The service is provided by certified registered nurse practitioners who make house calls in the patient’s home or assisted-living facility. Phone access to an office-based nurse is available to patients, family members, physicians and community agencies for information and assistance.
The nurse practitioners:
- Gain an understanding of the patient’s physical, emotional, social and spiritual needs
- Learn about the patient’s goals and treatment preferences
- Provide assistance with understanding the illness and available treatment choices
- Collaborate closely with all physicians involved in the patient’s care
- Foster communication so that all members of the care team and family are working together with a consistent understanding of the patient’s illness and the goals of treatment
- Help manage difficult symptoms
- Encourage self-management goals
- Provide support to patient and family
- Provide visits to the home every one to three months to monitor the patient’s health status and respond to emerging needs (Frequency of visits is based on patient need.)
- Link patients with additional services in the community
In our home-based service, our primary focus is getting to know you. We’ll come to your home or assisted-living facility and talk to you about your life, including your physical, emotional and spiritual needs. You may need help with taking care of your physical symptoms, helping your family cope with your illness or managing your health at home. We want to understand what’s important to you and will work to help you achieve your goals.
Over the course of several visits, we will talk about your illness and your personal goals so you can improve your quality of life, and if possible, avoid going to the hospital. We will always collaborate with your current doctors and continue to check on you, providing special help as needs arise.
If you need to go to the hospital, your medical team may consult the OACIS/Palliative Medicine Inpatient Consult Service, who will be there to support you and your family. We will help everyone understand your illness and explain the choices you have. We will help manage your difficult symptoms and communicate with your doctors to ensure they know what you would like them to do.