Admitting Registered Nurse
A registered nurse with advanced skills in clinical assessment, principals of diplomacy and negotiation, hospice philosophy of care, and Medicare/Medicaid benefits who screens for appropriateness of services and establishes (in concert with the physician and IDT) a comprehensive initial plan of care that meets patient and family goals for quality of end-oflife care.
Advance Care Planning
The process of understanding healthcare options, reflecting values and wishes related to those options, discussing those values and wishes, with closest family or friends and the physician, and formulating a plan designed to have one's wishes honored.
Art Therapist
A professional who is trained to utilize visual arts methods and materials to promote mental and emotional health. A registered art therapist (ATR) has completed training requirements established by the American Art Therapy Association.
Assisted Living Facility
Residence for people needing assistance with activities of daily living (ADLs) but wishing to live as independently as possible for as long as possible. Assisted living exists to bridge the gap between independent living and a nursing home. Residents in assisted living centers are not able to live by themselves but do not require constant care.
Autonomy
Derived from Greek words meaning "self rule." In bioethics, autonomy typically refers to the patient's rights of self-determination concerning medical care. Autonomy may be used in various senses, including freedom of action, effective deliberation, and authenticity. It supports such moral and legal principles as respect for individuals and informed consent.
Beneficence
A principle that involves duties to prevent harm, remove harm, and promote the good of another person. In bioethics, beneficence refers to the obligation of healthcare professionals to seek the well-being or benefit of the patient.
Bereavement
The normal, healthy response to the death of a loved one, which is usually characterized by a wide range of emotional, physical, and behavioral changes.
Bereavement Counselor
A mental health clinician who provides bereavement support and education to individuals, families, and groups through the Community Bereavement Services program.
Bereavement Support Groups
Support groups and grief education offered by Community Bereavement Services for adults who have experienced the death of a loved one. In addition to the Living Through Grief groups, which are open to any bereaved person, groups are often formed to address specific relationship losses, such as adult loss of a parent, young spouse, or child.
Bioethics
A form of applied normative ethics that involves the application of general ethical principles and rules to specific moral problems that arise in medical practice, the provision of healthcare, and scientific research.
Chaplain
A professional specially trained, in interfaith religious and spiritual disciplines to support and assist patients and their families who are living with serious illness. As a member of the H&PCCC IDT, the chaplain provides direct religious and spiritual care to those who request it. The chaplain may also coordinate care through the patient's or family's faith community.
Clinical Social Worker
A professional trained in direct social work practices to enhance, promote, maintain, and restore the best possible social functioning of clients, families, and small groups when their ability to do so is affected by actual or potential stress caused by illness, disability, death, loss, or injury. Services provided may be preventive, developmental, or remedial in nature, depending on agency purpose, setting, and need.
Comfort Care / DNR Order Verification Form ("form")
A standardized state-wide form for verification of DNR orders in the out-of-hospital setting, approved by the Department of Public Health. The CC/DNR Order Verification Form shall include the patient's name; date of birth; gender; address; date of issuance and date of expiration, if any, of the underlying DNR order; the signature and telephone number of an attending physician, authorized nurse practitioner, or authorized physician assistant; and the signature of the patient, guardian or health care agent. The CC/DNR Order Verification Form is the only DNR document that EMS personnel will be instructed to honor and can only be issued by an attending physician, authorized nurse practitioner, or authorized physician assistant.
Comfort Care / DNR Order Verification Protocol
A standardized state-wide patient care protocol to be followed by EMS personnel (EMT's and First Responders) when encountering a patient with a current, valid CC/DNR Order Verification Form and/or Bracelet. The protocol provides that the patient in respiratory or cardiac distress will receive palliative, comfort care consistent with the scope of the EMT's training and certification, but no resuscitative measures. The protocol applies to all emergency medical services personnel (Basic, Intermediate and Paramedic EMT's and First Responders) operating in an out-of-hospital setting and requires that they perform patient assessment and treatment in accordance with this protocol.
Community Bereavement Services
A program of H&PCCC, which offers bereavement support and education for adults and children faced with a life-threatening disease or the death of a loved one through illness, suicide, accident, or violent crime. Services include individual, family, and group support meetings; educational training; consultations with community providers; and staff volunteer support. Services are offered at H&PCCC sites in Hyannis, Falmouth, and Wellfleet as well as in community and school settings on request. See also Kids Grieve Too!®, and Adult Bereavement Support Groups.
Community Collaboratives
Projects that involve individuals and groups representing various programs, agencies, disciplines, and diverse communities to establish and achieve common missions and purposes; community collaboratives involve others in decision making, learning, completing tasks, and applying knowledge of group process and group interaction.
