VITAS Care Model for Advanced Lung Disease and COPD
VITAS Case Study: Patient with Advanced COPD
JR*, a 75-year-old male Army veteran who been diagnosed with advanced COPD, is hospitalized for the second time in three months for a disease-related exacerbation. He has had COPD for 20 years, has a 60 pack/year history of smoking, HTN, NIDDM, PVD, is oxygen-dependent, continuing weight loss/frailty, indicates he is unable to self-bathe or dress, only walks 4-5 steps at a time, and is lethargic due to respiratory symptoms.
During a goals-of-care conversation with his primary care physician and pulmonologist, JR expresses his preference to remain at home as his disease continues to progress. He is referred to VITAS where he his evaluated by a VITAS admissions nurse, who finds JR to be eligible to receive hospice services. He is admitted immediately and a VITAS RN meets with JR and wife at home.
The interdisciplinary VITAS team supports JR through regular at-home visits for disease-directed symptoms and provides complex modalities such as high flow oxygen, BiPAP, and IV fluids, while an open formulary supports comfort-focused medications to improve his quality of life, such as corticosteroids, mucolytics, antitussives, and bronchodilators. HME supplies related to the hospice diagnosis are provided at no cost to the patient, and he receives at-home therapy services such as RT, PT, OT, and speech.
After 16 weeks of hospice care, JR dies peacefully at home surrounded by his loved ones in accordance with his wishes.
*These initials represent an anonymized patient and are used for the purposes of education only.
What Does Hospice Treatment for COPD Involve?
VITAS offers high-acuity care and complex modalities to manage even the most aggressive symptoms related to chronic pulmonary disease, including dyspnea, tachycardia, and recurring bronchitis and pneumonia.
The VITAS plan of care for advanced lung disease includes 24/7 clinical support and a home-based care model with visits by an interdisciplinary care team which provides clinical and psychosocial support to address the patient’s and family’s needs.
Complex Modalities for Advanced Lung Disease/COPD
Through our open formulary and complex medical management treatment plans, VITAS can ensure your patients remain comfortable while still achieving their care goals in any care setting—including a patient’s home, nursing facility, or assisted living facility.
- Bronchodilators ease breathing by relaxing lung muscles and expanding airways.
- High-flow oxygen therapy provides additional relief for patients who require respiratory support beyond traditional oxygen therapy.
- CPAP and BiPAP therapy assists breathing by modulating airway pressure in patients who need respiratory support.
- Antibiotics can be administered through parenteral routes to fight infections related to advanced lung disease/COPD.
- Respiratory therapy from a licensed respiratory therapist supports the patient’s cardio-pulmonary care plan and goals of care, including:
- Non-invasive ventilation to assist or replace spontaneous breathing
- Compassionate ventilator withdrawal to provide maximum comfort in anticipation of death
- Therapy services including physical, occupational, speech, and massage help meet the patient’s unique needs near the end of life.
Oversight by Dedicated Physicians
VITAS care plans are overseen by our 700+ physicians, more than 50 of whom are board certified in hospice and palliative medicine.
They oversee integration with patients' primary care physicians, home visits, goals-of-care conversations, specialist consults, medication reconciliation, and palliative care.
Home Medical Equipment and Supplies
VITAS brings the hospital to your patients with home medical equipment and supplies that are 100% covered on the Medicare Hospice Benefit, not out-of-pocket costs for your patients. VITAS does not require O2 SATs to be able to provide oxygen to patients
VITAS maintains its own home medical equipment (HME) division*, and has established relationships with community HME partners, enabling 24/7 delivery to support the patient’s advanced lung disease or COPD care plan.
The following supplies and equipment can be delivered to your patient in any preferred care setting:
- Oxygen
- Non-invasive ventilation devices
- Nebulizers for aerosolized medication delivery
- Hospital bed
- Specialized mattresses to prevent pressure sores
- ADL assist devices such as walkers and commodes
- Incontinence supplies
- Wound care supplies
If your patient is ready for hospice, VITAS is ready to help. Refer your patient to VITAS today and you'll hear from an admission specialist in minutes. We’re always available.
*May be program-specific. Please check with your program.
