IDG meeting question

[danyd]

I am having trouble with a few of my Alzheimer's pt's at IDG meetings where it is my job "to paint a picture" of the pt and why they qualify for hospice. I know these pt's qualify, I am just having trouble coming up with something new every other week to say. I am consistently saying pt. pale, poor turgor, temportal wasting, max assist with ADL's, stares blankly, verbal but confused--talks non-sensically much of the time etc. This particular pt. is non ambulatory, she eats well, no skin breakdown. Are there any other phrases I could use? I feel like I am saying the same thing over and over.

Thanks

[tewdles, RN]

My experience is that if the patient is not in need of recertification you do not need to be that detailed....UNLESS...there is an issue which needs to be addressed by the team. So, for my dementia patients I present them according to their problem list and POC. It is important in IDTs not to get too narrative about minor details. The team is familiar with the patient and history. The purpose of the meeting is to collaborate on the POCs which should be reflective of the needs of the patient. If the POC is effective it is ok to say so and move on....IMHO.

[tewdles, RN]

I thought that I posted an answer to this thread before...

Hospices I have worked for prefer a concise "working" presentation. The purpose is to discuss patient/family problems that need interdisciplinary intervention. I work from the problem list, POC. If the patient is due for recertification the presentation needs to include the overall picture which qualifies them for hospice, I use the medicare hospice guidelines to keep me on point. If they are not recerting, I follow their POC. If the problem is well managed, and the POC is adeq for the patient or team needs I say so and move on. There is no need to narrate patient decline "colorfully" every week unless the decline is requiring changes to the POC. For me, it is helpful to remember what the meeting is for. Most of these people have seen the patient in question recently, they know who she is. I may have spoken on the phone about the patient with those who have not seen her. The purpose of the meeting is for an interdisciplinary collaboration. We collaborate to problem solve. Problems are the focus of the meeting. Patients with effective, well functioning plans of care are fast presentations. Nursing input 30 sec, MSW 30 sec, spiritual 30 sec, Med/Pharm 60 sec. This allows you to scoot through patients who are "stable" and spend more time on patients who have "issues". But...perhaps your agency wants something more...involved?

[tewdles, RN]

geesh....first response wasn't there when I rewrote...then just showed up when I submitted the second...sorry