Competence
A legal term that refers to a patient's capacity to make decisions about the provision of medical care. It is an element of informed consent, and involves comprehending information, choosing in accordance with one's values, and communicating a decision. A determination of incompetence may warrant paternalistic and coercive measures, such as involuntary commitment.
Conscience
A personal stance informed by an individual's basic moral values. Moral agents often appeal to conscience in making ethical judgments about particular cases. In medical ethics, healthcare professionals may refuse to perform certain procedures, for example, abortions, sterilizations, or withdrawal of life-sustaining treatment, based on fidelity to conscience, a practice known as "conscientious objection."
Continuous Quality Improvement (CQI)
An ongoing process to ensure high-quality care and services are provided by an organization. CQI involves monitoring and evaluating information to identify opportunities to improve client care services and provide a high level of client satisfaction.
Donor
An individual, group, organization, or business that has made a financial (or in kind) contribution to any of the programs of H&PCCC.
Education and Training Programs
A variety of education and training programs about advance care planning, and palliative and hospice care offered by the Center for Life Care Planning & Support. The programs appeal to diverse audiences and can be tailored to meet specific needs of consumers or professionals.
Ethics
Systematic reflection on the norms, principles, or values that do or should guide human conduct or action, and as such can be distinguished from morality, which is the practice or conduct itself.
Ethics Team
A team that consists of staff and volunteers from H&PCCC, and members of the community, who consult with patients, patients' families, and staff; make institutional policy recommendations; and offer in-service education on both clinical and organizational ethics issues and analysis.
HIV Coordinator
A member of the IDT with leadership ability in professional and interpersonal relationships whose main responsibilities are to act as a resource to the various disciplines involved in providing care to people with HIV disease and their chosen families. Working with the Medical Director, the HIV Coordinator establishes goals for the program and implements strategies and activities to achieve those goals.
Home Health Aide
A person who provides personal hygiene care services: simple wound dressing changes that do not require the skills of a licensed nurse; assistance with medications that are ordinarily self-administered and that do not require the skills of a licensed nurse; assistance with activities that are directly supportive of skilled therapy services, and routine care.
Hospice & Palliative Care of Cape Cod, Board of Directors
A volunteer board made up of community members who guide and govern H&PCCC, as it carries out its charitable mission. Two primary duties are to oversee the Chief Executive Officer (CEO) and to ensure that, as a charity, H&PCCC faithfully carries out its purpose without extravagance or waste.
Hospice Provider
A public agency or private organization that is primarily engaged in furnishing services to terminally ill individuals and their families in accordance with the principles of hospice care. To receive Medicare payment, the agency or organization must be approved by Medicare to provide hospice services.
Hospice Team
Works with patients and their families to develop a personalized care plan. Hospice staff respects patient wishes and helps foster communication among family members. The team may consist of the patient's primary care physician, the patient's family, caregivers, nurses, social workers, chaplain, trained volunteers, and home health aides.
Hospice Thrift Shop
Located on 6A in Barnstable Village, the Hospice Thrift Shop is operated completely by volunteers.
Informed Consent
A process designed to ensure professional disclosure and patient comprehension of information, and patient willingness and competence to consent to medical procedures. Except in emergency situations, physicians are morally and legally required to obtain a patient's informed consent to invasive medical procedures.
Interdisciplinary Team (IDT)
A group of skilled professionals from a range of disciplines that support patients and their families. Typically, the hospice team consists of physicians, nurses, aides, social workers, spiritual caregivers, counselors, therapists, and volunteers.
Justice
A general moral concept that requires individuals be given what they are due. Theories of justice have specified different criteria upon which such a determination may be made. For example, societal benefits might be distributed to individuals based on equality, need, effort, merit, or contribution to society. In bioethics, distributive justice is especially important in decisions about the fair allocation of healthcare resources.
Kids Grieve Too!®
A program of Community Bereavement Services offering bereavement support to children ages three to twelve together with education for their adult caregivers regarding children's needs during grief. The groups utilize creative arts therapy to help children express their feelings, share their memories, and identify positive ways to cope. The Kids Grieve Too!® name is a registered trademark of H&PCCC.
Leadership Team (LT)
A H&PCCC group made up of "constant members" as well as three elected staff members who:
- Provide effective communication and feedback mechanisms to inform and educate H&PCCC's internal and external customer regarding the organization's strategic mission and goal.
- Define and continue to reassess the organization's mission, vision, goals, and core competencies and implement mechanisms that ensure that these are met at an organizational and individual level.
- Monitor and evaluate the progress and performance of the organization.
- Measure and link the performance of the organization's teams and individuals to H&PCCC's strategic and operational goals.
- Act as CQI steering committee to review and approve all CQI processes and implement CQI strategies.
- Oversee and ensure regulatory compliance organization-wide.
- Ensure financial support and fiscal responsibility throughout the organization.
