Disposition Site
The best place to keep a person in the late stages of cancer is in their home. Hospitals or individual institutions are unsuitable because it will be more comfortable and more pleasant for the patient to be in a well-known place. It will be considered that the 32-year-old woman dying from ovarian cancer already has problems with movement; she needs support for walking or a wheelchair. Patients who have such difficulties require more thorough care, which can be provided by a hospice at home and the guardian. Medical personnel’s main task is to select and implement the necessary analgesic therapy, social assistance, care, and psychological help. Moreover, hospice staff morally supports the family and teaches them the practices of patient care if necessary. In other words, they are responsible for ensuring that a terminally ill person lives the remaining time as comfortably as possible, without pain and fear of death.
A house is an accessible place for everyone, where necessary equipment can be delivered. For example, at the bedside, the doctor can put a stand with a dropper, through which the pain reliever will flow into the patient’s arm. Furthermore, the atmosphere of the house is familiar and carries some calmness, which is crucial for the 32-year-old woman dying from ovarian cancer. She knows where the necessary items of daily activity are located, or they can be arranged closer to a specific functional part of the house, such as a toilet or a kitchen. It is essential to provide her comfortable conditions that will allow not to need help when performing a daily routine.
For the protection of a cancer patient, some modernization of the house may be required. According to the given case, she cannot move between floors independently, and it is necessary to equip the living area next to household necessities. Other types of protection are not expected since the disease cannot be transmitted by airborne droplets or through the blood. Hospice staff can bring the dropper and the wheelchair at home and arrange them according to medical requirements.
Care Reimbursement
Nothing is said about the availability of insurance and the financial situation of a 32-year-old woman dying from ovarian cancer; hence, it is necessary to consider three options for paying for hospice services at home. These are Medicare or Medicaid reimbursement, full or partial cash payments in case of private insurance, and incomplete disbursement and financing from grants, gifts, or special funds for people belonging to the social class with low income.
The best option, if possible, is the payment of bills for the care of a terminally ill patient covered by Medicare or Medicaid insurance. The cost of hospice care at home is fully covered, including medicines, maintenance, and necessary items, such as a wheelchair. The process of selecting a suitable service provider is not complicated since 90% of hospice organizations are connected to these providers (“Who pays for hospice care at home,” 2020). In some cases, emergency medical care may be required, and then the patient pays 5% of the service at their own expense (“Who pays for hospice care at home,” 2020). If a person has insurance and a fatal diagnosis, the hospital transmits the information to the coverage company, which activates the Medicare Hospice Benefit payment mode.
An alternative option for paying for hospice services at home is cash; it is required for people who do not have insurance or have a private medical policy. In the case of a complete lack of insurance, a person individually must pay for all services, medicines, and equipment. Private insurers usually offer partial refunds for assistance, which varies depending on the provider. The problem may be the high cost since medical services in the United States are very expensive.
The last payment option is special funds or partial payment, which are necessary for the poor population. This category is able to receive free or sliding scale-based assistance. The remaining amount is taken from donations, grants, and community sources. However, the poor population may face the problem of timely and correct completion of documentation to prove the need to receive full or partial funding.
Resources
The case of the 32-year-old woman dying of ovarian cancer needs to consider five resources after discharge. The first needed point is an explicit instruction of the guardian about the state of health and ensuring the needs. The caregiver should know keeping specifics, such as personal hygiene, nutrition, and symptom management. The second resource is new items necessary for a full-fledged patient’s life. It can be a wheelchair for free movement around the house or a proper bed. The third point is the message of the emergency phone number and the control of understanding the information. The guardian may not always be near; therefore, the person must have an alternative way of salvation. The fourth resource is the issuance of medicines for the first time and instruction on their use. The patient and his guardian should both receive the information from the last two points. The fifth resource is a discussion of the layout details, stairs, a ramp, the distance between the essentials. With cancer, a woman will soon stop walking; hence, doctors should talk about moving the bed closer to household necessities.
The doctors ‘ employer pays for the informative part of the resources, and the material items are compensated by insurance or the patient himself, depending on the options specified earlier. Access to coverage is carried out through the hospital or a personal appeal of the patient and his guardian. Transportation to the house is paid for by insurance, and if the patient does not have it and is too ill, the hospital provides transportation services free of charge.
Personnel and Services
Planning of discharge of the 32-Year-Old Woman Dying of Ovarian Cancer begins 1-2 days before its implementation, or earlier if the patient has been in the hospital for a long time. It involves the staff that the hospital prescribes, depending on the type of patient’s disease. (“Strategy 4,” 2017). In the provided case, the first role is played by a nurse who must provide the results of recent examinations. It includes analyses, the state based on the dialogue, and observational data. For example, a cancer patient has not experienced any deterioration over the past week; therefore, she can be moved home. The second participant is a therapist or oncologist who checks the entire medical history. The third person is the discharge planner; they are responsible for providing the necessary conditions for the patient’s treatment at home. It means contacting the insurance company, talking to the patient and their guardian, drawing up and discussing recommendations, and answering questions. This person organizes a general meeting to coordinate the collected information and form the final documents.
On the day of discharge, the last discussion of the recommendations checklist and payment methods takes place with the patient and their guardian. Doctors give out medicines for the first time, and the discharge planner ensures that the patient’s house is ready for arrival. If examinations are necessary, the medical staff gives instructions on when and where to apply next time. Staff is also required to inform the patient of the emergency number that may be needed after discharge. Material, human resources, and time are necessary for the discharge of a person.
24-Hour Schedule Needs/ Services
On the first day after discharge of the 32-year-old woman dying of ovarian cancer, the plan starts from the moment the patient wakes up. First, they need to go to the toilet, which a guardian can help with. He should lead the cancer patient by the arm or put her in a wheelchair. Then there is a move to the kitchen for breakfast in the same way. Next, he should take the woman back to bed and provide her resources for spending time, such as turning on the TV or comfortably arranging a book reading. Additionally, it is worth putting a glass of water and straw next to the bed for constant and easy access.
In a few hours, hospice staff will arrive, who will give medicines and help with personal hygiene. They will spend time on the moral and spiritual support of the patient and his guardian. During the day, it is worth feeding the patient, giving medicines, and taking him to the toilet if necessary. The patient may want to go outside, and the guardian or hospice staff can take him out in a wheelchair if this does not contradict the care plan. All basic needs are provided at home by a curator or medical personnel. It is essential to follow the doctor’s recommendations and take pills on time.
References
Strategy 4: Care transitions from hospital to home: IDEAL discharge planning. (2017). Agency for Healthcare Research and Quality.
Who pays for hospice care at home? (2020). Harbor Light Hospice.