Human immunodeficiency virus (HIV) is a disease which causes the body’s own immune system to attack itself. If left untreated, HIV can lead to acquired immunodeficiency syndrome (AIDS). AIDS is the most advanced stage of HIV. It currently has no cure.
HIV attacks a particular type of white blood cells called the T-helper cells or CD4 cells. CD4 cells are part of the body’s immune system, raising the alarm when the body needs to fight off an infection or illness. As HIV spreads through the body, more and more of the CD4 cells are destroyed, and the body becomes unable to fight off infections and disease.
When the number of CD4 cells falls below 200 cells/mmc3, the diagnosis is now considered to be AIDS, the final stage of HIV. An individual may also be considered to have AIDS if one or more opportunistic illnesses have developed.
While no specific number of symptoms is necessary to meet the hospice eligibility requirements for HIV/AIDS patients, here are a few of the criteria considered.
AIDS/HIV hospice criteria:
- Must have established AIDS or HIV diagnosis
- Decision has been made to forego antiretroviral, antibacterial, antifungal, chemotherapeutic and prophylactic drug therapy related specifically to the AIDS diagnosis.
- Chronic, persistent diarrhea
- Significant weight loss of 10% or more in the past three months
- Generalized weakness
- Viral load > 100,000 copies/ml
- CD4 count < 25
- History of frequent opportunistic infections
- Palliative Performance Indicator Score of 50% or less
- CHF at rest
- AIDS dementia complex
- Toxoplasmosis
- Generalized wasting
- Substance Abuse
AIDS/HIV symptom management.
Crossroads Hospice & Palliative Care provides patient-centered care to individuals who meet the AIDS hospice criteria. From a clinical standpoint, our team understands the nature of HIV and AIDs, and the additional conditions that develop in an immune-compromised patient. The goal of hospice care is to control these symptoms and provide comfort and relief from pain.
In addition to nursing care, our team provides aides to assist in personal care. Social workers are available to connect patients to resources and support within their community. Social workers may also assist with funeral planning, family meetings, and ensuring end-of-life wishes are respected. Chaplains and bereavement counselors address emotional and spiritual concerns for both the patient and their family. Volunteers are available to provide patient companionship and give family caregivers the opportunity to take a break to rest or run errands.
Patients with HIV/AIDS may face unique challenges at end of life. Many patients infected with HIV experience psychosocial issues related to their illness including feelings of anger related to how they acquired HIV. As treatment options for HIV have increased, patients may feel resentment or a sense of failure when their condition begins to decline. Crossroads Hospice & Palliative Care staff are trained to meet the unique needs of these patients and provide the support and comfort they require.
For primary care physicians.
When a patient meets the HIV/AIDS hospice requirements and is referred to Crossroads Hospice & Palliative Care, we become your partners in ensuring your terminally ill patient maintains the highest quality of life possible. On the clinical side, our team of end-of-life care experts will work to manage pain and control symptoms. In addition, we provide emotional and spiritual support to both the patient and their families.
Crossroads Hospice & Palliative Care is ranked in the nation’s top five for the number of care hours provided by nurses, hospice aides, and social workers. That care increases as the patient approaches their final days. In fact, Crossroads ranks second in the country for the number of hours spent with a patient in the last seven days of their life.
Our team is available 24 hours a day, 7 days a week, 365 days a year to address any questions or concerns your patient may have. Care is provided in the location that best suits your patient’s wishes and needs including their home, a nursing home or assisted living facility.
The hospice care team is an added support and resource for families, reducing the number of after-hours calls to your office and visits to the emergency room. By providing pain and symptom management in the patient’s residence, we are able to prevent many avoidable hospital readmissions.
If your patient is not yet ready or eligible to receive hospice care, we offer palliative care services to individuals facing serious, chronic, and life-limiting illnesses at any stage in the disease progression. Palliative care can be provided to patients alongside curative treatment. Our palliative care team treat symptoms and treatment side effects including:
- Anxiety
- Constipation
- Diarrhea
- Depression
- Fatigue
- Insomnia
- Nausea and vomiting
- Pain
- Spiritual and emotional distress
Our palliative care team provides regular updates giving the primary care physician additional insight into how closely the patient and their family is following the plan of care at home. If your palliative care patient becomes eligible for the hospice benefit, we provide a smooth transition, helping your patient understand the benefits of the increase in care and coordinating the additional services that come with a hospice admission.
When to call hospice.
If you believe that an AIDS patient meets the hospice requirements above, Crossroads Hospice can help. Patients can receive care in wherever they feel most comfortable - including their own home, an assisted living facilities, or an in-patient units. If you have questions and would like to speak with someone, please call us at 1-888-564-3405 for a free hospice consultation.