Tag Archives: healthnetwork foundation

Recovery after Total Knee Replacement

After total knee replacement (TKR), recovery and rehabilitation is an active process. To improve your chances for long-term success, it’s important to push yourself and commit to a plan over the 12-week recovery phase.

healthnetDay 1. There’s no rest for the weary! Rehabilitation will start almost immediately after surgery. Within the first four hours, a physical therapist (PT) will have you begin standing and walking using an assistive device. Expect to learn how to get in and out of your bed and learn exercises that strengthen your muscles. You will probably be set up with a continuous passive motion (CPM) machine to keep the knee in motion to prevent scar tissue and stiffness.

Day 2 until discharge. Exercises and activities will be slowly increased, including walking up and down stairs, transferring to a chair and toilet without assistance. Pain meds will be slowly tapered.

Goals at discharge include: Bend your knee well, at least to 90 degrees; dress and bathe on your own; get in and out of bed with the least use of an assistive device; and walk at least 25 feet and go up and down stairs using a walker or crutches.

Discharge through week 3. You may be discharged to a rehabilitation facility or directly home. Your PT will prescribe a daily exercise regimen for you. If you are unable to perform the exercises, it’s important that you inform your doctor. Outpatient or home PT can be arranged to help assist you. It’s helpful to have a family member learn the exercises, so they can act as your coach. Bathing and dressing should be easier. You may be asked to continue using a CPM machine.

Weeks 4-6. Increase the knee strength by continuing your exercises, including walking. Return to everyday activities and speak with your surgeon about when you can drive and return to work. Expect improved range of motion of the knee.

Weeks 7-11. This period is crucial for long-term success. Commitment to exercise and your rehabilitation plan will help you succeed. Pain should be significantly reduced.

Engage in basic activities such as driving, housekeeping and shopping, recreational walking, swimming, stationary bike, etc. Range of motion and strength training exercises might be modified as you can move the knee more freely. The goal is to be able to bend your knee 115 degrees.

Week 12. You should have less pain or no pain with normal activities and experience and full flexion and extension. Continue your ongoing exercise routine, but avoid highimpact activities (running, aerobics, skiing, basketball, etc.). Stay in contact with your medical team.

Week 13 and beyond. While full recovery times can vary, the typical recovery time is 3-12 months. Keep in touch with your medical team and don’t wait if you feel pain, stiffness, swelling or decreased motion of the knee. At this point, you should be almost entirely pain free and able to engage in a wide range of activities.

Remember, while you are rehabbing from a TKR, the harder you work, the more likely it is that you will achieve a fuller recovery in a shorter period of time.

SUSAN LOCKE,MD, is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

Legatus chaplain finds relief with Healthnetwork

Bishop Roger Gries awoke one morning last August realizing that a tendon in one of the fingers on his left hand had ruptured.

Bishop Roger Gries, OSB

“I had no movement in my finger,” the retired auxiliary bishop of the Diocese of Cleveland recalled.

“Having had a similar experience on my right hand many years earlier, I knew I needed an orthopedic appointment as soon as possible,” said Bishop Gries, who has served as the chaplain of Legatus’ Cleveland Chapter since 2002. “So I did what everyone does — call their doctor.”

His previous specialist would not be able to see him for a few months.

“As chaplain to the Cleveland Chapter, I knew the valuable help members received from Healthnetwork Foundation,” he said. “Our call to Carol [medical coordinator] at Healthnetwork on that Friday led to an appointment the following Monday.”

Bishop Gries met with an orthopedic specialist who confirmed that surgery was necessary to get movement in his finger. Once again, knowing the original surgeon was booked, he enlisted Carol to help with the search for a qualified surgeon.

“I met with a wonderful surgeon — Dr. Alan Panteck at the Cleveland Clinic — who carefully conferred with the notes from my previous surgeon before explaining how he was going to approach this new surgery. It was very comforting to know he was this detailed.”

Bishop Gries had the surgery and completed his physical therapy well before the date the original surgeon had open on his calendar.

“Thanks to Healthnetwork I was able to get this taken care of quickly,” Bishop Gries said. “I was anxious to get on with my life without a cast or splint.”

“We called Carol again when I needed help with a sleep apnea prescription,” he said. “Healthnetwork came through again and I was able to get the care I needed.”

