Have you seen a patient recently that has a “little bit of this and a little bit of that,” which adds up to a good case of the “dwindles”?

Today, the typical patient is living longer with more than one disease. Medical management of these patients can get complex and time-consuming. They have more than one doctor, may use more than one pharmacy and are often hospitalized multiple times for different yet related reasons.

Families are reporting the patient is changing, sleeping more, eating less, not as interested in doing their usual activities. They are losing weight, might be getting more forgetful or confused, have increased pain and are simply not thriving. As their physician, you think they might be heading toward end of life, but it is just so hard to determine which of their multiple co-morbidities is causing the decline. Heart? Kidneys? Dementia?

The Centers for Medicare and Medicaid Services (CMS) recognizes this dilemma and has created a hospice diagnosis to capture these difficult and increasingly common patient types.
It is called “cause of morbidity and mortality; debility; unspecified,” ICD9 799.3, or just debility. This diagnosis allows us to recognize that ALL of the disease processes are combining to cause progressive decline and possible end of life.

Our medical staff is available to help determine if hospice is the appropriate support for your patients and their families. Regional Hospice will coordinate with other agencies if needed to ensure they get the assistance they need.

The question to ask yourself remains the same: Would you be surprised if this patient died in the next six months? If you wouldn’t be surprised, call Regional Hospice today and let us partner with you to provide the quality care your patients need and deserve.

Medical College of Wisconsin Palliative Care Center:   www.mcw.edu/palliativecare.htm

Hospice and Palliative Nurses Association:   www.hpna.org

National Hospice and Palliative Care Organization:   www.nhpco.org

American Academy of Hospice and Palliative Medicine:  www.aahpm.org