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Cardiac Hospice Program

An evidence-based hospice program designed to improve quality of life and reduce hospitalizations for advanced-stage cardiac patients

Advanced cardiac conditions, especially heart failure, profoundly impact patients, providers, and health systems. It is a leading cause of hospitalizations among patients over 65, and its prevalence is growing.¹

Although guidelines from the American College of Cardiology and the American Heart Association recommend hospice and palliative care for advanced-stage patients,² many are not being connected to the extra level of care they need. It is notable that cardiac disease is listed as the primary diagnosis for only 12.2% of hospice patients, a statistic that has remained static over the past 10 years.³

VNSNY’s Cardiac Hospice Program: Filling an Important Gap in Care

To address this need, and to further the goals of the Triple Aim, we created the VNSNY Cardiac Hospice program. Designed specifically to improve quality of life and reduce hospitalizations for patients with advanced-stage heart disease, this program is the only one of its kind available throughout the five boroughs of New York City.

Specialized Hospice Care

Developed utilizing evidence-based clinical protocols, the VNSNY Cardiac Hospice program provides an enhanced level of care for patients and families, helping to keep patients safe and comfortable at home.

What makes this program unique is an interdisciplinary team with special training in managing advanced-stage cardiac patients:

  • Cardiac nurse practitioner—develops and oversees individualized plan of care in collaboration with patient’s cardiac team
  • Hospice specialty coach—supports and educates patient and family in symptom management skills including nutrition, weight management and energy conservation
  • Hospice medical director—accessible for clinician-to-clinician consultations
  • Nurse, physical therapist, social worker and spiritual counselor—provide expertise and psychosocial support as needed

The team works collaboratively with the patient’s cardiologist and PCP, either of whom can remain as the attending physician in tandem with the hospice team.

Other Key Cardiac Hospice Program Elements

Care is provided wherever patients reside—at home, in a skilled nursing facility, or at an inpatient facility—and includes:

  • Symptom and pain management to enhance quality of life and ensure goals of care are met
  • Ongoing assessment and communication, facilitating coordination between hospice providers and patient’s medical team
  • Ability to deliver medications to patient at any time, including medications to help manage fluids, discomfort or anxiety
  • Heart Failure Comfort Kit to address acute exacerbations when they occur, helping to reduce avoidable hospitalizations
  • 24/7 support line for patients and families, including access to the hospice medical team

Recognizing Signs and Symptoms

The following are some signs that your patient may benefit from VNSNY Cardiac Hospice Care:

  • Increasing hospitalizations, office visits or office calls
  • Declining quality of life, including:
    • Functional decline
    • Shortness of breath, or oxygen dependence at rest
    • Extreme weakness or fatigue with recurrent chest pain
    • Multiple comorbidities
  • Continual changes in medications as treatment options diminish
  • Growing need for home health assistance

For more information, download VNSNY’s Hospice Candidate Card.

Eligibility for VNSNY’s Cardiac Hospice Program

Patients who meet general hospice eligibility criteria, and have NYHA Class IV heart failure symptoms and/ or refractory Stage D heart failure are eligible for this program.4

Factors that support eligibility, but are not required, include:

  • Weight loss >10% in 6 months
  • Arrhythmias resistant to treatment
  • Ejection fraction <= 20%

Benefits of a Timely Referral

Referring patients early is critical, as it enables patients and families to maximize the time they can benefit from the added support, symptom management, and improved quality of life provided by this specialized hospice program.

We welcome the opportunity to meet with patients and families in person to help start the conversation and discuss care options. We are available 24/7.

To learn more or to refer a patient, please call VNSNY Hospice Care at 1-212-609-1900.

1 Chen-Scarabelli, C, Saravolatz, L, Hirsh B, et al. Dilemmas in End-stage Heart Failure, Journal of Geriatric Cardiology, 2015.
2 Adler E, Goldfinger J, Kalman, J, et al. Palliative Care in the Treatment of Advanced Heart Failure, Circulation, 2009.
3 Chen-Scarabelli, C, Saravolatz, L, Hirsh B, et al. Dilemmas in End-stage Heart Failure, Journal of Geriatric Cardiology, 2015.
4 Local Determination (LCD) for Hospice – Determining Terminal Status (L25678), National Government Services, June 5, 2009.

 

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