Palliative Care

For Health Care Professionals

Referrals - Palliative Care

 Palliative Medicine Consults

Palliative Care Unit (PCU) 14-beds

Palliative Care
in patient homes
and assisted living 

  • Natalie Mykytsey, MD 
    Internal Medicine
    Palliative Medicine
    Geriatric Medicine
  • Jodi Punke, DO
    Family Medicine
  • Becky Poirer, NP
    Family Medicine


  • Chrysis Bloom, RN
    PCU Supervisor
  • Bernie Stremikis, MSN, APRN-BC
    Palliative Care NP
  • Becky Poirier, NP
    Family Medicine


Referral Criteria

  1. Patient knows that he/she has a confirmed diagnosis of advanced life-limiting illness and has had an explanation of what it means.
  2. Patient and medical team agree and are aware of and agree to the referral, with an explanation of what Palliative Care is.
  3. Plus one or more of the following:
  • Multiple recent prior hospitalizations with same symptoms/problems
  • Difficult to control physical or emotional symptoms related to serious medical illness acute or chronic (multi-organ failure, metastatic cancer, anoxic encephalopathy, advanced COPD or CHF etc)
  • Patient, family or physician uncertainty regarding goals of care and prognosis
  • Patient, family or physician request for information regarding hospice appropriateness
  • Consideration of ventilator withdrawal with expected death
  • Consideration of patient transfer to a long-term ventilator facility
  • Metastatic or locally advanced cancer progressing despite systemic treatments
  • Karnofsky < 50 or ECOG > 3
  • Consideration of ICU admission and or mechanical ventilation in a patient
    • with metastatic cancer and declining function
    • with moderate to severe dementia
    • with one or more chronic diseases and poor functional status at baseline
  • Persistent, moderate to severe pain or other symptom distress after 24 hours of appropriate therapy
    Palliative Care   Hospice Care
Who can receive?   Anyone with a serious illness, regardless of life expectancy, can receive palliative care.   Someone with an illness and a life expectancy measured in months, not years.
Can people receive curative treatments?   Yes – Curative and palliative care can be provided at the same time.   No – Treatments and medicines are aimed at relieving symptoms and improving the quality of life.  We cannot add “days to the life”, so the focus is on adding “life to the days.”
Location   Provided at Aspirus Wausau Hospital, clinic, private home, assisted living or nursing home for qualified patients in Marathon & Lincoln counties.   Provided wherever a patient lives, including private home, assisted living, Aspirus Hospice House, or nursing home.  Acute hospice care is provided in hospital settings.
Medicare, Medicaid, or private insurance coverage?   Treatments and medications may be covered, based on insurance coverage.   Covered by Medicare and Medicaid.  Most insurance plans include a hospice benefit.
Who provides care?   An interdisciplinary team including physicians, nurses, social workers, and chaplains trained in hospice and palliative care.   An interdisciplinary team including physicians, nurses, social workers, chaplains and volunteers trained in hospice and palliative care.