3 Reasons to Consider LTACHs in Palliative Care Discussions
When a critical patient’s prognosis is unclear, often because they are unable to wean from the ventilator, care teams begin to discuss palliative care, advance care planning, and even hospice. Making decisions about long-term care goals can be challenging for patients and their families as they navigate the complexities of their conditions. Discussions often take place over many days while patients and families evaluate the options. Including long-term acute care hospital (LTACH) referral in these discussions benefits the patient for three reasons.
1. LTACH referral affords patients additional time to make decisions
Hospital ICUs are designed to stabilize patients in a matter of days before transferring them home or to a lower level of care. Patients with complex conditions and their families may not feel prepared in that short time to discuss long-term care goals. Environmental factors like machine alarms, constant activity and harsh lighting can lead to sensory overload or even ICU delirium, rendering decision making difficult. Referral to an LTACH allows patients to continue receiving the acute care they need, in a smaller, calmer environment, and gives patients and their families more time to set realistic long-term expectations. This extra time can relieve stress and put patients at ease while they make decisions about care goals.
2. LTACHs specialize in complex patient recovery
LTACHs are specifically designed to treat patients with complex conditions, including those with tracheostomies and PEG tubes, and generally uncertain prognoses. Kindred Hospitals, a network of LTACHs, offer:
- Physician-led care
- Intensive care and high-acuity units
- 24/7 access to respiratory therapy and weaning trials
- Early mobility for all patients, including patients with tracheostomies
- Ability to administer and titrate IV drips
- PEG tube removal with speech-language pathologists and dietitians on staff to help patients transition to food
At Kindred, our goal is to help patients recover from their complex conditions and begin the rehabilitation process before advancing to a lower level of care or even home.
3. LTACH treatment includes aspects of palliative care
LTACH treatment focuses on the whole patient. At Kindred, we strive to improve the quality of life for our patients and meet their unique needs. Our services include:
- Interdisciplinary approach to care: patients will have a team of clinicians that include physicians, respiratory therapists, nurses, pharmacists, rehabilitation specialists, and others, who collaborate to create an individualized treatment plan. They will meet at the patient’s bedside at least weekly to discuss progress and to provide education and emotional support to the patient and family members.
- Consultative care: Specialty consultations are available and include Cardiology, Pulmonology and Neurology, among others. These specialists evaluate acute and chronic conditions and provide additional education on disease processes.
- Symptom/pain management: Management may include the use of IV pain medications with daily reassessment for transition to a pain regimen that is appropriate for a lower level of care.
- Case Management/Social Work: Trained professionals are available to provide additional disease education, emotional support, and discharge planning. They can also arrange appropriate resources at discharge, including palliative care or hospice referrals.
- Goals of care and/or advance care planning discussions: These conversations start upon admission and continue throughout the stay.
- Additional supportive care: Chaplains and patient advocates or ambassadors may also be available to provide support.
At Kindred Hospitals, we provide complex patients the specialized treatment and palliative care they need, for the time they need it, empowering them to confidently take the next step in their care journeys.
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