For Health Care Professionals

PALLIATIVE CARE SUPPORT FOR HEALTH CARE PROFESSIONALS

Collaborating with Providers for Effective Patient Palliative Care
Serious illnesses can be complicated to explain, generate many patient questions, cause difficult-to-manage symptoms and create a great deal of emotional turbulence and stress in the lives of your patients and their families. And as much as you want to help them through these challenges, it can take time that busy practices just don’t have—resulting in patient and provider dissatisfaction.

Cascade Health Palliative Care can help you achieve better patient outcomes using less staff time. Palliative care has been shown to improve symptom control, psychological health, quality of life and satisfaction with care, as well as reduce late-stage hospitalizations and even increase life expectancy.

Our team provides you and your patients an extra layer of support by helping you manage difficult-to-control symptoms and comorbidities while also empowering and engaging your patients in their own care. Our services complement yours, allowing you to focus on your specialty while we take care of coordinating the care plan and various providers, tracking and managing symptoms, providing socio-emotional-spiritual support and making referrals. And we continue to collaborate closely with you to ensure that the care plan stays updated as the patient’s illness progresses or circumstances change.

Palliative Care Resources for Providers
Cascade Health is a local health care organization that has been serving our community for more than 50 years. As a nonprofit organization, palliative care is an important part of our core mission to improve quality of life in our community by helping to support and provide quality, charitable compassionate health care, now and for generations to come. We are service-driven, patient-focused and committed to developing healthy, collaborative relationships with our partners, patients and staff.

Cascade Health Palliative Care services include:

  • Making recommendations for symptom management to improve patient comfort, including thorough pain management.
  • Emotional and spiritual support for patients and their families.
  • Education and advice for advanced care planning to ensure the patient’s wishes are respected.
  • Patient advocacy.
  • Provide recommendations for referrals to specialists or complementary care providers to address new or persistent issues, or to prevent injury or deterioration.
  • Patient education about the disease process and help understanding treatment options.
  • Relaxation and self-care coaching to improve patient self-management.
  • Training for family and caregivers.

The Cascade Health Palliative Care team members will meet with the patient and their family/caregivers to conduct an extensive consultation and build a holistic care plan. We then coordinate with you to manage the plan, keeping you updated on patient progress and working with you to address new issues as they arise.

When to Refer Patients to Cascade Health Palliative Care?
Palliative care is based on need, not prognosis. It can become a part of a patient’s serious illness management plan at any age or stage, and it can complement curative treatment—not replace it, as in hospice. In fact, palliative care has been shown to have the greatest positive impact when started early in the disease process, and there are no known harms to adding palliative care to a patient’s care plan early.

To be eligible for palliative care, patients must have a serious illness. Other general criteria for referral may include:

  • Difficult to control symptoms that negatively impact quality of life and/or function, such as pain, nausea, fatigue, sleep problems, depression, anxiety, weight loss and others.
  • Declining functional or cognitive ability.
  • Multiple hospitalizations or repeated visits for the same issues.
  • Patient, family or physician uncertainty regarding prognosis or goals of care.
  • Patient or family emotional or spiritual distress.
  • Confusion about care plan or conflicting requests for care.
  • Lack of advanced care plan.
  • Use of complex treatments or those requiring training for patients or caregivers, such as tube feeding or TPN.
  • Chronic mental illness, homelessness or other indications of limited social support or exacerbating illnesses requiring more intensive assistance with presenting serious illness.
  • A patient, family or physician request for information regarding the appropriateness of increased care intensity, such as moving to a long-term care facility or hospice.

How to Make a Palliative Care Referral
The Cascade Health Palliative Care team works quickly to process your referral and reach out to your patient to establish care. You may begin the process by calling us at (541) 228-3050 or print and complete the Cascade Health Palliative Care Referral Form and fax it to (541) 228­ -3182. If calling, you will need to be prepared to provide the following:

  • Patient’s name, address and phone number.
  • Patient’s date of birth.
  • Diagnosis.
  • Referring contact and phone number.
  • Attending physician’s name.
  • Primary contact/caregiver name, phone number and relationship to patient.
  • Medicare/insurance carrier ID number, phone number, policy number and name of policy holder.

If you are including a recommendation for palliative care on hospital discharge orders, please refer to Cascade Health by name.

Your patient or their family members may also self-refer. If we receive an inquiry from someone who is your patient, we will contact you to coordinate care.

Questions?
We are happy to talk to you about any questions or concerns you may have about referring a patient to Cascade Health Palliative Care. Please feel free to call us at (541) 228-3050 or email us at pc@cascadehealth.org.

Medical Professional FAQs

1. Who is a candidate for Cascade Health Palliative Care?

Any patient with a life expectancy of more than 6 months who is diagnosed with a serious illness is a candidate for palliative care. Some examples of “serious illness” include COPD, heart failure, progressive renal disease, liver disease, ALS, Parkinson’s, Alzheimer’s or cancer. The patient’s age, stage and life expectancy are not determining factors for palliative care.

2. My patient is getting chemotherapy (or other curative care). Can they be on palliative care?

The purpose of palliative care is supportive—it does not replace your care or curative treatments. Unlike hospice, your patients can be on palliative care while you continue with aggressive curative treatments and manage their care. Cascade Health Palliative Care is consultative in nature, and we make recommendations as opposed to taking over care.

3. Who can order palliative care?

Palliative care can be ordered by a primary physician or other physician on a patient’s care team whenever a serious disease is diagnosed.

4. Why would I order palliative care for my patient? What will Cascade Health Palliative Care do to help them?

As you know, serious illnesses generally progress along a predictable path, with increasing frequency of hospitalizations for exacerbations and crises. Over time, patients may experience worsening symptoms along with reduced abilities to care for themselves, difficulty maintaining adequate caloric intake and increased sleep.

Cascade Health Palliative Care can help both you and your patient by making recommendations for symptom management while also providing counseling regarding trajectory of their disease process, help identifying their goals and communicating with family members, advanced care planning and recognizing when death is getting nearer. In short, we’re here to help you give your patients all the support and education they need without overtaxing your staff’s capacity.

5. My patient really needs caregiving help. Can you help?

We do not provide physical or household care but can help guide your patient to caregiving resources. Our social worker helps to seek out funding sources for patients as needed and available.

6. When does the patient transition to hospice?

When aggressive treatments are no longer working or a patient chooses to stop them, it may be time to consider Cascade Health Hospice instead of palliative care. Requirements differ for different diseases, but your opinion that they have 6 months or less to live is heavily weighted. If your patient doesn’t quite qualify, and they are not yet on Cascade Health Palliative Care, we can put them on palliative care for a higher level of monitoring and provide the services of symptom management and education regarding end-of-life decisions. Cascade Health Palliative Care staff can assist in helping the patient and family make decisions regarding when the time for hospice care seems right and assist in obtaining a referral for hospice from you.