KATE HANNIBAL is Healthnetwork Foundation’s marketing manager.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

New Jersey Legates rely on Healthnetwork

Healthnetwork Foundation has been a Godsend for a Jersey Shore Legatus couple . . .

Doug Gallagher, past president of Legatus’ Jersey Shore Chapter, considers access to Healthnetwork Foundation one of the top benefits of being a Legatus member.

Doug Gallagher and his wife Arlene are members of Legatus’ Jersey Shore Chapter and  Healthnetwork GOLD Supporters.

Doug Gallagher and his wife Arlene are members of Legatus’ Jersey Shore Chapter and Healthnetwork GOLD Supporters.

Whenever Doug and  his wife Arlene get the chance, they remind their fellow Legates about this benefit.

“Most members don’t realize they have access to Healthnetwork or what Healthnetwork can do for them,” said Doug Gallagher. “As a layperson, where else would you turn with a serious medical problem?

“How else would you get an appointment in literally a couple of days?

“The Healthnetwork medical coordinators are the greatest,” he continued. “They get you in the right direction and answer all of your questions. Some of the doctors we have gained access to were not taking on new patients but as a Healthnetwork member we got in.”

The Gallaghers say they believe in giving to organizations that they feel strongly about. As a nonprofit, Healthnetwork depends on the support of its members.

When asked why the Gallaghers became GOLD Supporters, Doug said, “We wanted to give back. It was time to give back. Healthnetwork is always there for us. I carry my GOLD card to remind me about the benefits of Healthnetwork. When I’m in a stressful situation, the GOLD card reminds me that I’m not alone and to call.”

Recently, Doug installed the Healthnetwork GOLD Access app on his smartphone. This exclusive app for GOLD Supporters provides direct access to Healthnetwork services from the home screen.

“I like the direct dial feature and I was able to send a note to the medical coordinators through the app,” he said. “My wife Arlene and I have called upon Healthnetwork nine times and have been 100% satisfied each time. One request was for me and the rest for our loved ones.”

KATE HANNIBAL is Healthnetwork Foundation’s marketing director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

Is concierge medicine right for you?

Dr. Susan Locke: ObamaCare is actually fueling the demand for concierge medicine . . .

healthnetThe shortage of physicians caused by the Affordable Care Act is driving a significant change in primary care practices. There is a growing shortage of primary care physicians (PCPs), and experts say the shortage will grow.

As a result, patients endure longer waits for appointments. And with declining reimbursements, PCPs will be forced to see more patients per day, hence shorter, more hurried appointments. Many PCPs are already overwhelmed. The average PCP manages 2,500 patients. Patients often experience service that is highly impersonal with delays in scheduling appointments, less face-to-face time with the doctor, and long waits in crowded waiting rooms.

If you want to have a personal physician see you for all your health care needs, you will need to pay for the privilege. With a concierge medicine practice, a physician is often seeing less than 10 patients a day, providing direct patient care, and continuing to have meaningful personal relationships with patients.

Concierge medicine’s popularity may also be driven by primary care physicians themselves. Those who want to continue to have a personal relationship with their patients will find it very difficult to be satisfied with the typical high-volume practice.

Concierge medical practices have emerged as an alternative medical practice model. Patients pay a monthly or annual “membership” fee for enhanced services which include: longer appointment times in an unhurried environment; 24/7 access directly to your personal physician by telephone, email or cell phone (after hours); no waiting and same-day appointments; expedited access to top specialists; and home visits.

Concierge care promises a return to more personalized care. Most concierge practices are limited to a few hundred patients. This allows the physician the time to deliver a higher level of personal attention. Most practices will bill insurance for services that are typically covered by a patient’s insurance.

Good candidates for a concierge medical practice include: older patients with complex medical problems or chronic ailments that require a “quarterback” to coordinate the care of multiple specialists; busy executives and professionals who value easy access to a physician when they require attention; patients who place a premium on prevention; patients who frequently travel away from home and value access to their own physician 24/7; and patients with a fair amount of anxiety about their health.

In 2012, there were about 4,400 concierge physicians. There are geographic concentrations of practices and other places where there are no concierge practices. To see the possibilities in your area, Google “concierge medicine” plus your city and state. This should reveal local opportunities for care.

When considering a concierge medical practice, keep these pointers in mind: Schedule a “meet and greet” with the physician; ask about the physician’s vacation coverage; find out who covers for the physician; ask if your physician would take care of you if you were hospitalized; meet the office staff. Make sure you are comfortable with them, and inquire about the fees. Fees may be as low as $1,000 per year or as high as $10,000 per year.

