Hospice Care : A Global View Of Palliative Care

"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>.

The World Health Organisation (2010) defines palliative care as: An approach that improves the quality of life of patients and their families facing problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. It is also our duty to support John and his wife`s in their decision for John to die at home, Department of health (2008) patients should have a choice over the care they receive and where.

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.

Before I started this class I thought palliative care was only used as end of life care, or for when a curative treatment was unavailable or had failed. As we learned about the different models of care, and how they have changed over the years, it became evident that the use of palliative care has changed drastically over the past several decades. In the 1800s to 1900s, palliative care was only used once the patient had reached the dying stage, and only included the patient in this care, not their families1. Before taking this course, this is what I thought of palliative care as well. Since the late 1900s though, palliative care has been used in a more proactive approach. From the moment an individual receives a life threatening illness, palliative care begins. This includes caring for the family of the patient as well. This care increases as the patient’s illness progresses, and even continues for the family after the death of the patient. Learning this has really made an impact on how I would like to work as a

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 study also showed that for-profit, small and community hospitals had very limited accessibility to palliative care; and the higher request for physician assisted death came from outpatient facilities. It has been noted that palliative care practices are extremely low nationwide. Neither primary care physicians nor specialists who treat terminally ill patients routinely are provided with palliative care training. These are important facts since statistics show that although most individuals support the option for a physician-assisted suicide the low numbers of actual requests for assisted death reflected the preference of alternative treatment options. As patients regain the power of making decisions regarding their care, aggressive pain control measures are put in place; consideration of physician-assisted suicide becomes an avoidable option for a dignified death. Regardless of the views on physician-assisted death healthcare professional

According to Allen et al. (2012), “millions of people with chronic illnesses endure unrelieved pain, uncontrolled physical symptoms and unresolved psychosocial or spiritual problems.” This issue occurs because palliative care is often considered a form of end-of-life care. Palliative care is a treatment that can be used for patients who suffer from chronic illnesses and diseases while receiving curative treatment. (Horowitz, Grambling & Quill, 2014) purposely states the misconceptions of palliative care and advocated for seriously ill patients that education must bring under control the misconceptions. Some patients do not receive appropriate symptom management because the palliative care treatment needed is often confused with end-of-life care. However, end-of-life care attempts to relieve pain and suffering when a disease is no longer responsive to curative treatment. Pain and suffering could ultimately be controlled or even eliminated through the proper utilization of palliative care. Patients who are not referred to palliative care in a timely manner is more likely to have poor quality of life, uncontrolled symptom management and increased amounts of visits to the emergency room during the disease process. Patients with life limiting illnesses bear the burden of increased discomfort and increased suffering. Nurses experience clinical practice issues and difficulties in the clinical setting during the delivery of comfort and symptom management. These issues

This is recognized to be an issue, and throughout the article the authors provided an understanding of how palliative care and end-of-life care are provided too late for a patient and should be provided at an earlier time in order to bring more comfort to the patients. The authors suggest that when and how end-of-life care is provided should be altered, with nursing ethics in mind, so that patients and nurses may feel better about the care they receive. This source will help my research by providing information on how changing the policies of end-of-life care and palliative care can result in the patient feeling a relief from their suffering and ultimately feeling more comfortable. This will also help my argument in how altering the current policies and focusing on providing better end-of-life care can lead to the diminishment of physician-assisted

The very factors that contribute to vulnerability in populations serve as barriers to their ability to access palliative and hospice care at the end of life.

According to the survey of WHO 2011a end of life care patient suffer unnecessarily due to underassessment and treatment of their problem due to lack of access and awareness of palliative care. Office for national statistics 2013d for bereavement survey suggests that most likely the patient with cancer receive high quality and dignified end of life of care. Survey also suggested that dignity and respect rated high in hospice and low in acute hospital settings. Patient who are very frail and have dementia, experience poor end of life care due to less involvement in advance decision process about their care (Alzheimer's society 2008).Study suggested that 40% of people who died in hospital did not need treatment and nearly most of them have been in hospital for over a month (Nation Audit office 2008).Hospital is considered least choice for end of life care so localities show the wide variation in capacity and place of

The Journey of Cultural Practices in End of Life Care initiative is a program under the umbrella of public health and as such reports the stakeholders formed of by the Board of Commissioners. The program coordinator is the current hospice social worker who will instill a less formal style of governance, according to the by-laws of the agency. Unlike the hierarchal and marketing approach of public health, which focuses on the

Additional studies done in the United Kingdom researched similar issues on how Hospice and Palliative Care could expand into other areas of care. In a major article reporting on this research, Nicola

In this site can let more people understand the definition of hospice palliative care services and process. It explains different part of the structure and mandate service in hospice palliative care, like the provincial leadership, Provincial Governance and the Regional Palliative Care Network. They also provide the frequently asked questions that facilitates the public to understand the information immediately and improve understanding of the nature of the service.

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.

3. Palliative Care Council of South Australia. (1996). Good palliative care project: final report. Retrieved September 4, 2002, from Palliative Care Council of So