Essay on Demographics and Data Collection Methodology

Hospice provides a place where care and support with persons that have incurable diseases that are at their last stage of their disease process. During the twentieth century, there were many life-threatening diseases were discovered which caused many deaths which could have been due to the prevention of medications. During this time frame life expectancy was at a very young age and chronic non- communicable diseases were taking over the world.

"The Hospice Philosophy by Joyce Remy." Seniors Digest RSS. N.p., n.d. Web. 25 Nov. 2013. <http://www.poststat.net/pwp008/pub.49/issue.333/article.464>.

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

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.

Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.

Some of the variables include readmission rates within 30 days for patients with or without inpatient palliative care consult, patients discharged to hospice with a palliative care consult, and patients who die in the hospital with a palliative care consult. These are all variables that the hospital wants to keep track of, because it allows them to monitor whether they are providing quality care to the patients coming into the hospital. In addition, it allows the hospital to examine these factors in comparison to the average length of stay within the facility, along with other patient details like diagnosis, insurance provider etc. While working on this activity I tried to absorb as much information about the older population and their willingness to receive palliative care information, how old they were and their health status. Reviewing the information on palliative care relates to the research project I was apart of last semester, on levels of knowledge and perceptions of self-reported palliative care and whether it enables someone to use the services if the need

Briefly describe the patient and his/her situation, diagnosis and prognosis, brief history of the disease, and how/why the patient entered palliative-focused care.

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

According to the National Hospice and Palliative Care Organization, (NHPCO, 2012) in 2011, an estimated 1.65 million patients received services from hospice and an estimated 44.6% of all deaths in the United States were patients under hospice care. In 2001, an estimated 36.6% of cancer patients accessed three of more days of hospice care. The median length of service in 2011 was 19.1 days. 56.4% of hospice patients were female and 43.6% were male. 83.3% of hospice patients were 65 years of age or older, and more than one-third of all hospice patients were 85 years of age or older. 82.8% of hospice patients were white/Caucasian. Patients of minority (non-Caucasian) race accounted for more than one fifth of hospice patients. Today cancer diagnoses account for less than half of all hospice admissions (37.7%). Currently less than 25% of U.S. deaths are now caused by cancer, with the majority of death due to other terminal diseases. The top four non-cancer primary diagnoses for patients admitted to hospice in 2011 were debility, dementia, heart disease, and lung disease (NHPCO, 2012).

A. Explain how your own perceptions about quality of life and health problems might affect your care for a dying patient with a lingering illness such as cancer.

The researcher will conduct an anonymous survey with all participants (palliative care enrolled nurses and enrolled nurses in the casual pool who are not supervised by the researcher) to identify their level of confidence in caring for the patient with terminal restlessness. The research will examine the potential risk and the benefits an ethical consideration that will be apply through this research. The survey approach will be used for this research due to a potential conflict of interest, easier and cost-effective.

Hospice patients vary in age, race, and socioeconomic demographic. Hospice agency care for neonate, pediatric, adult and generic patients, in 2014 0.5% of patients were less than 24 years of age, 32.4.% of patients were 25-74 years of age , and 67.1% of patients were over 75 years of age (National Hospice and Palliative Care Organization, 2015). Most importantly when looking at hospice patients by race/ethnicity, we are able to see the need for cultural diversity and sensitivity, in 2014 76% of hospice patients were Caucasian, 7.6% were African-American, and 7.1% were Hispanic or Latino. This indicates a decrease in diversity compared to the findings of 2013.

This study supported the idea of receiving hospice or palliative would be beneficial for patients and primary caregivers which reduce the negative symptoms and have an advantage for receiving hospice or palliative care which also support and be relevant to the thesis that I would like to research on.

I have been a registered nurse at UCLA for 18 months. One particular issue that has captured my attention is the utilization of palliative care in health care. Because nurses are generally at the bedside all the time, they have an important role to play in voicing the importance of its utilization and implementation in the patient’s care.

* 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.