Concierge practices are not for everyone. However, they can offer peace of mind and an alternative for patients who desire more attentive and personalized care. After all, getting medical care should not feel like a struggle.

SUSAN LOCKE, MD, is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. What is Healthnetwork Foundation? One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

Questions to ask before surgery

Susan Locke writes that it’s necessary to ask many questions before surgery . . .

Susan Locke

Susan Locke

Millions of Americans undergo surgery each year. All surgeries have risks and benefits, and the more you familiarize yourself with the procedure, the better.

Smart patients arm themselves with vital information about the surgery, whether it’s an elective surgery or an emergency surgery. Before undergoing any surgical procedure, make sure you understand why the surgery is recommended. Once you have reviewed why surgery is necessary, you should start asking questions prior to undergoing the procedure. Consider taking notes as you may want to compare them with a second opinion.

• What are my alternatives to surgery and what are the outcomes of these alternatives?
• What if I don’t have the surgery?
• Are there different ways to perform the surgery? Could you tell me about the pros and cons of different techniques? Ask about minimally invasive surgical options.
• What are the risks and the complications of the surgery?
• How many of this type of surgery have you done?
• How many of these surgeries are performed by this hospital every year?
• How do your results compare to other surgeons?
• Can surgery be done as an outpatient?
• Where will the surgery be done?
• What pre-operative preparations will be needed?
healthnet• Based on the medications/health conditions I have, what adjustments will be necessary. How do I best prepare for the surgery with the medications I take?
• What are the dietary restrictions before or after surgery?
• Can surgery be done under local anesthesia? What type of anesthesia will be used?
• How long will surgery take?
• How long will I be in the hospital?
• What complications are likely based on my history?
• How much pain can I expect and how will it be treated?
• How long will I be in bed?
• Will I need any special adaptations when I return home?
• Will I need any physical therapy?
• When can I drive?
• When will I be able to return to work? Normal activities?
• How long will it take my incision to heal? Will I have a scar?
• Will I need additional treatment for my condition?
• What post-operative symptoms warrant a call to your office?
• Who should I call if I have a problem? How do I reach them?
• How many post-operative appointments will I have?

Prior to surgery, contact your insurance company to confirm whether the surgery will be covered by your policy. Taking an active role in your health or having someone close to you advocate for you is always a good idea.

SUSAN LOCKE, MD, is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

Genetic testing: Are these your mother’s genes?

Susan Locke writes that genetic testing can help pinpoint diseases and disorders . . .

Susan Locke

Susan Locke

Genetic testing — also known as DNA-based testing — has been an evolving technology in medicine. Different types of genetic testing are done for different reasons. Samples for genetic testing are obtained from blood, hair, skin, amniotic fluid or other tissue.

Newborn screening is the most widely used type of genetic testing in the U.S. Most newborns are screened for phenylketonuria and congenital hypothyroidism.

Predictive testing will detect gene mutations associated with disorders that occur after birth and can be beneficial in making decisions about medical care.

Pharmacogenetics is a newly evolving field to help determine what medication and dosage will be most effective for an individual.

Prior to genetic testing, it’s often helpful to meet with genetic professionals to discuss the benefits, risks and limitations of a particular test. While the physical risks involved with testing are minimal, the psychological consequences may be significant.

The results of genetic testing aren’t always straightforward, so interpretation of results must be taken in the context of family history, personal medical history, and type of genetic test. It’s also important to remember that only limited information can be provided about an inherited disease. For example, it cannot predict severity of symptoms or progression of a condition. Lifestyle and environment also play a part in an inherited disease.

For more information on genetic testing, I turned to a world-renowned genetics physician Charis Eng, MD, PhD, the founding chair of Cleveland Clinic’s Genomic Medicine Institute.

What is your opinion on Direct-to-Consumer (DTC) testing?

DTC testing provides consumers with a genetic analysis of their saliva by testing for a range of single nucleotide polymorphisms (SNPs) — DNA sequence variations — that have been loosely associated with, but never shown to be causative of, disease. These low-cost tests can be engaging, allowing consumers to investigate their heritage and network with others who share similar genealogy and disease risk. However, consumers and health-care providers alike need to understand the limitations of this testing.

