How about another example of how our culture loves multi-tasking? Open Access describes providing curative treatment alongside palliative care.
An example might be someone receiving the tail end of a chemo regimen while on hospice. The patient benefits from the hospice agency’s pain and nausea control while the chemo reduces the cancer burden a little more.
Hospice agencies utilize Open Access as a marketing tool, promising augmented care. It can be expensive for the agency which must pay for the curative treatment. Open Access is controversial: does it violate the rule that says hospice is palliative care only?
One Texas Hospice patient suffers from acute leukemia. His symptoms are fatigue, weight loss, nausea and shortness of breath. A while back I gave him a blood transfusion to ameliorate his shortness of breath. It worked great.
The upsides of the transfusion?
- The patient loved the extra care and how he felt afterwards.
- I enjoyed getting to provide that for him.
- The hospice team felt like they were part of something special.
- We learned a lot about outpatient blood transfusions, and made a lot of friends in the hematology world.
The downsides:
- Some might say that we utilized a finite blood supply. I say that there was no irresponsibility here. We improved and extended the life of a human being. The Fort Worth blood bank was well-stocked.
- It was expensive.
- There was some medical risk: transfusion reaction and infection.
All that said, he did great. I plan to transfuse him again when the cancer depletes his blood count. That sounds like good hospice to me.
