Hospice:
Hospice is a philosophy of care. It treats the person rather than the disease and focuses on quality of life. It surrounds the patient and family with a team consisting of professionals who not only address physical distress, but emotional and spiritual issues as well. Hospice care is patient-centered because the needs of the patient and family drive the activities of the hospice team.
1. There are many different kinds of hospice settings. What kinds of Hospice services are available in Omaha? Choose a specific home based hospice service and an inpatient hospice setting. What does each of these offer in terms of patient care?
Pathways to Compassion Hospice provide care for patients mainly in their own home settings. Their primary goal is to well-manage pain and symptoms while keeping comfortability.
Hospice House-The Josie Harper Residence offers inpatient and routine hospice care. It provides necessary individual terminally ill care that could be overwhelming and difficult to provide in the home. The tentative care received by residents living with terminal illnesses, families, and friends is full of compassionate and comfort.
2. Who makes up the hospice team and what are their responsibilities?
As described by Batchelor (2010), hospice team and responsibilities are as follow:
Family member: A primary caregiver and assist with decisions making for the patient.
Nurses: Assist the patients and families to cope with the end-of-life process such as assessing and
Caring Hospice is a company that will provide nursing care to patients that are terminally ill. The ultimate goal is to insure the patient is kept as comfortable as possible while maintaining dignity during the dying process. This company will send registered nurses to the patient’s home for routine physical assessments, medication teaching and administration, education about terminal diseases and the dying process. The nursing staff will also create and maintain appropriate plans of care for the multi-disciplinary team to provide holistic care to the patient.
Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely
The aim of a hospice is to improve the quality of life of the dying
A survey was conducted in 2000 on more than 9,000 patients discharged from more than 2,000 hospices on the services they received (Carlson, 2007). It revealed that 22% of them received five major palliative care services, which varied among the hospices. These palliative care services were nursing care, physician care, medication management, psychological care, and caregiver support. Approximately 14% of the hospices provided all five services and 33% provided only one or two services. Only 59% of these patients received medication management services. These included administering medication, dispensing correct dosages, and setting and following dosage schedule.
Many terminally-ill patients give up hope when treatments are no longer available to help them and hospice care is given to them as an option. However, hospice care has proven itself to provide the best quality care for the last six months of the dying. The purpose of hospice is to provide the best care for terminally-ill patients at the end stage of their lives. Hospice offer services to support too many aspects a patient’s life such as medical, legal, spiritual care. Hospice includes art therapists, music therapists, and certified chaplains on the palliative team.
Rather, the hospice staff and the patient understand the patient is going to die and no further treatment options are available. Therefore, hospice care centers direct their attention towards providing a dignified ending to a patient’s life by delivering comfort and emotional support through a palliative care approach designated to alleviate pain and emotional distress. For example, at Hospice of Dayton, each patient residing at the care facility is provided their own room where their family is able to stay with them and the patient is able to receive the pain management and emotional support they need to die a little closer to peace and security. Additionally, at Hospice of Dayton, there are full-time doctors, nurses, counselors, and religious support-staff that provide patients the physical treatment they need to minimize their pain, as well as the emotional support they need to live the last moments of their life with dignity and emotional well-being. Most importantly, Hospice of Dayton because of its volunteers. Volunteers provide the invaluable service of listening, crying, and laughing with those who may not necessarily have someone to spend time with, while they undergo their long, arduous, and painful experience of
Care designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life, rather than cure. The goal is to enable patients to be comfortable and free of pain, so that they live each day as fully as possible. Aggressive methods of pain control may be used. Hospice programs generally are home-based, but they sometimes provide services away from home in freestanding facilities, in nursing homes, or within hospitals. The philosophy of hospice is to provide support for the patient's
This might be one reason why some patients choose conventional treatment instead of choosing a hospice program, there is many other factors that may contribute to this decision such as; financial status. This research will help give nurses a stronger knowledge base of characteristics and advantage of hospice care. In addition, nurses will be able to explain the advantages of Hospice programs to more of their patients, thus, they will be able to educate and encourage more families to choose hospice care. Not only will it help the patient live out a comfortable life it will also help the caregivers with
