We never say "there is nothing more we can do"
Are you seeing patients who may be hospice or palliative-eligible, but not sure how to broach the subject?
- Cancer: Stage 4 or metastatic disease and reconsidering active treatment
- Heart Failure: NYHA Class IV
- COPD: GOLD Level 4 (FEV1<30%)
- Dementia: Stage 7 on the FAST scale
If you would not be surprised if the patient was no longer living in 6-12 months, call us for a palliative care consultation.
We talk to patients and families about their needs and wishes without focusing on prognosis—an inexact science at best. Our experience guides “the Conversation” – even if it takes more than one meeting – which can be in the clinic, at the hospital, at home, or at another location of their choosing.
Once a patient is on our service, our board-certified Medical Directors (oncology, internal medicine/palliative) ensure the highest quality clinical care. The nursing team has quarterly formal training in each of our Focused Care specialties. Our Hospice Programs help bridge the gap between traditional hospice and palliative care by including a disease management perspective and tools customized for the diagnosis and the individual.
More About Palliative Care Consults
We offer Palliative Care Consults for patients who are dealing with a diagnosis of serious illness. These consults are designed to maximize individual attention and interaction outside of a normal clinic schedule and are structured as discussions. Topics may include:
- Patient’s view of their current situation and treatment history
- Expectations, hopes and concerns for the future
- Family considerations
- Advance care planning and “Goals of Care”
- Symptom and ADL management
Palliative consults are provided by Dr. C. William “Bill” Dronkowski, board-certified in Internal Medicine and Palliative Medicine. Dr. Dronkowski’s 30+ years of experience, including critical care, general medicine and geriatric care, ensures comprehensive support during this important conversation.
Criteria for Palliative Consult
- Patient lives in the 5-county greater Portland area
- Patient is 18 years of age or older
- Patient is suffering from one or more serious illnesses
- Patient and primary treating physician agree that palliative consult could be beneficial
A Palliative Consult may be followed by Palliative Care Case Management. Specific conditions and services covered under Palliative Case Management will depend on the patient’s insurance benefits. In the Portland area, Regence and Health Net offer palliative coverage.
Dr. Dronkowski serves as Care Partners Associate Medical Director, in association with Medical Director, Dr. Gerald Gibbs (board certified in Internal Medicine and Oncology). Care Partners also has two Nurse Practitioners available for supplemental services. Dr. Dronkowski always respects patient freedom of choice in decisions regarding future care providers. “When it comes to palliative care, each patient and family’s choices and path must be respected, and no two are the same.”
As a community-based nonprofit, Care Partners has delivered on its mission of providing “Exceptional Care, without Exception” since 1982. Since our founding we have specialized in the care of cancer patients, and we have offered palliative care since 2008.
Our Focused Care Programs
Patients With Cancer
We say “yes” to advanced symptom treatments
Patients With Heart Failure
We help keep them in balance
Patients With Lung Disease
We help them breathe easier
Patients With Dementia
We make their world better
Patients With Other Diagnoses
We bring over 37 years of serious illness expertise
Hospice Care FAQs
- Studies in patients with cancer and heart failure showed that those on hospice lived longer than those receiving active treatment
- About 15% of patients on hospice are discharged due to a stabilization or improvement in their health
Especially for people over age 70, going to the hospital has many risks. People with who are frail and have restricted mobility or cognitive impairment are especially at risk. At home, consistent monitoring by hospice RNs and CNAs helps prevent the development of problems that would require hospital or ER admission.
- Medications that effectively treat symptoms of the patient’s primary diagnosis can continue to be provided; each hospice has their own formulary, and ours includes many newer drugs with proven benefits.
- Medications unrelated to the hospice diagnosis can be paid under the patient’s Medicare Part D benefit or other private insurance.
The selection of their hospice physician is up to the individual. They can choose you, another community provider, or our hospice medical director. If our medical director is selected, we will stay in close contact with you on their care plan.
A Do-Not-Resuscitate order is not needed to be on hospice. We encourage people to fill out POLST forms and Advance Healthcare Directives to clarify their wishes, but no specific choices are required.
Whenever possible we use non-drug therapies and techniques. With medications, we strive to use the lowest doses necessary to meet patient needs/goals. We want to maximize quality of life, which includes the capacity to interact with family and friends. A number of people even travel with our assistance.
The hospice benefit includes 4 levels of care, one of which is general inpatient care (GIP) for symptoms that cannot be adequately managed in the home setting. Hospice patients may also be hospitalized for conditions unrelated to their terminal illness, if required.
Check out the presentation below for links to publications and more
We Are Available Day or Night
Care Partners is on call around the clock to meet your needs. Call now to speak with an experienced and caring nurse. We’ve been helping people like you for more than 37 years.