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The Hope Hospice Cardiac Program Includes: l Bi-Weekly Skilled Nursing Visits: 1st month of service, an expertly trained Cardiac Care nurse will visit the patient 2 times a week to ensure patients symptoms are optimally managed l Cardiac Medications: Each Cardiac patient receives a Cardiac Comfort Kit upon admission for crisis management l Contingency Orders: Individualized orders to keep patients fluid neutral and to manage exacerbations l Medication Teaching & Planning: Personalized plan created by RN and family with a focus on medication appropriateness, effectiveness and compliance l Certified Nurses Aide: Visits: Cardiac patients receive a minimum of 3 visits a week to provide assistance with activities of daily living and provider caregiver relief l Class III and IV Cardiac patients median survival rate is 1 year or less Dietary Counseling: Each patient will receive a dietary counseling session and needs assessment l Cardiac Disease in the United States costs more than $30 billion, with 60 percent associated with hospitalization Innovation & Technology Tools: real time access to patient records to ensure continuity of care and assistance with using available smart technology for medication reminders as well as pain and vital sign tracking and monitoring l Medical Equipment & Incontinent Supplies: We provide all of the equipment and supplies needed to assist with patient care which are delivered to your home. These include hospital beds, oxygen, wheelchairs, shower chairs, incontinence and wound care supplies and nutritional supplements as suggested by our dietary counselor. l Respite Care: level of care available every month to caregivers when they need time to recharge. Hope will facilitate and cover the cost of placement of a loved one in one of our contracted partner facilities l RN On Call 24/7: Hospice MD and RN staff available 24 hours a day, 7 days a week, including Holidays and Weekends for emergent needs l Patient & Family Empowerment & Support Plan: Individualized plan designed to ensure competence and confidence in managing Cardiac symptoms and caring for their loved ones at home l Patient Outcome & Vital Statistic Reports: weekly trend reports which include weight, vital signs and physical assessments provided upon request Cardiac Care Program Hope Hospice’s comprehensive Cardiac Care program significantly reduces cardiac crisis and risk of hospitalizations for our patients 80% of Americans say they want to die at home, only 20% do. Only 4% of patients dying of Cardiac Disease get palliative care at end of life Average Out of Pocket Cost to the Cardiac patient is approximately $12,000.00 a year Providing a loving embrace on a difficult journey for over 30 years General Predictors of Hospice Eligibility New York Heart Association (NYHA) Functional Classification Prognostication of mortality rate for Cardiac Disease is difficult due to the unpredictable disease trajectory and symptom variability. The following guide can help in determining if Hospice may be right for your patient. • Class 4 Symptoms And 1 or more supporting factors below • Recent Cardiac Hospitalization (triples 1 year mortality) • Elevated BUN (defined by upper limit of normal) and/or creatinine > or = to 1.4mg/dl (120 umol/1) • Systolic blood pressure <100 mm Hg and/or pulse • Decreased left ventricular ejection fraction (linearly correlated with survival at LVEF < or = to 45%) • Ventricular dysrhythmias, treatment resistant • Anemia (each 1 g/dl reduction in hemoglobin is associated with a 16% increase in mortality) • Hyponatremia(serum sodium < or = to 135-137 mEq/l) • Unintentional weight loss or gain • Reduced functional capacity Class Patient Symptom I No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath). II Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath). III Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea. IV Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases. Areas Served Patients Living In or Discharging to: How to Refer Fax to Hope Hospice at (830) 606-1388: • • • • Face Sheet History and Physical Medication Administration Record MD Order to “evaluate and admit if appropriate” Comal & Guadalupe (830) 625-7525 Fax (830) 606-1388 Toll Free (800) 499-7501 Web hopehospice.net Member: New Braunfels Chamber of Commerce Comal Bulverde Canyon Lake Garden Ridge New Braunfels Spring Branch Startzville Sattler Hays San Marcos Wimberley Martindale Kyle Woodcreek Guadalupe Cibolo Geronimo Kingsbury Marion McQueeney New Berlin Schertz Seguin Bexar Converse Live Oak Selma Windcrest Universal City Caldwell Luling Lockhart We will consider patients living outside of coverage area on a case by case basis. Services Board Certified Hospice & Palliative Care Medical Director, Skilled Nursing, Certified Nursing Assistants, Physical Therapy, Speech Therapy, Dietary Counseling, Medical Social Worker, Massage Therapy, Spiritual & Emotional Support, Licensed Grief Counseling, Pet Therapy, Volunteer Services Providing a loving embrace on a difficult journey for over 30 years