Palliative Care Advanced Practice Nurse Karen Caputo (right) and her team work with physicians to help control pain and symptoms for people with advanced, chronic illness who are not on hospice.

Improving Quality of Life for Patients Not on Hospice

Recognizing the great need in our community for a home-based pain and symptom management service for people who are NOT on a hospice program, Hospice of Northwest Ohio has formed a palliative care consultation service that is separate from our hospice program. It is called Sincera – Supportive Care and Symptom Relief.


While we have provided this service to hundreds of people since 2008, we felt it was important to give the program its own identity to eliminate confusion in the community. Unlike hospice care, where we manage all aspects of your care and provide a wide range of ongoing services and support, Sincera is a short-term relationship which focuses only on alleviating the symptoms of your disease or the side effects of treatment.

Who can benefit from a Sincera Consultation?

Patients with advanced chronic illnesses such as cancer, heart disease, lung disease, and neurological disorders have sought—and received—relief from our program. In fact, 94% of those surveyed said Sincera’s interventions made a significant improvement in the way they feel! Sincera has great expertise in managing:

  • Nausea
  • Shortness of breath
  • Constipation or diarrhea
  • Anxiety or depression
  • Bone, muscle, tissue, nerve, or tumor pain
  • Spiritual or emotional concerns
  • Any other debilitating symptoms

How can you request a visit?

The consultation service requires a referral from your primary care physician or specialist; however, if you contact us directly, the Sincera team will work with your doctor to obtain the referral on your behalf. Following the referral, an advanced practice nurse will visit you in your home to assess your needs. She will work with Sincera’s physicians to determine the best way to control your pain or other symptoms and will then make a recommendation to your physician. Your own physician will write any necessary prescriptions and will continue to manage your care.

The Sincera nurse will automatically follow up with you via phone several times after the initial consultation and will visit again, if needed, to reevaluate symptoms and your response to treatment. Additional recommendations would then be shared with your physician so he or she can make any necessary changes to your care plan, including adjusting prescriptions.

What are the costs of a consultation?

Medicare and most commercial insurance plans will cover the cost of Sincera’s consultation service, just as they would other medical treatment. You will be billed for the percentage of the fee your insurance requires you to pay. Remember, if you are enrolled in an HMO, you may need preauthorization. Medicaid patients will receive the service at no cost to them. Fees for anyone without insurance will be based on ability to pay; no one will be turned away due to inability to pay.

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For more information on the program, or how to speak with your physician about a referral, please contact Sincera, weekdays, from 8:30 am to 7 pm at
419-931-3440.