When DTC tests appeared on the market, some consumers, health care providers and policy makers mistakenly believed these tests provided a genetic risk assessment equivalent to that obtained by a family health history-based risk assessment. Our research has shown that these two methods of risk predication are quite different.

Evaluation of family health history still remains the gold standard in personal disease risk assessment. A personal family health history report can be completed at little cost, and this type of information is typically readily accessible and easily gathered by the patient.

What is the role of pharmacogenetics?

Pharmacogenetics uses a person’s genetic information to predict his or her response to drug treatments. For example, warfarin (Coumadin) is widely prescribed to prevent blood clots in patients with certain heart conditions. A genetic test is available to help select the right dose of warfarin, based on a patient’s genotype.

Currently, there are more than 100 medications approved by the FDA with pharmacogenetic information on their labels. A small number of these carry a “boxed warning,” which is a warning reserved for those medications that may have serious or sometime fatal complications for people who carry a rare genetic marker. If tests show that a patient has such a marker, the physician will adjust the dose or prescribe an alternate treatment.

If you would like more information about an appointment with a genetic specialist, please contact us today.

SUSAN LOCKE, MD, is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

Get the inside tract on IBS

Irritable Bowel Syndrome (IBS) is one of the leading cause of absence from work . . .

Irritable Bowel Syndrome (IBS) is the most commonly diagnosed gastrointestinal condition. It’s the second leading cause of absence from work (behind the common cold) and affects one in five Americans.

Symptoms and causes

healthnetThe primary symptoms of IBS are abdominal pain and altered bowel habits. In Western countries including the U.S., women are twice as likely as men to be diagnosed with IBS.

• Abdominal pain can be crampy and vary in intensity. Pain may be worsened by eating or emotional stress. Having a bowel movement often relieves the pain. Abdominal pain is often the most troubling symptom to IBS patients and has been the most difficult symptom to treat.
• After pain, changes in bowel habits are the second most frequent IBS symptom. This can include diarrhea, constipation, or alternating diarrhea and constipation.

IBS has been linked to Small Intestinal Bacterial Overgrowth (SIBO). Abnormal contractions of the colon (“spastic colon”) may also be a cause. Stress and anxiety are seen in many of the patients who seek medical help for IBS, but they are probably not the root cause.

Many patients with IBS have food intolerances, raising the possibility that it is food allergies or food sensitivity. But the most important trigger for IBS is now believed to be food poisoning. If you had recent travel and developed diarrhea or ate food you think caused illness, try to determine if that is when your IBS started.

Diagnosis and treatment

There is no diagnostic test for IBS. However, the constellation of symptoms including abdominal discomfort and irregular bowel habits are very typical of IBS. In the absence of blood in the stool, weight loss, or anemia, the condition is likely IBS.

It’s important to rule out other diseases. Over the age of 50, a colonoscopy is important for all people as part of routine screening for colon cancer. In addition, it’s recommended that a blood test for celiac disease be performed in all people with suspected IBS. While Crohn’s disease and ulcerative colitis are rare, these should at least be considered in someone with new onset symptoms.

There are a number of different treatments for IBS and often a combination of long-term treatment is used.

• Keep a record of your symptoms and identify factors that might affect your symptoms
• Reduce foods that cause gas such as beans, cabbage, brussel sprouts, cauliflower and broccoli, and increase daily fiber either with food or with a bulk fiber supplement. Lactose intolerance is common and can aggravate IBS or cause symptoms that mimic IBS.
• Several classes of medicine are used to relieve symptoms. Ask your doctor for details.
• Regular exercise, massage, and prayerful meditation help relieve stress.

Most people with IBS find that symptoms improve as they learn to control their condition. Only a small number of people with irritable bowel syndrome have disabling signs and symptoms.

Fortunately, unlike more-serious intestinal diseases such as ulcerative colitis and Crohn’s disease, irritable bowel syndrome doesn’t cause inflammation, changes in bowel tissue, or increase your risk of colorectal cancer. In many cases, you can control irritable bowel syndrome by managing your diet, lifestyle and stress.

If you would like an appointment with a gastroenterologist for your digestive issues, please contact us today.

