Patient Guide for Hospice Services - UPMC

Patient Guide for Hospice Services

Your Hospice Team

Hospice Team: V33 Phone: 814-432-6555 Toll Free: 1-877-300-3171 If you have any complaints or worries, please call 814-432-6555.

My Hospice Team Members Primary Nurse Licensed Practical Nurse Home Care Aide Social Worker Chaplain Volunteer Registered Dietitian Other Pharmacy Medical Supply Company Durable Medical Equipment Company

Emergency Plan

Important Phone Numbers

(Please fill in each box)

Ambulance/Police/Fire 911 or

Poison Control 1-800-222-1222 or 911

Hospital

Family

Doctor

Electric Company

Doctor

Phone Company

Non-Emergency Transportation

Other

Water Company Gas Company

DNR ( ) Yes ( ) No Advance Directive ( ) Yes ( ) No Comments:

Table of Contents

President's Welcome Letter . . . . . . . . . . . . . . . . 1 Mission, Vision, and Values . . . . . . . . . . . . . . . . 2

Important Information About Hospice What is Hospice? . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Role of the Interdisciplinary Team . . . . . . . . . . . 5 How to Reach Hospice . . . . . . . . . . . . . . . . . . . . . 8 Overview of the Organization . . . . . . . . . . . . . . . 8 Plan of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Information About Your Medicare Summary Notice . . . . . . . . . . . . . . . . 11 Patient Rights and Responsibilities . . . . . . . . . 11 Advance Directives -- Living Wills . . . . . . . . . 14

Safety in the Home General Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Fall Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Causes of Falls and How to Prevent Falls . . . . . . . . . . . . . . . . . . . . . . 17 General Equipment Safety . . . . . . . . . . . . . . . . . 17 Instructions for Specific Equipment . . . . . . . . 18 Medicine Safety . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Fire Prevention and Safety . . . . . . . . . . . . . . . . . 19 Oxygen Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Weather Emergencies . . . . . . . . . . . . . . . . . . . . 21 Emergency Preparedness . . . . . . . . . . . . . . . . . 21 Infection Prevention . . . . . . . . . . . . . . . . . . . . . . 22

Hand Washing to Prevent Infections . . . . . . . 22 Waste Disposal and Equipment Cleaning and Storage Tips . . . . . . . . . . . . . . . . 24

For Your Family Members/ Caregivers Bereavement Services . . . . . . . . . . . . . . . . . . . . 26 Decision Making . . . . . . . . . . . . . . . . . . . . . . . . . 26 Patient Satisfaction Surveys . . . . . . . . . . . . . . 26 UPMC's Notice of Privacy Practices . . . . . . . 26 Your Rights Concerning Your Health Information . . . . . . . . . . . . . . . . . . . . . . . 32 Violation of Privacy Rights . . . . . . . . . . . . . . . . 34 Changes to This Notice . . . . . . . . . . . . . . . . . . 34 If You Have Questions About This Notice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Pain Management Are You Having Pain? . . . . . . . . . . . . . . . . . . . . . 35 Tell Us About Your Pain . . . . . . . . . . . . . . . . . . . 35 Treatment of Pain . . . . . . . . . . . . . . . . . . . . . . . . 36 Pain Management Diary . . . . . . . . . . . . . . . . . . 37 Monthly Schedule . . . . . . . . . . . . . . . . . . . . . . . 39 Patient Interdisciplinary Communication (PIC) Log . . . . . . . . . . . . . . . . 42 Smoke-Free Environment . . . . . . . . . . . . . . . . . 43 Language Interpretation Services . . . . . . . . . 44 Notes About My Care . . . . . . . . . . . . . . . . . . . . 45

Dear Patient, Welcome to the Hospice Program. Making an informed choice is important when selecting a hospice program that will meet your needs and those of your loved ones. Our organization is committed to service excellence. Our dedicated, competent, and compassionate staff strives to provide you with the best possible hospice care available. We are committed to making your hospice experience one that provides comfort and support to you and your loved ones. We believe that our patients and families deserve the highest quality care possible when faced with difficult symptoms and challenging end-of-life decisions. Our staff wants to do everything they can to help preserve your quality of life and to avoid any complications or infections. One simple thing you and your family can do to help prevent infections is to wash your hands often and make sure that everyone who touches you, including our hospice staff, washes their hands. Please feel free to remind our clinical staff to practice good hand hygiene at all times. I also encourage you to discuss your care with our staff and let them know whether we are meeting your expectations. You are provided with contact numbers in this booklet, and I encourage you to call with any questions or concerns you may have. On behalf of the Venango Home Care and Hospice organization, I would like to thank you for choosing the UPMC Visiting Nurses hospices to provide your care.

Sincerely,

Penny S. Milanovich, RN, MSN, MBA, FACHE President

Visiting Nurses Association of Venango County, part of UPMC Visiting Nurses, prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, gender identity, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, Visiting Nurses Association of Venango County will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in Visiting Nurses Association of Venango County programs and activities. This commitment is made by Visiting Nurses Association of Venango County in accordance with federal, state, and/or local laws and regulation. Visiting Nurses Association of Venango County is operated by UPMC Visiting Nurses which is owned by UPMC Community Provider Services, Jefferson Regional Medical Center, and Fayette Regional Health System. Visiting Nurses Association of Venango County is accredited by the Joint Commission.

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