End of Life Care: How Hospice Makes a Difference
Facing the end of life is frightening for many people, especially if it is unexpected or sudden. For the majority of people, however, death is not instantaneous and can be slow and painful. For patients in this situation, an alternative to receiving palliative care and extraordinary measures to prolong life is the use of hospice care. Hospice care has been constructed to provide supportive care in the final phases of terminal illnesses and centers on the comfort and quality of the life of the patient, rather than curative measures. An important feature of this type of care is that the patients are most often cared for in their own homes, offering a familiar and comfortable environment. The care
…show more content…
Routine care has been estimated to be the most common level of care received by patients and involves care given at the patient’s residence, whether that is a private home, assisted living facility, or nursing home. General inpatient care revolves around symptom control and pain management and care is provided in a facility that will have a registered nurse available twenty-four hours a day. Continuous home care is principally revolved around nursing care and focuses on keeping the patient comfortable and symptom and pain-free, this type of care is provided anywhere from eight to twenty-four hours a day. The last level of hospice care is inpatient respite care; this level of care temporarily relieves the primary caregiver from their duties so that they may perform other daily tasks, such as errands and going to work. Respite care is not meant to be utilized on a consistent basis, therefore most facilities enact a limit of five consecutive days (National Hospice and Palliative Care Organization, n.d.). At each of these levels, a team of highly trained professionals provides a comprehensive and individualized plan of care for each patient, taking into consideration the specific symptoms and pain that will need to be managed and/or relieved to allow the patient the greatest …show more content…
Every person wants to feel like they are in control of as many things as possible, especially when they have no control over their terminal illness. To some, this may mean doing things they have always wanted to, all the way up to making every possible decision they can when it comes to their final moments, their advanced directives. While some that are scared of the end still may want extraordinary measures taken to try and prolong life for even a short amount of time, many hospice patients elect to make themselves a DNR (do not resuscitate), meaning if their heart stops beating, no person will begin CPR. Other countries have also followed suit with these types of standards, passing certain laws to uphold their patients’ autonomy during hospice care. In Asia, the “Natural Death Act” was implemented to guarantee a patient’s right to choose to be a DNR, and subsequently, the “Patient Autonomy Act” came next, which gave the patient the right to decline any treatment according to their own will (Cheng, Chen, & Chiu, 2016, p. 293). While these choices are universal in our health care system in the U.S., how these choices implemented into action is the key. When in a palliative care hospital setting, patients will have machines and IV lines attached to them, nurses and other healthcare personnel coming in to help them to and from the restroom or bedpan, and other types of embarrassing 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.
Hospice exists in the hope and belief that, through proper care and the encouragement of a caring and sensitive team, patients and their families may be free to achieve some level of mental and spiritual preparation for death that is comfortable to them. The goal is to help
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.
A legal requirement of end of life care is that the wishes of the individual, including whether CPR should be attempted, as well as their wishes how they are cared for after death are
In reviewing the two studies I found, it is very clear there is a difference in quantitative and qualitative studies. To start, Lee et al. (2017) conducted a qualitative study in which the problem statement recognizes that end of life care (EOLC) in dementia patients is less than optimal when compared to cancer patients. The researchers aimed to determine what service managers and frontline staff at different facilities felt were the key aspects in improving EOLC in dementia patients (Lee et al., 2017). As a result, the researchers purpose was to contribute to the current evidence base on good EOLC and interventions to increase quality of care of end of life dementia patients.
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.
My perceptions have changed dramatically since the Clinical 1 rotation. I have noticed that the minute I walk into my patient’s room, I start to collect data. I notice if they are breathing normal, what their skin looks like, what their cognition level is, and what equipment they have in their room. I have started to connect the “puzzle pieces” of the patient’s health, rather than just feeling like I have a bunch of random information. My perception of people has continued to stay the same from Clinical 1. I continue to have an interest in learning about patients and believe that they also have something to teach us. I have learned so much from the patients and it is fun for me to get to know different
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
In nursing, the goal of care is usually to restore the patient back to the highest level of health possible. In some cases, however, the goals of care change when a curative approach is no longer appropriate. The new goals of care could simply be palliation and pain control rather than a restoration back to full health. This type of care is called palliative care. Palliative care is not the same as end-of-life care, but the two go hand-in-hand at times. The goal of end-of-life care is a “good” death, good being defined by the patient. Palliation is part of that “good” death. Both palliative care and end-of-life
Judge Neil Gorsuch, President Donald Trump’s nominee for the Associate Justice of the U.S Supreme Court, is soon up for a vote to join their rankings. The article proceeds to mention a book that Judge Gorsuch wrote in 2006 and his stand-point on the matter of End-of-Life Care where he is against the idea. The article switches to the perspective of Dan Diaz, the husband of a patient who needed medical aid in dying after being diagnosed with a terminal brain tumor. Diaz says that if Gorsuch would have been in his position at the time of his wife’s situation he would have a different outlook towards medical aid in
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
Palliative care is a relatively new concept. Palliative care programs have become more numerous and better utilized since 2000 and continue to grow. It is now accepted that the palliative care model is appropriate for patients with life-limiting illnesses. Chan et al. (2013) stated that the ultimate goal of palliative care is to relieve suffering and to maximize the quality of life for dying patients and their families, regardless of the stage of illness or the need for other medical treatments (p. 133). As life-expectancy increases, there is a growing need for these services. People are living longer with chronic diseases and palliative care services can provide an extra layer of support to patients and their families. Evidence has shown that 13% - 36% of hospital inpatients qualify for palliative care services (Robinson, Gott, & Ingleton, 2014).