Topic > Patient Transition to Hospice Care - 1065

I. Introduction The patient presented in this article is Mrs. H, an 83-year-old African American woman who appears younger than her stated age with a history of multiple myeloma. The patient's medical record was reviewed and an interview was conducted. Interestingly, the patient had kept every note, lab, hospital H&P, and discharge summary in a folder in her possession. Ms. H was diagnosed with multiple myeloma in April 2008 while she was admitted to her dentist for a toothache. X-rays taken revealed that he had bony lesions in the zygomatic process and in the skull above his right eye. She was referred to the Hematology Oncology Center for further investigations. A bone marrow biopsy revealed he had multiple myeloma. During the course of treatment the patient received Thalidomide, Revlimid, Velcade, Aredia, Zometa and Decadron. Remission was achieved and the patient underwent a stem cell transplant in February 2009. The transplant was successful and the patient was cancer-free until August 2012 when she received news that her cancer had cleared. resubmitted. Current medications are Lisinopril 20 mg PO daily for HTN, Omeprazole 40 mg PO for GERD, Topamax 25 mg BID for headache, calcium 500 mg PO TID for osteoporosis, Zofran 4 mg q6h/prn for nausea , Vicodin 5/325 mg every 4 hours/prn for pain control. H has 3 adult children and 4 grandchildren in their early twenties. During the initial phase of treatment, Ms. H was employed part-time at JC Penney. Once sent to a Jewish clinic for a bone marrow transplant, she retired. You are on traditional Medicare with Medicaid because you have maxed out your secondary Humana plan. Mrs H is divorced but has a supportive friend, Mr P, who has been by her side throughout her diagnosis and treatment. He... half of the card... benefit.V. Analysis of Transition Admission Forms Admission forms include Consent, HIPPA Acknowledgment Form, Patient and Family Bill of Rights Receipt, Medicare Bill Authorization. The forms required for hospice admission are few and concisely written to reflect the Medicare hospice benefit. Patients who are impaired enough to sign their own forms are usually ill enough to appreciate the number of forms needed. Mrs. H and her family were amazed and pleased at the need to have fewer signatures to admit. References(1.)Blood. March 15, 2008; 111(6): 2962–2972. doi: 10.1182/blood-2007-10-078022 PMCID: PMC2265446(2)ASH 50th Anniversary Review Article on Multiple Myeloma…(see)(3)Publish Date: 2008-03-18Medicare Benefits Policy Manual Chapter 9 - Hospice Coverage (4) JOURNAL OF PALLIATIVE MEDICINE Volume 9, Number 6, 2006