For Health Care Professionals

Learn when and how to discuss palliative care and hospice services with your patients and their families.

This page offers resources for health care professionals whose patients or long-term care residents may need palliative care or end-of-life care. Our staff are here to assist you as you talk to your patients and their families about any of our services, including end-of-life matters.

Making a referral: If you think a person in your care could benefit from hospice, please let them know you will contact Agrace on their behalf. You are welcome to call Agrace’s Enrollment Team at (800) 930-2770 at any time to ask questions or make a referral.

When we receive your referral, we will do our best to visit with your patient (and family/guardian, if appropriate) in the next day or two. Representatives from Agrace will meet with them to talk through their concerns and recommend services that best meet their needs, whether that is hospice care or PalliaHealth by Agrace, a palliative care program.

Medicare Hospice Benefit

The Hospice Medicare/Medicaid Benefit

Signs of Eligibility

When is it time to ask for Agrace? Please call our Enrollment Team at (800) 930-2770 with your questions. For reference, here are Medicare's eligibility guidelines for several common life-limiting conditions.

Signs of Decline/When to Call Agrace
Medicare Guidelines for Hospice Eligibility
Signs that a person may be eligible for hospice, arranged alpha by diagnosis (find individual pages for each diagnosis and related assessment tools below).
Amyotrophic Lateral Sclerosis (ALS) Eligibilty
Cancer Eligibility
Cerebral Vascular Accident, Stroke or Coma Eligibility
Dementia/Alzheimer's Disease Eligibilty
Heart Disease/CHF Eligibility
HIV Disease Eligibilty
Huntington's Disease Eligibility
Liver Disease Eligibility
Lung Disease/COPD Eligibility
Multiple Sclerosis (MS) Eligibility
Muscular Dystrophy Eligibility
Parkinson's Disease Eligibility
Renal Failure (Chronic) Eligibility
New York Heart Association (NYHA) Functional Classification
PPS Palliative Performance Scale
FAST Functional Assessment Staging

Physician/Clinician Education

Educational resources about palliative and end-of-life care for physicians and long-term care professionals.

Managing Dementia-care Issues via Telemedicine Consults
Learn how to help LTC residents cope better with dementia-related symptoms and behaviors by discussing case studies with PalliaHealth by Agrace.
Identifying Late-stage Dementia
Helping Patients through Late-stage Cardiac Illness
Keeping Residents in Place with Continuous Care in LTC Facilities
Learn signs that may make a hospice patient eligible for "Continuous Care" during a health crisis.
Clinical Practice Guideline: Active Dying
A detailed reference for health care professionals caring for people in the final days or hours of life

LTC Newsletter

Partners on the Journey: A newsletter for long-term care professionals caring for residents with serious or life-limiting illnesses

When to Use Continuous Care; Online Referral Form - Summer 2017
Improving Behaviors Related to Dementia - Summer 2016
For more dementia-care help, listen to "Dementia at the End of Life" in the "Audio" section below.
How Agrace Can Help You with Pain Management, Family Support - Winter 2016
Reducing Falls, Honoring Acute Care Preferences - Winter 2014
Recognizing Types of Pain - Fall 2013
Diagnosis Reporting Changes Don't Affect Hospice Eligibility - Summer 2013
Wound Care, Vigil Volunteers, Grief Support - Winter 2013

Forms

Here are links to Wisconsin advance care planning forms.

Audio

Click to view and listen to an album’s tracks.

