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Even though a majority of Tidewell’s patients have cancer, each potential admission is individually assessed for appropriateness for the program. Tidewell routinely has patients with end-stage congestive heart failure, COPD (Chronic Obstructive Pulmonary [lung] Disease), ALS (Lou Gehrig’s Disease), Alzheimer’s and other diseases. The key here is the individual assessment and prognosis.
The Medicare Hospice Benefit covers nursing care, social services, medical equipment, medications used for pain and symptom control, and consulting physicians’ fees relative to the terminal illness and planned by the Tidewell interdisciplinary team. It also covers hospitalization if under the hospice plan of care. The key is relativity to the terminal illness.
Through the Medicare Hospice Benefit, Tidewell assumes full responsibility for treatment related to the terminal illness. The patient is not billed for these goods and services, and there is no deductible or co-payment.
Tidewell does not affiliate with or subscribe to the Hemlock Society or any other similar organization. The essence of the Tidewell philosophy is quality of life. By seeking Tidewell services, patients and families indicate a desire to spend their last days together with dignity, control over their situation and with the patient as free from pain as possible. Tidewell makes this possible. It neither hastens death nor prolongs life.
Tidewell does care for AIDS patients whose admission to the program is based on standard criteria: 1) Residency in Sarasota, Manatee, Charlotte or DeSoto counties, 2) Seeking pain and symptom control rather than curative care, 3) Prognosis of six months or less.
Neither is necessary for admission. Tidewell does, however, encourage families to have advance directives. They are also asked not to call 911, but to allow the care of the patient to be guided by Tidewell. This does not mean that the patient can’t go into the hospital, but only that it be at the recommendation of the Tidewell team. Heroic efforts to save lives through artificial means are generally not a part of the care program. Tidewell does cover the costs of hospital admissions for any Tidewell patient, regardless of ability to pay, when they are related to the terminal diagnosis and within the plan of care.
Tidewell is not a religious organization, but the nature of its philosophy encompasses spiritual issues. The issue of addressing spirituality is a personal decision, reached by the patient or family. Tidewell always respects the rights of its patients and families on this and all other issues.
Curative measures are those intended to cure; palliative measures are those that offer pain or symptom control, without curing capabilities. When a patient enters Tidewell, he/she acknowledges that curative measures are no longer appropriate and palliative care is required for comfort.
Tidewell does provide services to persons with advanced illnesses who are living in nursing homes. These patients may either be homebound patients who transfer to nursing homes or nursing home patients who are admitted to the program. Tidewell has contracts with more than 40 nursing homes. Patients receive care regardless of ability to pay
Tidewell has a strong bereavement program with full-time grief specialists who facilitate a network of bereavement follow-up for all families. Tidewell’s practice is to maintain contact with families for a year following the death of a patient. Regular phone contact, as well as support groups, are available for any who choose to participate. More intensive one-on-one counseling is also available and all services are free and open to the community.
Although this situation rarely occurs, there are times when a patient who does not have a physician is referred. Tidewell has two choices at this point: encourage the patient to seek a physician through physician referral services, or the patient can come under the care of one of Tidewell’s physicians.
Yes, the state supports Medicaid benefits that mirror the Federal Hospice Medicare benefits.
Tidewell’s services are financially supported by Medicare and Medicaid reimbursement, as well as that of some private insurance carriers. Although it depends on third-party payors for the majority of its operating funds, Tidewell does have approximately 4-percent unreimbursed services each year. This deficit is addressed through fund-raising efforts
To the contrary: Tidewell affirms life and regards dying as a natural process. It does not encourage false hopes of cures, but validates the hope of living each day to its fullest with emphasis on human dignity and preservation of the quality and sanctity of life.
Many patients are not ready to talk about their illness or impending death and that’s okay. The patient or family has acknowledged the reality of the advanced illness by seeking Tidewell’s services. Tidewell allows each person to establish his/her own level of outward acceptance with the assurance of a strong support system, with or without discussion of death. Rather, they may choose to address their immediate needs as they present themselves.
Although the majority of Tidewell’s patients are over 65, many patients are well under that age. In fact, Tidewell’s Children’s Program includes children from birth into their 20s. Individuals of any age who meet admission criteria are eligible for hospice care.
Tidewell is currently in the process of converting all of its hospice house beds to in-patient licensure, which is similar to a hospital inpatient unit, except for the intensity of the services being provided. Patients who have symptoms that can’t be managed in their current settings are appropriate for the General Inpatient Unit. Once pain and other symptoms such as nausea, vomiting and delirium are under control, the patient may be returned to his/her home or another suitable facility.
In addition, Tidewell has contracts with area hospitals that enable it with prior knowledge and approval to provide care for its patients when they are admitted to these hospitals for a problem related to the terminal illness. Patients may also be admitted to Tidewell while in the hospital. Tidewell currently has hospice houses in Venice, Ellenton, Bradenton, Sarasota, Englewood, Arcadia and Port Charlotte.