A specialized program providing evidence-based, individualized care to hospice eligible patients with wounds. The program is overseen by wound care specialists in conjunction with the patient’s hospice integrated care team.
Many patients with terminal illnesses are known to present with wounds. Factors like frailty, impaired mobility, poor nutrition, and incontinence often lead to development and increasing severity of wounds. Wounds are often painful and unpleasant to patients. Wound symptoms, such as bleeding and odor, may discourage loved ones from spending as much time as they would like with the patient.
If a patient is hospice eligible and has wounds, referral to VNSNY Wound Care in Hospice Setting allows them to receive palliative wound treatment alongside all the other benefits of our hospice service.
Wound Care in Hospice Setting focuses on alleviating pain and other symptoms in order to give the patient the best possible quality of life for as long as possible. Like all hospice services, the wound care goal is to make the patient comfortable and make loved ones comfortable being with the patient. This means minimizing unpleasant symptoms of wounds—especially odor, bleeding, and appearance.
While VNSNY Wound Care in Hospice Setting uses evidence-based treatment protocols for common types of wounds, consistent with National WOCN (Wound Ostomy Continence Nurse) Clinical Practice Guidelines©, each patient’s plan of care is specific to their situation and their goals. For example, some hospice patients may decide against negative pressure treatments in favor of less aggressive care with less discomfort. But for other hospice patients, negative pressure treatments may be appropriate.
When a patient is admitted to VNSNY Hospice, a nurse performs an overall assessment that includes making notes of the patient’s wounds, if any, and reviewing any reference to wound care found in the treating physician’s notes. If there are wounds, one of our Advanced Practice WOCNs is consulted and collaborates with the care team on wound treatment. WOCNs communicate with hospice nurses electronically and are also available for in-person consultations and hands-on treatment, such as bedside debridement, when necessary. Hospice physicians are also available to consult on wounds and have peer-to-peer conversations with the patient’s PCP or treating physicians.
The hospice care team includes the physician or nurse practitioner, hospice nurse, hospice aide, social worker, spiritual care counselors, caregivers, and others as needed, including the WOCN wound care specialist. At VNSNY Hospice, treatment and other decisions are made with input from the patient and their loved ones. Hospice is about empowering patients to make the choices that are right for each patient and their caregiver(s).
VNSNY Wound Care in Hospice Setting uses a formulary built on the basis of providing evidence-based care with the least amount of distress to the patient.
The primary objective of Wound Care in Hospice Setting is increasing the comfort and quality of life of the patient. However, in patients with terminal illnesses, the extent of the disease may undermine any treatment plans with respect to wound care. Additionally, factors such as poor nutrition, perfusion, and multiple comorbidities may also effect healing potential. With a care plan focused on symptom relief and less aggressive treatment, over half of our patients experience wound healing.
One of the best times to refer a patient to hospice is when curative care is no longer working and the patient has a prognosis of six months or less. Hospice provides an integrated care team that focuses on making the patient comfortable. It aligns patient care with the patient’s choices and values, including those that relate to wound care. There is also evidence to suggest making patients more comfortable and improving their quality of life, may lead to patients actually living longer than they would if they continued more aggressive treatments.