Acadiana's Only Nonprofit Hospice
Glossary of Terms
A
Acute Care - acute care is a branch of secondary health care where a patient receives active but short-term treatment for a severe injury or episode of illness, an urgent medical condition, or during recovery from surgery. In medical terms, care for acute health conditions is the opposite from chronic care, or longer term care
Adjuvant Therapy – a treatment used with medication to aid its effect.
Advanced Directive – Written or verbal instructions for your care if you are unable to make decisions.
Aggressive Treatment - when a patient chooses to continue with lab work, diagnostic tests and curative treatment and is not looking at comfort measures.
Apnea - a condition causing a person to stop breathing for a period of time. This can last for 15-30, even up to 60 seconds, before the person takes another breath.
B
Buccal - medication given on the inside of the cheek.
Bereavement Department - grief specialists who work with the family for up to 13 months after the death.
C
Capacity - In relation to end-of-life decision-making, a patient has medical decision-making capacity if he or she has the ability to understand the medical problem and the risks and benefits of the available treatment options. The patient’s ability to understand other unrelated concepts is not relevant. The term is frequently used interchangeably with competency but is not the same. Competency is a legal status imposed by the court.
Cardiopulmonary Resuscitation (CPR) – a procedure used when the patient’s heart stops beating; it can involve compressions of the chest or electrical stimulation
Caregivers - Family members, friends or paid staff who provide care to a person who is ill.
Cheyne Stokes - a breathing pattern characterized by a period of apnea lasting 10-60 seconds, followed by gradually increasing depth and frequency of the respirations.
Concentrated Care Nurse (CCN) - the nurse who sits with the patient at the bedside when concentrated care has been initiated.
Continuous Care - a level of care initiated when a patient’s symptoms are not being controlled. During concentrated care, a nurse can be placed at the bedside for eight-hour shifts until symptoms are under control.
CNA - certified nursing assistant
Comfort Kit (ER Kit) - medications that are usually ordered at the time of admission to have available PRN (as needed) for symptom control.
Coordination of Care – An approach in which all members of the medical team work together to plan for a patient’s care in the hospital and for discharge.
D
Do not Resuscitate (DNR) Order – A physician’s order not to attempt CPR if a patient’s heart or breathing stops. The order is written at the request of the patient or family, but must be signed by a physician to be valid. There are separate versions for home and hospital.
Durable Power of Attorney for Healthcare – A document that designates the person you trust to make medical decisions on your behalf if you are unable.
Dysphagia – difficulty swallowing.
E
Election of Hospice Benefit – when papers are signed and the patient is admitted to hospice
F
Face-to-face Visit – a hospice physician or nurse practitioner must have a face-to-face visit with a patient every 60 days to determine continued eligibility once the patient has been on service longer then the two initial 90-day periods. The visit must take place prior to the 180 day recertification.
G
General Inpatient (GIP) - a level of care under which the patient is hospitalized due to symptoms that are not being controlled. Once the symptoms are under control, the patient will return home to routine home care.
H
Healthcare Agent - The person named in an advance directive or as permitted under state law to make healthcare decisions on behalf of a person who is no longer able to make medical decisions.
Healthcare Proxy – Similar to a durable power of attorney for healthcare; a document that designates the person you trust to make medical decisions on your behalf if you are unable.
Hospice Appropriate Patient - a patient who meets the criteria for admission to hospice as determined by the hospice medical director and the patient’s primary physician.
Home Care – Services provided in the home, such as nursing and physical therapy
Hospice - Considered a model of quality care, hospice focuses on relieving symptoms and supporting patients with a life expectancy of months, not years. Hospice involves a team-oriented approach to expert medical care, pain management and emotional and spiritual support. The emphasis is on caring, not curing. In most cases hospice care is provided to a patient in his or her own home. It also can be provided in freestanding hospice facilities, hospitals, nursing homes and other long-term care facilities.
Hydration – The process of providing water or fluid by mouth, tube, or intraveniously
I
Impending Death - when death is expected within the next two to three days.
Interdisciplinary Team - the staff members who together make up the patient’s team of caregivers (e.g. nurses, LSW, chaplains, CNAs, volunteers, grief specialists and medical director).
Interdisciplinary Team Meeting (IDT) -where all members of the primary team meet to review the patient’s plan of care.
Intubation – The process of inserting a tube into a patient’s lungs to help with breathing.
L
Level of Care (LOC) - the specific level of care the patient is on (e.g. routine home care, general inpatient, respite and concentrated care).
Life-prolonging Treatment – Medical treatments that aim to cure or remedy an illness.
Living Will – A document Stating a Patient’s wishes regarding medical treatments.
Long-term Care – Care that supports patients with chronic impairment for an indefinite period of time; it is provided in nursing facilities, at home, or in the community.