SUSAN LOCKE, MD, is Healthnetwork Foundation’s medical director. Mark Pimental, MD, gastroenterologist at Cedars-Sinai Medical Center, also contributed information for this article.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

Searching for specialists

Finding a specialist isn’t easy, but Healthnetwork helps make it easier . . .

healthnetWhere do you go when you find yourself or a loved one with confusing symptoms? Ideally, the first step is to see your primary care physician (PCP) to decide whether you need a specialist — and which specialist you need to see. Many specialists require a referral from a physician first.

When you’re looking at a physician’s credentials, make sure the specialist that you see is board certified in his/her specialty. Here are definitions of specialists and what they commonly treat.

Psychiatrists are medical doctors who can prescribe medications. Although psychiatrists are trained in psychotherapy, most psychiatrists choose to manage medications and refer to a therapist for psychotherapy. Therapists can have many different types of titles and educational degrees. They may pursue subspecialty training for marital and family therapy, chemical dependency and school counseling.

Anesthesiologists provide relief from acute and chronic pain (pain management specialists) and help stabilize a patient’s condition during and after an operation or other medical procedure.

Cardiologists treat heart conditions. Electrophysiologists are cardiologists who specialize in cardiac rhythm abnormalities.

Dermatologists specialize in skin conditions.

Endocrinologists diagnose and treat disorders such as thyroid disorders, diabetes, osteoporosis, menopause, infertility, metabolic disorders, etc.

Gastroenterologists treat a variety of conditions related to the digestive tract including ulcers, reflux, liver problems, gallbladder disease, diarrhea/constipation, inflammatory bowel disease, etc.

Genomic Medicine Specialists specialize in genetic-linked diseases and provide genetic counseling.

Hematologists diagnose and treat diseases of the blood, spleen, and lymph glands, such as anemia, sickle cell disease, hemophilia and leukemia.

Infectious Disease physicians specialize in treating bacterial, viral and fungal infections.

Nephrologists treat disorders of the kidney, high blood pressure, and fluid and mineral imbalances.

Neurologists treat diseases of the central nervous system (brain and spinal cord) and peripheral nervous system. This encompasses a wide range of disorders including headaches, seizures, dementia, back pain and other conditions. Neurosurgeons perform surgery on the brain, spinal cord and peripheral nerves.

Orthopedic surgeons typically specialize in a particular joint (knee, hip or shoulder) for repair or replacement.

Obstetricians and Gynecologists (OB/GYN) focus on female reproductive issues, including pregnancy.

Oncologists diagnose and treat all types of cancer, often with chemotherapy, and consult with radiologists and surgeons on other treatments.

Ophthalmologists treat disorders of the eye, such as cataracts, glaucoma, refractive surgery (LASIK) and retinal disease

Optometrists are trained to prescribe and fit lenses to improve vision and to diagnose and treat various eye diseases.

Otolaryngologists treat disorders of the ears, nose and throat (ENT physicians).

Pulmonologists treat diseases of the lungs. Allergists treat problems related to asthma or allergies. Immunologists treat allergies not associated with breathing.

Rheumatologists will diagnose and treat diseases of joints, muscles, bones, and tendons such as arthritis, autoimmune diseases, vasculitis, and heritable connective tissue disorders.

Urologists treat disorders of the urogenital system including bladder, prostate and male sexual organs. Female urological issues are frequently treated by a gynecologist or urogynecologist.

Vascular medicine specialists diagnose and treat conditions like peripheral artery disease, aneurysms, and deep venous thrombosis. Vascular surgeons surgically treat blood vessels of the body with the exception of the vessels of the heart.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org SUSAN LOCKE,MD, is Healthnetwork Foundation’s medical director.

Seeking a second opinion

Susan Locke: Getting a medical second opinion is always in your best interests . . .

heathnet

If you have any doubts about a diagnosis or treatment plan, get a second opinion. Even if you like or trust your physician, it’s natural to wonder if something was missed or if a new treatment is available.

Even if most second opinions just confirm what you already know, they still play an important role. A second opinion offers peace of mind. With the exception of true emergency treatment, decisions regarding your health should be made after you have been completely informed about your diagnosis, prognosis and available treatment options.

A second opinion could be very helpful when:

• Surgery is recommended
• You are diagnosed with a life-threatening diagnosis
• You’ve been advised to have a radical treatment when less drastic treatments exist
• Your physician recommends you have long-term medical treatment
• Your physician recommends a risky or experimental treatment
• Your physician doesn’t know what is wrong with you
• The medical treatment you are on is not working

Many physicians welcome another physician’s input. Don’t worry that your physician will be angry with you. If your physician is put out because you want to get a second opinion, perhaps this physician is not the right one for you.

