Respiratory Therapy for Hospice Patients

For patients with end-stage COPD and other advanced cardiopulmonary conditions, dyspnea (shortness of breath), cough, chest tightness, and excessive mucous production represent more than symptoms: Each contributes to heightened anxiety and fear that diminishes quality of life and can lead to further exacerbations.

Many patients report dyspnea to be even more distressing than physical pain.

VITAS clinicians, including physicians and nurses, deliver the best in end-of-life care for hospice patients with advanced lung disease or other advanced cardiopulmonary conditions such as heart failure, ALS, or lung cancer. Such patients, whether on routine treatments of oxygen and inhalers or specialized respiratory care, may be eligible for hospice and benefit from VITAS Healthcare’s comprehensive approach to compassionate end-of-life care.

Our interdisciplinary care teams help ensure your patients spend their final months in comfort, without fear of being unable to breathe.

Solutions for Patients With Terminal Lung Disease and Cardiac Disease

Hospice is a post-acute care option that offers multiple levels of care to match patients’ symptoms and care goals.

VITAS clinicians provide a range of solutions for your patients with advanced lung disease and advanced cardiac disease in the comfort of their own home, whether home is a traditional residence, assisted living facility, nursing home, or other preferred care setting.

Medical equipment such as an oxygen concentrator or portable oxygen are provided by VITAS for use in the patient’s home while they are receiving hospice services. These treatments often result in meaningful benefit—even though a patient may not meet the “Medicare oxygen condition requirements”—through improved symptom management, including shortness of breath, fatigue, anxiety, and general well-being.

Moreover, VITAS does not charge any deductible for equipment that are part of the hospice plan of care for the palliation and management of conditions related to hospice eligibility.

As part of the interdisciplinary hospice team, VITAS physicians and nurses make visits as needed to manage symptoms, ease anxiety, provide pulmonary hygiene, and educate caregivers on appropriate care.

Our clinicians provide education on appropriate and safe inhaler and oxygen use, outline steps to take when acute respiratory symptoms occur to improve symptoms, and help patients stay at home and out of the emergency department and hospital.

Additionally, VITAS clinicians help support end-of-life cardiopulmonary patients with complex needs, such as:

  • Non-invasive ventilation (Trilogy)
  • Tracheotomy care
  • Compassionate hospital or home ventilator discontinuation
  • High-flow oxygen therapy

Up to 70 percent of all hospice patients experience dyspnea or other respiratory issues near the end of life, so respiratory therapy is often beneficial to patients without advanced lung or cardiac disease.

Case Studies: Respiratory Therapy and Advanced Illness Patients

High-Flow Oxygen Therapy

The patient, AZ, is 76 years old with Stage IV lung cancer. Hospitalized twice in the past five months for pneumonia and shortness of breath, she relies on high-flow oxygen therapy.

AZ is admitted to hospice with VITAS and begins high-flow oxygen therapy at home with assistance from ICC. A respiratory therapist and nurse take shifts at AZ’s bedside to monitor her condition around the clock. When necessary, they provide medication to relieve her dyspnea. The respiratory therapist educates AZ’s family on comfort care and the administration of appropriate medications.

After four days on hospice, AZ dies surrounded by family and friends, who are eligible for up to 13 months of grief support from VITAS.

Non-Invasive Ventilation

The patient, JS, is 64 years old with amyotrophic lateral sclerosis, pneumonia, and respiratory failure. Prior to hospice, JS was hospitalized for community-acquired pneumonia, fitted with a PEG tube, and sent home on ventilator support.

With support from VITAS, JS is visited at home by a respiratory therapist who sets up a PRVC-mode ventilator to help with her persistent cough. The respiratory therapist educates her family and caregiver on ventilator usage, airway suction, and tracheotomy care. VITAS also delivers tracheotomy and suctioning supplies to her home.

JS continues to receive hospice team visits on a weekly or as-needed basis. With ongoing care plan updates, respiratory therapist visits, and 24/7 Telecare support, JS and her family feel comforted and supported by VITAS.

Ventilator Removal

The patient, CJ, is 79 years old with COPD, heart disease, and sepsis. He has been hospitalized twice in the past three months for pneumonia and sepsis. CJ’s ability to breathe is now dependent on a ventilator.

With help from round-the-clock VITAS Intensive Comfort Care® (ICC), CJ receives hospice care at home and undergoes vent removal. A respiratory therapist oversees the procedure and educates CJ’s family on tracheotomy care, oxygen therapy, airway suction, and the medical equipment involved with each process.

After six days on hospice, CJ dies surrounded by family and friends, who can receive up to 13 months of grief support.

Download: How VITAS Supports Compassionate Ventilator Withdrawal >

Trust VITAS today to deliver the best in respiratory care for your advanced lung and heart disease patients including those with complex and specialized respiratory care needs.

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