Diagnosis Of A Terminal Organic Or Cognitive Illness

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

Documentation and communication are constant challenges that healthcare providers face when seeking continuity of care for their patients. Every time a patient moves from a hospital to a nursing home, or from a skilled nursing facility to home health or hospice, the staff that cares for the patient is at risk for a gap in patient care and communication. Home health and hospice agencies rely heavily on Medicaid and other insurance for reimbursements in order to continue to provide care for their patients and keep the doors to their agencies open. Thorough and timely documentation is the key to ensuring proper reimbursement for nursing services and other therapies provided from insurance agencies. This same

Hospice patients often receive palliative care to help them cope with the stress, pain, and anxiety that comes with hospice care. Galfin, Watkins, and Harlow (2011) explored the need to train palliative care nurses how to provide not just physical care, but also psychological care. The authors reference previous studies that addressed similar training programs, but point out that many lack an explanation of what the palliative care entails, or statistical evidence to show if guided self-help improved patient’s psychological distress.

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

Great strides have been made to improve end-of-life care through palliative care and hospice programs, but sometimes that’s just not enough. In America, the care that is offered to the elderly and the chronically ill is less than ideal. Statistics show that an

The purpose of this assignment is to demonstrate understanding of long term conditions and palliative care. Nursing care in general entails holistic care and collaborative care of individuals of all ages, families, groups and communities, whether sick or well (Royal College of Nursing, (RCN) 2007). Better management of lifelong conditions has been the priority of the National Health Service since the 1990s. When long term conditions are managed well in the community, patients’ can live a quality life without visiting hospital frequently (RCN, 2011). In Britain, six in ten people are reported to be suffering from long term conditions that currently cannot be cured; and these people are often suffering from more than one condition that makes their care challenging. It is estimated that by 2030 the UK will have double the number of people aged 85 years or over, who are living with one or more long term condition (Department of Health, 2014).

In recent years, Hospice care have risen to popularity and is being widely used among many terminally – ill patients and their families. This is evident in a report from the National Hospice and Palliative Care Organization, “In 2014, an estimated 1.6million – 1.7 million patients received services from Hospice” (NHPCO, 2015). It is seen that many people uses Hospice care which means that many deaths are also under the care of a Hospice program, therefore, patients and families satisfaction is a crucial factor in assessing the quality of Hospice care and how to make improvement for future services. Thus, I decided to conduct a research on patient and/or caregivers satisfaction that received care from hospice programs.

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).

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).

Before beginning, I would like to preface my remarks with one disclaimer. I am currently an Assistant Professor of Medicine, on the faculty at the University of Virginia School of Medicine. Additionally, I serve as Medical Director of our in-patient hospice and palliative care unit. Moreover, I serve on the board of our local hospice organization, Hospice of the Piedmont, where I also serve as Associate Medical Director. Though my work with these organizations has greatly enhanced nd deepened my commitment to the care of the terminally ill, I in no way claim to speak for or on behalf of any of the institutions for which I serve. The opinions expressed below and in my written testimony are entirely my own.

The information contained in this report was gathered in a private nursing home over 2 weeks that for the sake of this essay, be called “facility x”

Quality of Life and Functioning for End of Life Care. HAT2 Community Health Nursing. Western Governors University.