If you do decide to seek a second opinion, here are some general recommendations:

• Healthnetwork can help you identify top physicians and hospitals.
• It’s a general practice that physicians will not give opinions over the phone; you will need to make an appointment.
• Choose a physician who is an expert in your medical condition. Physicians with clinical expertise will be aware of all the options for treatment as well as clinical trials.
• Make sure you have all of your records including x-rays, scans, blood work, biopsy reports, etc. Most physicians like to receive this information in advance of the appointment.
• Many physicians and patient advocacy groups suggest that you provide the second opinion physician with all the data, but not reveal the first physician’s recommendation upfront to try to get the most unbiased second opinion. This is not always possible to do because this information is usually in your records somewhere.
• Ask your insurance company if a second opinion is covered. Sometimes insurance companies require a second opinion for some elective procedures.

So what happens after you get a second opinion? The second opinion may confirm your first diagnosis or treatment recommendation, which can be reassuring. The second opinion may explain things in a way which you may find more understandable.

The second opinion may differ from the first regarding diagnosis, treatment plan or both. In this situation, the best course of action is to get a third opinion from another expert at another institution. In the majority of cases, two of the opinions will be similar. Remember that being informed is the best way to feel confident in your choice of treatment.

To schedule a second opinion appointment with a specialist, please call or email Healthnetwork Foundation today.

SUSAN LOCKE, MD, is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

Dignity and comfort for the dying

Some helpful advice in planning for hospice care for yourself or a loved one . . .

Dr. Susan Locke

Dr. Susan Locke

Throughout our lives, we make plans — for our own life and the lives of our loved ones. But few of us think about the end of our lives — how we can ensure our dignity or the dignity of a loved one.

When the time comes, it’s important to start this conversation with physicians, caretakers and family members. In partnership with the Visiting Nurse Association of Ohio, Healthnetwork Foundation now has the resources to assist you and your family with hospice and in-home nursing care. To help you with this journey, we engaged the assistance of VNA’s hospice medical director, Cynthia Katzan, MD.

How do you know when you or a loved one is ready for hospice?

Usually your primary physician or specialist will bring up the topic of hospice with you if they feel the disease is considered “end-stage.” Some patients inquire about hospice themselves if they decide they don’t wish to continue with aggressive treatment such as chemotherapy or dialysis.

The primary criterion common to all is that a physician believes the patient is within the last six months of life if the illness continues on its course. At any time the patient or their family may call Healthnetwork to discuss hospice options.

How does a family get started?

The patient’s physician typically activates the hospice admission process. However, if you want to explore hospice options, a phone call to Healthnetwork will start a dialogue with hospice specialists at the VNA of Ohio.

If a family chooses hospice care at home, a nurse will assess for eligibility, explain the hospice philosophy and answer all questions. The nurse will also describe the types of support and resources available. Together with the patient and the family, they will prepare a plan customized to the physical, spiritual and emotional needs unique to that family.

Who will be the physician once the patient enters hospice?

Most people who have a rapport with their primary physician or oncologist will continue under their care, focusing on comfort, for the rest of their lives. Many hospices have a medical director who can assist as well.

Does the patient have to sign a DNR (Do Not Resuscitate) form?

Most hospice programs make this request. CPR is not in keeping with the hospice philosophy of a comfortable death with dignity. Performing CPR on someone who has a frail and diseased body never buys quality time.

Will the patient go to the hospital for their care?

Hospice is dedicated to “comfort care.” It’s designed for patients who are not seeking active treatment of their illness. Lab tests, X-rays and procedures are not part of the hospice philosophy.

If they are able to go to their physician’s office, some patients will continue to see their physician for symptom management. However, many terminally ill patients desire to remain at home. Hospice staff will do everything they can to honor that wish. Usually symptoms that arise can be managed by the hospice team.

Can the patient receive intravenous fluids in hospice?

When the patient is not drinking, it may be because they do not have thirst. This is a normal part of the physiologic process of dying. When they are thirsty and unable to drink or receive fluids intravenously, a simple technique called hypodermoclysis may be employed.

If you find yourself contemplating hospice services and in-home nursing care for a loved one, please contact Healthnetwork and allow us to guide you and your loved ones on that path.

SUSAN LOCKE, MD, is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org