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Bronson Healthcare and Hospice Care of Southwest Michigan collaborate to provide home-based advanced illness management services. Home-Based Advanced Illness Management

(HB AIM) provides services in western Calhoun, Kalamazoo and eastern VanBuren counties for adults 18 years or older. The interdisciplinary Home-Based AIM in partnership with primary care providers, gives an extra layer of support to patients facing life-limiting illness. The team manages complex symptoms, helps patients understand their illness and care options and assists with advance care planning.


Home-Based Advanced Illness Management General Referral Criteria

 

Bronson PCP, WMed, Family Health Center (full Epic access for continuity of care)

Three county service area

Adults 18 yrs. and older

 

Presence of a serious illness and one or more of the following.

  •   Declining ability to complete activities of daily living

  •   Weight loss/Failure to thrive

  •   Progressive metastatic cancer

  •   Two or more hospitalizations illness within six months

  •   Difficult to control physical or emotional symptoms

  •   Advancing Dementia

  •   Patient or family requests for futile care

  •   DNR order conflicts/Need for Advance Care Planning

  •   Conflicts regarding the use of non-oral feeding/hydration in cognitively impaired, seriously ill or dying patients

  •   Patient, family or physician request for information regarding hospice appropriateness

  •   Patient or family psychological or spiritual distress

 Non-Qualifiers: pain management unrelated to cancer, substance abuse, mental health  (severe bipolar, schizophrenia)

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