Pathways for End Stage Heart Disease - For PHYSICIANS

Pathways for End Stage Heart Disease was created to identify and manage the unique end-of-life symptoms and medical needs of your cardiac patient. Hospice of Hamilton has identified key factors to help manage patients in their home environment, avoid unnecessary Emergency Department (ED) visits and hospital readmissions and facilitate improved quality of life for your patient and his/her family caregiver(s). These key factors include:

1. Identifying patients who are at higher risk for returning to the hospital when symptoms arise.
2. Providing Cardiac Comfort Paks (CCP’s) to be kept in the home. (The CCP contains Furosemide tablets and vials, Nitroglycerin tablets, Aspirin and Morphine sulfate.)
3. Utilizing Hospice of Hamilton’s comprehensive care options instead of a hospital or ED.
4. Focusing on supporting the caregiver.

Hospice of Hamilton offers a complete Physicians Guide for ESHD patients, which contains:

• Criteria to help you identify when your patients are appropriate for hospice care
• Tips and talking points for end-of-life conversations
• Clinical care paths for symptom management
• The caregiver guide to assist family caregivers in managing symptoms

IF YOU WOULD LIKE TO RECEIVE A PATHWAYS PHYSICIANS GUIDE, PLEASE CALL 513-792-7965. It would be our pleasure and honor
to partner with you.

How do I know when to refer my patient to the Pathways for End Stage Heart Disease Program?
Answering these simple questions may serve as a guide:

1. Is your patient optimally treated with diuretics, vasodilators, ACE inhibitors, beta blockers or inotropic medications?
2. Does your patient have significant symptoms or recurrent congestive heart failure at rest?
3. Does your patient experience disabling dyspnea at rest, resulting in decreased functional capacity?
4. Does your patient have other co-morbidities such as renal insufficiency or pulmonary disease or dementia?
5. Has your patient reached a point where a left ventricular assist device (LVAD) or transplant is NOT an option?
6. Do you believe your patient might be ready to seek “aggressive comfort care” instead of aggressive treatment?

If you answered “yes” to one or more of these questions, now may be an appropriate time to refer your patient to Hospice of Hamilton. We would be happy to discuss your patient’s specific situation and answer any questions about hospice appropriateness. Please feel free to call us directly at 513-792-6900.

Pathways for End Stage Heart Disease Literature and Materials for Physicians

• Pathways Overview for Physicians
  This mini-brochure provides an overview of the program and clearly outlines how Hospice of Hamilton’s Pathways program can benefit your patient and you.