End of life comes too quickly for many, especially the people taking care of the terminally ill. This can be a very difficult time for everyone involved. Hospice is a great opportunity to take advantage of; it is used for patients who are not to be recovered from their illness but rather to provide comfort and emotional support to the terminally ill, resulting in the patient being as comfortable as possible. The caregiver and patient can also have an extra support system from the nurse and interdisciplinary team. Not everyone understands what hospice is and has different views on what it may offer to the patient and family. According to the National Hospice and Palliative Care Organization; “hospice care involves a team oriented approach to expert medical care, pain management, and emotional and spiritual support tailored to the patient’s needs and wishes” (National Hospice and Palliative Care Organization). No patient wants to experience end of life in pain, and the family and caregiver definitely don’t want to see their loved one in pain. With hospice care, pain is kept to a minimum which keeps the patient as comfortable as possible and makes it easier for the family. Nurses play a main role in this type of care.
The nurse’s number one main concern while taking care of a patient in hospice is controlling pain and maintaining the highest quality of life while patient continues to be as independent as possible. The number one pain relief measure is over the counter pain
Essentially, Hospice and palliative care focus on managing symptoms when a patient is deemed to have 6 months or less to live and allows patients to live out their lives away from a hospital or nursing home setting. Partially the reason why most people, including me, haven’t heard that much about Hospice is most likely because it is intended for people at the very end of their lives. However, another major reason is addressed in Gawande’s book, and it revolves around the idea that doctors don’t inform their patients every time that Hospice is really an option. Gawande admits himself throughout his book that like most doctors, he is always over-optimistic and focus on the treatment of the disease, forgetting to focus on the idea of just managing the symptoms in cases where treatment would only prolong the inevitable or giving too many choices for families to make. Gawande explains “All-out treatment, we tell the incurably ill, is a train you can get off at any time- just say when”, however other options are often never talked about (2014, p. 187). One example from Being Mortal is the story of Sara Monopoli, who faced an incurable form of cancer at a rather young age. Sara, along with her family and husband, never focused on just symptom management, but rather what new and outrageous treatment can be done
2. Address Mrs. Thomas’s Physical pain and decline. Explore Mrs. Thomas’s attitudes and feelings about the use of narcotics. Some patient’s choose to forgo pain medications because they fear decreased alertness and want presence with family and friends. Non-narcotic and non-sedating medication options should be explored and discussed. Help Mrs. Thomas verbalize her fears about the medications. Explain the difference between addiction and dependence. Explore Mrs. Thomas’s openness to alternative methods of pain control such as visualization, music therapy, self-hypnosis and mediation. Encourage her to listen to her body by resting when needed and participating in life when she has the energy. Mr. and Mrs. Thomas both require education about palliative care options for management of symptoms associated with her disease.
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
At some point in a terminally ill person 's life, there comes a time when all treatment options have been exhausted, and patient comfort is the number one priority. During this process, hospice care comes into play to ensure quality of life of a patient. Pain management and supportive services are provided to anyone who is willing by Medicare, and other government assistance programs, for individuals and families that cannot afford private home care. These services are provided by a trained group of professionals, including; Doctors, Nurses, Counselors, Social workers, Physical therapists, Volunteers and Chaplains. There are different types of hospice
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.
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
Hospice crusade in the United States has advanced over the past 25 years. The focus of hospice is comprehensive physical, psychosocial, emotional and spiritual therapy in people, who are terminally ill and their families. Hospice providers are helping the quality of life by whenever they can, instead of hospitals, protecting patients treated at home from the burden and provide intervention. Hospice nurses are mainly in accordance with the 1983 Medicare Benefits Act, guidelines of the federal program that allows the patient to die in their own home with family and friends at their next offer treatment (Nurses for a Healthier Tomorrow, n.d).
Hospice goals “are to promote patient-family autonomy, to assist patients in obtaining pain control and real quality of life before they die, and to enable families of patients to receive supportive help during the dying process” (Leming & Dickinson, 2016). Hospice care can be delivered in any setting, mostly with the majority of patients receiving care either in their primary place of residence or in a hospice inpatient facility (Leming & Dickinson,
Despite significant advances in the multidisciplinary approach of palliative care and the growing body of evidence-based practice, a multitude of variables continue to interfere with excellence in end-of-life care for everyone (Anonymous, 2007). Because of this the primary nurse must be diligent in administering the proper medications to allow the patient to have minimal pain or suffering and provide emotional support and reassurance to family members, and possibly fellow staff members
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
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
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
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.
Answer: One of the mean goals of the hospice nurse is to provide comfort measure to your patients not cure. Therefore, the biggest concern for Mr.J at this time is ensuring he is not experiencing any discomfort or pain while providing him my presence on the farewell. By doing so, the nurse respects the ethical principles of Advocacy which mean to understand the patient and provide help and comfort. Sometimes, touch therapy could be an option to maintain the palliative care for your patient.