- Oversee, assess, and address current operational issues affecting the organization.
- Implement organizational change processes in recognition of internal and external opportunities for improvement and growth.
- Recognize and acknowledge organizational team and individual accomplishments both large and small.
Life-limiting Illness
An illness that no longer responds to aggressive, cure-oriented treatments.
Medical Director
The individual who has overall responsibility for the medical component of patient care and for ensuring achievement and maintenance of quality standards of professional medical care.
Medicare/Medicaid
Federally funded programs that help pay for healthcare to certain populations: Beginning at age sixty-two and older, individuals are eligible for Medicare (health insurance) if they or their spouse worked for at least ten years in Medicare-covered employment and if they are citizens or permanent residents of the United States. Younger people with certain disabilities sometimes also qualify for coverage. Part A Medicare/Medicaid pays for stays in hospitals, skilled nursing facilities, and under the Medicare Hospice Benefit, hospice services for up to six months; Part B pays for outpatient hospital services, diagnostic tests, physicians' fees, and a variety of other medical expenditures.
The Medicare Hospice Benefit
A benefit under Medicare Hospital Insurance (Part A) to beneficiaries with a very limited life expectancy. A Medicare beneficiary who chooses hospice care receives noncurative medical and support services for his or her terminal illness. Home care is provided along with necessary inpatient care and a variety of services not otherwise covered by Medicare.
Memorial Garden Walk
A brick walk located in the front of Mary McCarthy Hospice House, that contains the names of friends and family, and inspirational messages, engraved on granite bricks donated by Hospice friends.
Memorial Giving
A means of expressing sympathy, love, and respect while remembering family members and friends. Any nonprofit foundation, hospital, school, civic organization, or other entity may be designated as a beneficiary of memorials so that family and friends may make donations in the memory of loved ones.
Nursing Home
A facility that provides skilled nursing care and rehabilitation services to people with illnesses, injuries, or functional disabilities. Most nursing homes serve the elderly. Some provide services to younger individuals with special needs, such as the developmentally disabled, mentally ill, and those requiring drug and alcohol rehabilitation. Nursing homes are generally stand-alone facilities, but some are operated within a hospital or retirement community.
Pain Management
Utilization of assessment, reassessment, teaching, and medicinal and non-medicinal treatments to meet the patient's identified goals of comfort.
Planned Giving
The process of making a charitable gift of estate assets to one or more nonprofit organizations, a gift that requires consideration and planning in light of the donor's overall estate plan. Such gifts usually involve legal documents that may require the assistance of a qualified professional advisor to complete.
Primary Caregiver (PCG)
A life partner, relative, or friend who is trained to work closely with staff to help with feeding, bathing, turning, administering medications, and monitoring changes in a patient's condition.
Private Pay
Paying for health care, medical coverage, and other needs with personal funds (not insurance).
Proxy Consent
Consent to medical treatment given on behalf of a patient by an individual appointed to make decisions when the patient has been determined to be incompetent and incapable of giving informed consent. The proxy, frequently a family member or relative, may be appointed by the court or designated by the patient through an advance directive.
Quality of Life
Often contrasted with quantity or sanctity of life and indicates that there are moral limits to the use of life-prolonging medical interventions. Quality of life is regarded as a patientcentered moral criterion, emphasizing the worth of the patient's own life to him or herself.
Referral
Any individual, agency, or facility that recommends a patient or family to receive hospice and palliative care services.
RN Case Manager
A registered nurse who is trained to assess quickly the overall situation, make recommendations about needed services, and if necessary, coordinate community resources and hire and manage paid caregivers.
Speakers Bureau
A service of H&PCCC, that makes available trained staff members, members of the Board of Directors, or volunteers to present community groups with information on the various programs of H&PCCC.
Spiritual Care
Services provided by H&PCCC chaplains who work to assist patients and their families as they seek, during the dying process, both spiritual well being and spiritual growth that fosters inner strength, integrity, and peace.
Spirituality
The life principle that pervades an individual's entire being and that integrates and transcends one's biological and psychosocial nature.
Substituted Judgment
A process whereby a proxy makes a decision about medical treatment for an incompetent patient based upon his or her understanding of what the patient would have decided if competent. The "substituted judgment standard" has been important in influential legal decisions and is typically contrasted with the "best interest" standard.
Volunteer Coordinator
A member of the H&PCCC, staff who plans, develops, and implements volunteer services for effective utilization of volunteer resources that support the goals of the organization.
Volunteers
Unsalaried personnel who share their skills, knowledge, and time in a variety of positions to support the program activities of H&PCCC. Volunteers allow the organization to spend every dollar and then do more by extending the budget and the organization's sphere of influence. Volunteer assignments include: patient care, thrift shop, administrative support, development activities, and Hospice Houses.