Transitions Advanced Illness Management Program
Sharp HospiceCare's Transitions Advanced Illness Management Program is designed to provide home-based palliative care and management for patients with advanced progressive chronic illness. Every person is unique and the program is adapted to match each patients physical, emotional and spiritual needs.
Our specially trained staff, including nurses, social workers and other team members, provide pain and symptom management, advanced health care planning, education about the disease and community resource referrals. Your physician will continue to oversee and manage your care in conjunction with the Transitions Team.
What are the goals of the transitions program?
- Decide on goals of treatment
- Encourage proactive participation of patient and family in health care decision making
- Establish a realistic and effective plan of care
- Facilitate advanced health care planning
- Improve quality of living
- In collaboration with the physician, discuss disease process and expected course with patient and family
- Manage symptom disease
Prevent unnecessary emergency visits and hospitalizations
- Provide psychosocial, emotional and spiritual support
Who qualifies for transitions?
- People who are experiencing a decline in functional status and/or nutritional status in the past 30 to 60 days due to advanced chronic illness
- People who have an advancing chronic illness such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), recurrent stroke (CVA), neurological diseases and cancer
Who pays for transitions?
If you belong to a senior commercial HMO plan, Transitions may be covered by your health insurance. Traditional Medicare fee-for-service plans will not pay for Transitions. Questions about financial coverage can be directed to the Sharp HospiceCare Intake Department at 619-667-1900.