PATH. On the right. Suggested Websites. For Patients with a Serious Illness. PATH is a service provided by:

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1 On the right PATH For Patients with a Serious Illness transitional care for patients with a serious illness Suggested Websites hospicesacredheart.org seriousillness.org/nepa elderlawanswers.com caringinfo.org alz.org aging.state.pa.us PATH is a service provided by: The Region s Leader in Hospice & Palliative Care 600 Baltimore Drive Wilkes-Barre, PA Toll Free: hospicesacredheart.org

2 Introduction As the health care system in the United States continues to improve and develop, many more people are living to an advanced age; as a matter of fact, seniors over the age of 80 are the fastest growing segment of our population. However, as we age, many chronic and/or serious illnesses may develop. Here in Northeastern Pennsylvania, we have one of the highest percentages of seniors over age 65 only Florida and South Carolina are ahead of us. Many of our seniors suffer with many illnesses such as dementia, serious heart disease, emphysema or simply a debilitated condition. We at Hospice of the Sacred Heart recognize that while many patients don t meet the criteria for hospice care, they may not realize all the many services that are available in NEPA to assist patients and families dealing with serious and chronic illnesses. We are pleased to offer our PATH program to patients with serious illnesses who may need support and assistance in the community. Please use this brochure to guide you through the available systems of support throughout our 9 county coverage area, which extends from Schuylkill to Susquehanna counties. Our hope is that with our assistance, patients and their families can access the care and help that is necessary to live a dignified, comfortable and independent lifestyle.

3 Path Program The PATH program is a free, volunteer supported service for patients and their families who are dealing with serious, chronic or possibly terminal illnesses. Many times, patients are not quite eligible or ready for hospice services, but still require support and guidance on their journey. The mission of the PATH program is to meet patients wherever they are on the health care continuum and to enhance the communication and care between patient and the health care system. We provide a supportive environment of non-abandonment, recognizing early changes in a medical condition, so that prompt attention and treatment will enable patients to remain safely and comfortably in their homes, or wherever they call home. Because the PATH program is a free service provided through the mission of Hospice of the Sacred Heart, it will not interfere with or replace other services or treatment that you are currently receiving. Home health, chemotherapy, radiation, dialysis or any community services would never be interrupted; our goal is to coordinate volunteer support and any other community services that could enhance and improve your function and quality of life.

4 Path Team Our PATH program is a volunteer-supported service, coordinated by a qualified staff including a social worker, counselor, volunteer director and physician. Our volunteers are well trained and supervised to provide any number of services in a compassionate, dignified and non-intrusive manner. As with all services offered by Hospice of the Sacred Heart, the primary care physician guides and supervises the care provided to patients and families receiving services from the PATH program; he/she is an important part of the team certainly no one knows the needs of the patient better that the personal physician. Services can be provided to patients in the private home, assisted living facility or long term care facility. Who Qualifies for this Service? Since the PATH program is a free service, there are few mandated eligibility criteria that need to be met. Patients who may qualify for PATH services are those who have: Serious congestive heart failure Advanced COPD Early-moderate dementia Poorly controlled pain or other symptoms Frequent falls Weak, frail elderly Patients with cancer receiving active therapy Age over 80 with multiple health problems Poor nutritional status/persistent weight loss Frequent hospital or ER visits Patients discharged from the hospital with chronic illnesses

5 Services Available The intention of this innovative level of care originated as a way to assist patients who were discharged from hospice and also the frail elderly bereaved. We noted that those patients who no longer required hospice services or those spouses who survived the death of a loved one, felt abandoned and without guidance in the community. This concept of care quickly developed, has been fostered by our staff and now recognized as a viable option for volunteer support of frail patients in our community. Available services may include: Volunteer visits Volunteer telephone support Recognition of early condition change utilizing a prompted script and timely report to physician Providing transportation to doctors offices Counseling Completion of advance directives Clergy visits as requested Assistance with identifying and coordinating community resources Referral to home health as physician directed Explanation of insurance benefits Coordination of Meals on Wheels/Telespond and other community services

6 Transitional Care Program The PATH program sponsored by Hospice of the Sacred Heart is a nationally recognized service known as Transitions Care. There are currently many franchised programs in the US, and the only program of its nature with a favorable legal endorsement by the OIG. Actually, Hospice of the Sacred Heart is the only agency in Northern Pennsylvania that provides this valuable service to patients and families. The mission of the program is to customize a volunteer supported plan of care for patients with a prognosis of 1 year or less. Patients may benefit from Transitions Care, or PATH, when the service is coupled as part of the discharge plan from ERs, hospitals or Long Term Care facilities. The ultimate goal is to maintain close contact with patients in the home environment, to monitor for early changes in condition as to prevent repeat hospital and ER visits always mindful of our precious healthcare dollars. The program is supported by volunteer staffing, grants, bequests and planned giving.

7 About Hospice of the Sacred Heart Hospice of the Sacred Heart is a not for profit agency of care serving the needs of patients and families with an advanced or terminal illness. In existence since 2004, our experienced, compassionate and dedicated staff has quickly positioned us to be recognized as the leaders of hospice and palliative care in the area which we serve. Our service area includes Scranton, Wilkes-Barre, Hazleton and many other surrounding communities in our 9 county service area. Hospice of the Sacred Heart has an array of programs serving our patients, families and the community at large. Some of these programs deserve special mention: Palliative Care Consultations in conjunction with community palliative care specialists Pediatric hospice services Comprehensive bereavement programming Spousal support groups Dragonfly program for grieving children Lunch and Learn programs providing community education Specialized CHF hospice program Veteran s Hospice Program Dementia Support Group

8 We are proud to be Medicare and Medicaid certified and CHAP accredited. We serve patients and their families regardless of their religious affiliation, diagnosis, sexual orientation, race, age or ability to pay. Our mission is to provide comfort, care, hope and choice to patients and their families as they travel the end of life journey. We envision a community where patients with serious illnesses can access the appropriate level of care: whether hospice services, a palliative care consultation, our PATH/Transition Care Program or perhaps an educational session or bereavement visit. We pledge to work respectively and collaboratively with our community physicians, hospitals, home health agencies as well as other providers of hospice and palliative care services. We at Hospice of the Sacred Heart have a common ideal to advance the care of patients and families as they journey with an advanced or terminal illness. We promise that you will not be alone. The Region s Leader in Hospice & Palliative Care