible
• 5:44
  Speaker 3: unless they have a cancer diagnosis.
• 5:46
  Speaker 2: But things below fifty, that.
• 5:47
  Speaker 3: Would be someone who is maybe a bed to chair
• 5:50
  Speaker 3: existence or maybe their wheelchair bound, or they have very
• 5:53
  Speaker 3: limited intake, maybe their conscious level of consciousness is in
• 5:57
  Speaker 3: and out, so it's different things, but it really varies
• 6:00
  Speaker 3: on that person. So we generally would look at kind
• 6:02
  Speaker 3: of what their baseline was, you know, a year ago,
• 6:05
  Speaker 3: where were they on that pps, and then now let's
• 6:08
  Speaker 3: look at them now. So again, anything above fifty is
• 6:12
  Speaker 3: probably not hospice appropriate, but below fifty we.
• 6:14
  Speaker 2: Want to look at them.
• 6:16
  Speaker 3: Then the final one is if they're seeing increasing visits
• 6:19
  Speaker 3: to the emergency room, go into the hospital, you know, hospitalizations,
• 6:23
  Speaker 3: multiple visits to their doctor, lots of falls, just things
• 6:27
  Speaker 3: that kind of show that their condition is decreasing. So
• 6:31
  Speaker 3: those are just some basic guidelines. And then the next,
• 6:34
  Speaker 3: the next you know, kind of bullet point is that
• 6:37
  Speaker 3: they have to be dependent in at least two of
• 6:40
  Speaker 3: their activities of daily living. Now, dependent doesn't mean one
• 6:43
  Speaker 3: hundred percent dependent, It just means that they need assistance.
• 6:46
  Speaker 3: So I kind of look at it and kind of
• 6:48
  Speaker 3: explain it as like a toddler. You know, a toddler
• 6:52
  Speaker 3: is able to go to the bathroom by themselves, but
• 6:54
  Speaker 3: they don't always.
• 6:55
  Speaker 2: Do it right, Okay, they may need some assistance. Same
• 6:58
  Speaker 2: thing with feeding.
• 6:59
  Speaker 3: You know, they can often feed themselves, but maybe not
• 7:02
  Speaker 3: with utensils or you know, so they need to have
• 7:04
  Speaker 3: a dependence and at least two activities of daily living.
• 7:06
  Speaker 3: That includes bathing, dressing, feeding, transferring, toileting.
• 7:11
  Speaker 2: And ambulation.
• 7:12
  Speaker 3: So if they're using no walker, that's an assistant device
• 7:15
  Speaker 3: with their ambulation. If they need help getting from the
• 7:17
  Speaker 3: bed to the chair or from the toilet to the
• 7:19
  Speaker 3: bed or whatever that's requiring assistance.
• 7:22
  Speaker 2: They need help with bathing doesn't necessarily mean that.
• 7:25
  Speaker 3: You're in there giving them the bath, but you're having
• 7:28
  Speaker 3: to prompt them or you know, be in there to supervise.
• 7:31
  Speaker 3: So any kind of activities of daily living that they
• 7:33
  Speaker 3: need help with. If they need help with two of those,
• 7:36
  Speaker 3: that's another guideline for hospice criteria. And then there are
• 7:40
  Speaker 3: things like weight loss and explained weight loss, increase in
• 7:43
  Speaker 3: their time slept. I was speaking with a friend of
• 7:46
  Speaker 3: mine just a few days ago who told me that
• 7:48
  Speaker 3: someone she knows is now sleeping about twenty hours of
• 7:50
  Speaker 3: the day, and so, you know, she's like, what do
• 7:53
  Speaker 3: we do? I said, it looks like we need to
• 7:54
  Speaker 3: talk more about this about our services. But increase in
• 7:57
  Speaker 3: time slept sometimes decrease in time slipt. So if they're
• 8:00
  Speaker 3: if their sleeping pattern has changed drastically. Maybe they used
• 8:04
  Speaker 3: to sleep from you know, eight pm to eight am
• 8:06
  Speaker 3: and then take a two hour and nap in the afternoon.
• 8:08
  Speaker 3: Now all of a sudden, you're noticing that they're sleeping
• 8:10
  Speaker 3: from eight to eight. They get up in the eat breakfast,
• 8:12
  Speaker 3: they go back to bed, they sleep from ten to twelve,
• 8:14
  Speaker 3: they get up, they eat lunch, they go back to bed.
• 8:16
  Speaker 3: You know, if you just notice some significant changes, or
• 8:19
  Speaker 3: maybe they're not sleeping at all, right, if they have
• 8:22
  Speaker 3: that just kind of change in their pattern.
• 8:24
  Speaker 2: So those are some things to look forward to.
• 8:27
  Speaker 3: Dysphasia, choking, changes with their process of eating, anything like
• 8:33
  Speaker 3: that that's just not normal for them. It doesn't mean
• 8:35
  Speaker 3: that it's a serious condition maybe for anybody else, but
• 8:39
  Speaker 3: if it's a significant change for that particular person, that's
• 8:42
  Speaker 3: when we want to look at them.
• 8:43
  Speaker 1: A lot of the time, when we're looking at hospice benefits,
• 8:47
  Speaker 1: it's very much under the Medicare type.
• 8:50
  Speaker 2: Yes, aspect of.
• 8:51
  Speaker 1: Governmental health care, but you can also assist others too. Correct.
• 8:55
  Speaker 3: Yes, Medicare does cover hospice one hundred percent, and so
• 8:58
  Speaker 3: anybody that has Medicare, even if they have a Medicare
• 9:01
  Speaker 3: replacement plan, if they've ever had a Medicare number, Medicare
• 9:04
  Speaker 3: pays for it. It flips to traditional Medicare for payment.
• 9:07
  Speaker 3: Medicaid also covers hospice, and most commercial insurances cover hospice
• 9:12
  Speaker 3: care as well. There occasionally there's a time when there
• 9:15
  Speaker 3: may be a copay, but it's usually very very minimal.
• 9:19
  Speaker 1: We are talking with Michelle Freeley today with Genteeva Hospice
• 9:24
  Speaker 1: and how would somebody get in contact with you or
• 9:28
  Speaker 1: with Gentiva.
• 9:28
  Speaker 3: The best way to get in touch with us is
• 9:30
  Speaker 3: just to give me a call on my mobile. It's
• 9:32
  Speaker 3: nine one eight for zero four six eight nine nine.
• 9:36
  Speaker 3: I'll say it again, nine one eight for zero four
• 9:39
  Speaker 3: six eight nine nine. You can also go to our
• 9:41
  Speaker 3: website gentivahs dot com. There's you can you can do
• 9:47
  Speaker 3: inquiries through the web. You can just you can call me,
• 9:49
  Speaker 3: you can email me. There's lots of different ways. But
• 9:53
  Speaker 3: anywhere that you know someone that may need help, I
• 9:55
  Speaker 3: can connect you. So you don't have to go, oh,
• 9:57
  Speaker 3: I need to find a Gentiva in Maine. You know
• 10:00
  Speaker 3: I can help connect you. You don't have to go in
• 10:02
  Speaker 3: and do all that dig and just call me and
• 10:04
  Speaker 3: I'll take care.
• 10:04
  Speaker 1: Of it for you. Hey, great service as always. Michelle
• 10:07
  Speaker 1: Freeley with Gentiva Hospice. Here going one on one with
• 10:10
  Speaker 1: the professional on K one, the one you trust. Thanks
• 10:16
  Speaker 1: for listening to one on one with a professional, A
• 10:18
  Speaker 1: paid presentation at fourteen hundred K one