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Hospice Center opens retreat for patients Patients and their families who endure terminal disease or injury now have another option when selecting hospice care.   In June, Hospice of Charleston opened the Hospice Center, a serene, retreat-like inpatient facility designed to meet the needs of patients and families when they are unable to manage the disease process and its impact in the home.     The new facility, located off of Long Point Road on Wando Park Boulevard, receives referrals via the MUSC Palliative Care Service.     The Hospice Center encompasses 20 private bedrooms, a family kitchen, and sunrooms that overlook live oak trees and a garden. The center focuses on providing pain and symptom management, honoring patients’ wishes, handling caregivers’ crises and offering respite care for caregivers.   Angus Baker, M.D., MUSC Hematology/Oncology clinical assistant professor, and Scott Lake, M.D., MUSC General Internal Medicine and Geriatrics clinical assistant professor, are serving as medical directors for the new facility. Both are board-certified palliative care physicians.   The center is staffed by highly-trained physicians, nurses, social workers, volunteers and chaplains who recognize the emotional and physical strains of caring for a family member with an advanced disease.  It  seeks to ease those difficulties by providing spiritual assistance and supportive care to those bearing the burdens in moments of crises.   Area hospitals are encouraged to offer referrals for  appropriate patients.   MUSC’s Palliative Care Service will assist with determining eligibility for hospice center referrals from MUSC for admission to the center. Referred patients must be eligible for Medicare, Medicaid, or other insurance hospice benefit (prognosis of six months or less if disease follows expected progression) and the patient or personal representative must understand that the goals of care focus on the physical, social, emotional, and/or spiritual comfort of the patient. In addition, MUSC’s Palliative Care Service assesses clinical criteria for admission to the center.   The MUSC Palliative Care Service is a resource for inpatient care at MUSC with consulting services for pain and symptom management in life-limiting illness. The service also communicates with patients and families, assists attending doctors with the transition from curative to palliative/comfort care, and assists with discharge planning to appropriate settings or hospice care.   To access MUSC’s Palliative Care Service, call 792-2123 and request Palliative Care Service specifying if the patient is an adult or a child. The number for the Hospice Center is 529-3100, or visit http://www.hospiceofcharleston.org/about/. The following are circumstances that may prompt the admission of a patient to the Hospice Center: Pain symptom management: A patient’s disease progression causes an increase in pain or symptoms that become difficult to treat in the home; A caregiver crisis: This encompasses many scenarios, from the patient who chooses to live alone during their serious illness, to the patient with no family or friends who can care for them during the last stages of life and who have no place to go. The center is also ideal when a caregiver becomes sick, elderly, or physically unable to care for the patient in the home; A patient’s wish is to not die in the home; and/or Respite: This option is used to relieve the patient’s primary caregiver and family for a temporary basis up to five days and five nights. Hospice recognizes the needs of both patients and families, which can mean allowing caregivers a much-needed break and an opportunity to care for themselves to prevent burn-out. One or more of the following clinical criteria must be present: Pain: An investigation must define appropriate treatment modality, active treatment to control pain, including change in medications and/or routes of administration, titration of medications that cannot be done safely at home, or a need for advanced technology for analgesic administration; Death is imminent and care requires frequent skilled nursing intervention; Palliative sedation is required when distressing symptoms cannot be relieved by other means; Severe anorexia and/or inability to swallow necessitate alternative routes of medication administration; A deteriorating mental status necessitates titration of medications; Severe respiratory distress is unmanageable in the home setting; Intractable nausea or vomiting; Open skin lesions requiring professional care; Unstable or multiple pathological fractures and other complicated care for stable or unstable medical conditions including frequent suctioning, hemorrhage, severe anemia, and/or recurrent seizures; and/or Psychological pathology including evaluation of hallucinations, delusions, paranoia, agitation with combativeness, extreme depression and anxiety, failure of support systems at home, and/or an unsafe home environment including neglect, abuse, or inadequate resources to sustain necessities like food, water and electricity.     Friday, Aug. 4, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.