LSW - Licensed social worker
M
Medicaid - the largest source of funding for medical and health-related services for people with low income in the United States.
Medicare - The US government's national health insurance program for people aged 65 and older who have worked for at least 10 years in Medicare-covered employment, and who are citizens or permanent residents of the US. Medicare Part A covers inpatient hospital stays, and Medicare Part B covers physician and outpatient services.
Medicare Hospice Benefit - anyone eligible for Medicare is qualified to receive the Hospice Medicare Benefit if he or she is appropriate for hospice services, with a prognosis of six months or less. Under this benefit, patients receive all medications, equipment and supplies related to the terminal diagnosis. This also includes all visits and services from hospice staff.
Morphine - A powerful narcotic agent that has strong analgesic (pain relief) action and other significant effects on the central nervous system.
Mottling - when the skin has a bluish/purplish color to it. This is due to circulation slowing down as the blood supply to the area is decreased. It is often seen on the bottoms of the feet, ankles or knees, and is common over bony prominences. It can come and go quickly. Not everyone will have mottling before they die, but it is a sign to look for.
N
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) – A calss of pain medications such as ibuprofen and asprin.
O
On-Call Nurse - Hospice nurse who is available after hours. Hospice of the Red River Valley has a nurse available 24 hours a day to meet the needs of the patient at any time, day or night.
Opioids – A class of pain medications that have some opiate narcotic properties but are not derived from opium.
P
PPO - medications given by mouth.
Palliate – To relieve the symptoms of a disease or disorder.
Palliative Care - comfort measures only. The patient is no longer seeking aggressive treatment.
Pathway Volunteers - volunteers who are trained to sit at the bedside with patients when they are imminently dying and resting comfortably. This needs to be a request of the family, not just facility staff.
Percutaneous Endoscopic Gastrostomy (PEG) – A surgical procedure for inserting a tube into the stomach to provide nutrition and hydration.
Plan of Care (POC) -this is developed for each patient individually depending on his or her needs.
Primary Attending Physician – A patient’s main doctor, who coordinates all referrals to specialists.
Primary Caregiver (PCG) - at the time of admission the person who is designated as the patient’s primary “go-to person.”
Primary Care Team - the patient care team providing the care, including the hospice medical director, nurses, LSWs, CNAs, chaplains, volunteers and grief specialists.
PRN – Pro re nata; a Latin phrase meaning in circumstances or as the circumstance arises. It is commonly used in medicine to mean as needed or as the situation arises.
Q
Quality of Life – The patient’s ability to enjoy normal life activities. Quality of life is an important consideration in medical care. Some medical treatments can seriously impair quality of life without providing appreciable benefit, whereas others greatly enhance quality of life.
R
Recertification - a written certification of terminal illness for each benefit period the patient is on hospice. Initially, there are two 90-day periods, followed by an unlimited number of 60-day periods as long as the patient continues to qualify for service as determined by the hospice medical director.
Referral - when hospice staff meet with patients and families to talk about our services and what we can provide. This can be done whenever and wherever it is convenient for the patient and family. Referrals are provided free of charge and without obligation.
Respite Stay - a five-day respite stay used to provide rest for both the caregiver and patient. It is provided at various locations and placement is made on a case-by-case basis. The patient returns home after the respite stay, and returns to routine home care at that time. This benefit can be used once every 30 days.
Resuscitation – Similar to CPR, a protocol used when a patient’s heart stops beating; it can involve compressions of the chest or electrical stimulation.
Routine Home Care - the level of care most patients are routinely receiving when their symptoms are being controlled.
S
Secretions - a sound caused by the accumulation of secretions at the back of the throat and around the lungs. This is caused by the inability of the dying person to cough and clear the secretions due to his or her weakness.
Subacute Care – Short-term care in a nursing facility, usually for physical therapy
Sub-Q Line - a small, needleless butterfly that is placed in the fatty tissue, and taped in place. SQ route is used to achieve pain/symptom control when a patient is unable to take oral meds, or as an alternative to repeated injections.
Sublingual - medications given under the tongue.
Surrogate Decision-Making - Surrogate decision-making laws allow an individual or group of individuals (usually family members) to make decisions about medical treatments for a patient who has lost decision-making capacity and did not prepare an advance directive. A majority of states have passed statutes that permit surrogate decision-making for people without advance directives.
Symptom – A feeling a patient has that indicates a disorder or disease
T
Transdermal patch - a drug impregnated adhesive patch applied to the skin for controlled release of a medication (e.g. fentanyl patch).
V
Ventilator – A machine that breathes for a patient when he or she is unable to do so independently.
Volunteers - individuals who volunteer their time to help hospice patients and their families. This may include providing companionship, assisting with daily tasks, running errands or whatever is most helpful for the family.