Dementia at the End of Life

Play	Track
	1.	Defining advanced dementia
	2.	Communication
	3.	What kinds of communication can a patient with advanced dementia still understand?
	4.	How will my mother, who has dementia, express herself when she is dying?
	5.	Is it possible to experience reconciliation and closure with my father who has dementia and is dying?
	6.	Pain and the Difficult Behaviors Caused by Pain
	7.	How can we treat challenging behaviors exhibited by patients with dementia?
	8.	The patient seems more restless than before. What's wrong?
	9.	What if the patient's restlessness does not have a physical cause?
	10.	How do patients with advanced dementia communicate pain?
	11.	How is pain treated in patients with advanced dementia?
	12.	Can medications be used to control aggressive behavior?
	13.	Infections and Antibiotics
	14.	Should antibiotics be used for infections such as urinary tract infections?
	15.	Should my mother's pneumonia be treated?
	16.	Medications
	17.	Are there medications that can treat dementia?
	18.	Should we stop the medications or should she continue taking them?
	19.	Nutrition, Swallowing and Artificial Nutrition
	20.	How does advanced dementia affect the patient's nutritional status?
	21.	What options do caregivers have if their loved one shows signs of losing their appetite?
	22.	What if the patient is having difficulty chewing or swallowing?
	23.	My mom often chokes on her food. Is this normal?
	24.	What are some other ideas to help make mealtime less stressful?
	25.	Does a feeding tube improve quality of life? How might it affect the course of the disease?
	26.	Skin Care
	27.	My mother's skin seems so fragile. What's happening?
	28.	What can be done to prevent pressure sores or other injuries to the skin?
	29.	Advance Directives
	30.	What if my sister's dementia has progressed and she does not have an advance directive, such as a Living Will or a Power of Attorney for Health Care?
	31.	What is activation of the Power of Attorney for Health Care, and when does activation take place?
	32.	In my mother's Power of Attorney for Health Care, she has appointed me her primary decision-maker. What are my responsibilities?
	33.	How do I ensure my brother's wish not to be resuscitated is honored?
	34.	If my wife has DNR status, does that mean her care will be limited?
	35.	Hospitalizations and Emergency Room Visits
	36.	How may an emergency room visit or hospitalization affect a patient with advanced dementia?
	37.	What resources are available in the hospital setting to help address my husband's dementia care needs?
	38.	My grandfather need to leave the hospital now, and I cannot provide his care at home. What options are available to me?
	39.	If my grandfather has another episode, do I have to take him to the hospital?
	40.	Hospice Eligibility and Services
	41.	What is hospice care?
	42.	Can you be more specific about the kind of support that is provided by Agrace HospiceCare?
	43.	How do I know when someone with dementia is eligible for hospice?
	44.	Can the patient be eligible for hospice even if she is in early stages of dementia?
	45.	Are there grief services available for the caregivers of dementia patients in facilities?
	46.	When a patient with Alzheimer's or dementia loses their "personality," what can we do for the family?
	47.	Do advanced dementia patients have spiritual needs?
	48.	How can we meet the spiritual needs of a patient with advanced dementia?
	49.	Conclusion

Top 50 End of Life Questions

Play	Track
	1.	Why am I so tired?
	2.	How much time do I have?
	3.	Can I get married?
	4.	What should we tell the rest of the family?
	5.	May I die at home?
	6.	What is dying like?
	7.	Will I die suddenly?
	8.	How soon will I die if I stop dialysis?
	9.	How did my weak father get out of his bed?
	10.	Can she hear us?
	11.	Do you have to tell him that he's dying, because I'd rather you didn't?
	12.	What is autonomy?
	13.	Do we have to follow the advance directive to the letter?
	14.	What is capacity or decisional ability?
	15.	When and how do you activate the Power of Attorney for Health Care?
	16.	Should I be resuscitated if my heart stops or my breathing stops?
	17.	Can I refuse futile care for myself or my loved one?
	18.	My father doesn't remember that you talked to him yesterday about Mother's dying. Why is that?
	19.	Is artificial nutrition something I should consider?
	20.	My mother swallows once in a while. Why can't I feed her?
	21.	If Mother doesn't eat or drink, why can't you feed her through a vein?
	22.	Are intravenous fluids appropriate?
	23.	How about feeding tubes - are they appropriate?
	24.	Does she feel pain?
	25.	Why does Agrace HospiceCare prescribe morphine?
	26.	Why don't you just give pain medicine by injection?
	27.	Isn't that a lot of morphine?
	28.	Is one opiate better than another?
	29.	Is methadone safe?
	30.	How do you know you are not killing her?
	31.	What is palliative sedation?
	32.	Should more tests be done?
	33.	Should another treatment be pursued?
	34.	Should we have more transfusions?
	35.	Why don't you treat the gangrene?
	36.	Shouldn't the pneumonia be treated?
	37.	Should antibiotics be used for infections like pneumonia?
	38.	Can you remove the excess fluid in my mom's abdomen?
	39.	You said Dad had trouble breathing because of the fluid in his lungs. Can you remove the fluid?
	40.	Should the blood thinner he's on be stopped?
	41.	Why are you stopping cortisone?
	42.	How do you know it is dementia?
	43.	Do demented patients have feelings?
	44.	Do demented patients have pain?
	45.	Do demented patients know they are dying?
	46.	Can you help me die faster?
	47.	Isn't that suicide?
	48.	Isn't that euthanasia?
	49.	How do you know when someone is close to death?
	50.	Our father is dying. Why doesn't my brother come to visit him?
	51.	Conclusion

End of Life Issues

Play	Track
	1.	Gaining the Confidence of the Patient and the Family
	2.	Gaining a Family's Confidence
	3.	Helping Families Make Tough Decisions
	4.	Addressing Spiritual Matters With the Patient
	5.	Military Service
	6.	Addressing Code Status
	7.	Addressing the Question of "What Dying Is Like?"
	8.	Why We Use Morphine
	9.	Nutrition and Hydration of Dying Patients
	10.	Anticipating the Need for a Mechanical Ventilator in Respiratory Crisis
	11.	Total Sedation
	12.	How Does One Know a Patient is Dying
	13.	Prognostication
	14.	Suicide and Agrace HospiceCare
	15.	Humor in Hospice Care

(800) 553-4289

For Health Care Professionals

Medicare Hospice Benefit

Signs of Eligibility

Physician/Clinician Education

LTC Newsletter

Forms

Audio

(800) 553-4289

Madison

Janesville

Baraboo

Rockford