Hospice is compassionate care provided to patients facing terminal illness or illness for which there is no cure. These patients are diagnosed with an illness from which they will never recover and usually have a life prognosis of six months or less (Hospice Foundation of America, 2014). The goal of hospice care is improving quality of life and managing the symptoms of disease and the dying process. The care hospice offers is focused on pain management and emotional and spiritual support for both the patient and family (National Hospice and Palliative Care Organization, 2012). Hospice care can be provided in many different settings, often the patient’s own home. Hospice care can also be provided in hospitals, nursing homes, long-term care facilities and free-standing hospice centers and is available to patients of all ages (NHPCO, 2012). A patient receiving care in a hospice program has a team of healthcare individuals that can consist of the patients own physician, nurses, home health aides, clergy, social workers, and speech and physical therapists (NHPCO, 2012). Usually, a care plan is developed by the hospice team and care of the patient is provided by family members with the support of the hospice staff (NHPCO, 2012). Nurses make regular visits to the patient and family and are on call 24/7. Once enrolled in a hospice program hospice covers everything that will be needed to care for you, from medications to manage pain to
Palliative care is a relatively new concept, stemming from the hospice movement of the 1960s. This type of care focuses on the quality of life of its patients at any time in their treatment process. Palliative care is a concept that is often used synonymously with hospice care. Although it can be congregated with hospice care, they are not the same thing. Thus, it can easily be misunderstood. Sherner (2015) explains that both clinicians and people alternate palliative care and hospice. Unfortunately, she says, these people believe that palliative care implies the patient is refusing curative care. The purpose of this analysis is to explore the concept, clarify the meaning, and differentiate the concept of palliative care.
Hospice care is a model of care that focuses on relieving symptoms and supporting patients with a life expectancy of six months or less (Altshuler, 2013). For most nurses, caring for a dying elder (individual aged 65 years and above) is a discrete, time-limited experience that begins with first contact, often in a hospital, emergency room, or long term care facility, and ends with the death itself (Phillips & Reed, 2008).
Routine home care is the first level of hospice care that is designed to let the patient have access to medical services in the comfort of their own home. This level of care is available when a patient 's condition or illness does not require around the clock support from a doctor or registered nurse. Although the patient is terminally ill, there pain and comfort level can be managed by family or friends. Many supportive options can be used by the patient and their family at this stage to ensure quality of life. A religious representative or chaplain may make regular visits to the home and offer “spiritual guidance”. Social workers assist families in many ways during hospice care, some examples include; helping to find community and nonprofit organizations (support groups, meal assistance, etc), assistance with insurance issues and funeral planning or other end of life decisions. Nurses and physicians help to educate family members on pain management and keeping their loved ones comfortable. During this stage of hospice, a nurse makes regular scheduled visits and does not “stay” with the patient 24 hours a day. Medical equipment such as a special bed or other assistance items are supplied to the hospice patient as well as medications and special support services. With the ultimate goal of keeping the patient in their own comfort, not going back
When a patient is given a short amount of time expectant to live, they are referred to hospice. Hospice services provide the best possible quality of life. Hospice services include physician services, skilled nursing visits, on call, and around the clock during crisis periods, medical social workers, certified nurse’s aide, home health aide/ homemaker, trained volunteers, medication, equipment, and medical supply, short term inpatient care, bereavement counseling, and pastoral care.
Hospice is a component of palliative care. A person does not necessarily have to be dying in order to see a palliative care specialist. This is where the service is often underutilized in the hospital. In the 18 months I have been a nurse, I have cared for many patients with chronic illnesses who have dealt with symptoms that have severely impacted their quality of life. Most of the time, it seems as though the patient’s care providers are interested in treating the patient’s acute problems. My experience has been that the symptoms are often overlooked or are being treated in a manner that is to the dissatisfaction and discomfort of the patient.
* Attention to residents’ transition from active curative care to palliative care (with comfort care and symptom management) requires that care team members provide the resident and their families with sufficient information about the transition process to facilitate decision making. This provision of information can reduce residents’ and families’ concerns and increase their satisfaction regarding the appropriateness of a palliative approach.