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Routine Care. Routine Care includes ongoing medical care and coordination, including pain and symptom management; emotional, psychosocial and spiritual counseling; patient and family caregiver education; dietary counseling; art and massage therapy; rehabilitation therapies and personal care services. Spiritual care and bereavement counseling for family members is also included in Routine Care. In addition, VNA of Ohio Hospice provides 24-hour on-call support, social work services and linkage to community resources. "Routine Care, the standard hospice care, is delivered to patients and families, wherever they call home," explains Linda Ambrose, RN, BSM, Executive Director of Hospice, VNA of Ohio. "Medicare covers the daily cost of care that is provided by our interdisciplinary team of doctors, nurses, social workers, therapists, dieticians, counselors and home health aides," she adds. "Medications related to the terminal diagnosis, durable medical equipment, and medical supplies are also included in the Medicare benefit." Continuous Home Care. Continuous Home Care is nursing care delivered to patients in their own home during a crisis, which allows them to remain in their home and out of the hospital. "An example of a crisis would be a patient who is close to death and has symptoms that are out of control but they cannot be moved, by circumstance or family wishes," says Ambrose. "Staff must provide at least eight hours of care within a 24 hour period. At least half of that care is provided by a licensed nurse." General Inpatient Care. If a patient has acute symptoms that require a higher level of care, such as extreme pain, intractable nausea, severe anxiety or respiratory dif- ficulties, VNA of Ohio Hospice can transfer the patient to an acute care or skilled nursing facility for services. "Our nurses work in tandem with the providers of these facilities to ensure each patient is delivered a seamless continuum of care," Ambrose explains. This type of hospice care is also available to patients who are already admitted to an acute care or skilled nursing facility. "If the patient is too sick to be moved home, and is referred to hospice care, our interdisciplinary team will begin General Inpatient Care services," says Dr. Marsick. Respite Care. Designed to help family caregivers who may be exhausted or ill or need to attend an out-of-town event, Respite Care enables hospice patients to be transferred to a long-term care facility for up to five days, per the Medicare benefit. "Usually, five days is enough for the caregiver to regroup. However, sometimes it is not," says Ambrose. "That is when a VNA of Ohio social worker will assist the patient and family in formulating a back-up plan, based on recommendations from the interdisciplinary hospice team." VNA of Ohio Special Care In addition to the continuum of hospice care, VNA of Ohio offers a unique program, Special Care, for patients with limited-life expectancy who choose to continue curative treatments. The Special Care team works with patients, families and physicians to identify goals of care, while providing pain and symptom management. In many cases, patients will continue to receive curative treatment for their illness, while others may opt for hospice care. "Ultimately it comes down to patient and physician choice," says Dr. Marsick. "When in doubt, call us to discuss options. Clinical liaisons are available to speak with patients, families, and physicians to determine what is in the best interest of each patient." In addition to Hospice and Special Care services, VNA of Ohio offers skilled nursing care, chronic disease management, mental Christine Marsick, MD, Medical Director, VNA of Ohio Hospice Linda Ambrose, RN, BSM, Executive Director of Hospice, VNA of Ohio health services, rehabilitation therapies, and Home Assist private-duty/personal care a s s i s t a n c e. Fo r m o r e i n f o r m a t i o n , v i s it w w w.V NA ohi o.or g. To r e f e r a patient, call 216-931-1400 or toll-f ree 1-877-698-6264. ■ 2 0 1 4 N OV E M B E R / D E C E M B E R ■ M D N E W S . CO M ■ MD NEWS Cleveland/Akron/Canton | 2 7