A toolkit to establish an emergency department palliative care program within your hospital can be found at the Improving Palliative Care in Emergency Medicine (IPAL-EM) website at www.capc.org/ipal/ipal-em.

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Key Element #4: Role of Hospice

A branch of palliative care, hospice is a Medicare benefit that provides patients with terminal illness a complete care program, which includes nursing support, physical therapy, psychological support, and durable medical equipment. Hospice is frequently thought of for those who are terminally ill with cancer, but it is a welcomed adjunct for a son or daughter struggling with a parent with dementia. With the help of hospice, patients can frequently be managed at home instead of in a nursing home. Hospice is a total-care system that is designed for terminally ill patients likely to die within the next six months. It can be provided in any location, including one’s home or a nursing home.

The role of emergency-department palliative care is to support life-sustaining management and alternatives and to allow patients to approach death and dying on their own terms, with comfort and control, while maintaining their dignity.

Reference

1. Hogan C, Lunney J, Gabel J, Lynn J. Medicare beneficiaries’ costs of care in the last year of life. Health Aff (Millwood). 2001;20:188-195.

Mark Rosenberg, DO, MBA, FACEP, FACOEP-D, is chairman of the Department of Emergency Medicine, chief of Geriatrics Emergency Medicine, and chief of Palliative Medicine at St. Joseph’s Healthcare System in Paterson, N.J.

Rebecca Parker, MD, FACEP, is executive vice president for EmCare’s North Division; attending emergency physician at Presence Covenant Medical Center in Urbana, Ill., and Centegra Health System in McHenry and Woodstock, Ill.; clinical assistant professor at Texas Tech University-El Paso; and an ACEP Board member.