Hospice Care Essay

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

The aim of a hospice is to improve the quality of life of the dying

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.

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

Hospice is a philosophy of care. It treats the person rather than the disease and focuses on quality of life. It surrounds the patient and family with a team consisting of professionals who not only address physical distress, but emotional and spiritual issues as well. Hospice care is patient-centered because the needs of the patient and family drive the activities of the hospice team.

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.

Long-term care is a result of people having terminal conditions, disabilities, illnesses, injuries, or being elderly. The purpose of long-term care is to provide services to people and to aid people at a time in their lives when they cannot depend on themselves to maintain daily activities. There are many variations of long-term care available – such as home care, adult day care, and independent and assisted living, personal care facilities, nursing homes, and hospice.

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

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).

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

Hospice care is for terminally-ill people who have stopped treatment and expect to die in less than six months. Professional health care providers offer the end-of-life services to prepare people and their families for death.

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.

The case study based on the palliative patient Mrs. Mavis looks at issues both the family and the patient are dealing with in regards to the end of life treatment Mrs. Mavis is receiving. Mrs. Mavis is a palliative patient, currently unconscious, who is dying and only wants comfort measures within her nursing care. This was made clear through her advanced care directive, which was made weeks before beginning to receive her end of life care. Mrs. Mavis’ comfort measures include pain relief, hygiene and keeping her comfortable. Mrs. Mavis’ family want her to have fluids and medications to help improve her health. They also want oxygen and pain relief to help with her breathing. Issues such as educating and supporting the family, pain management, the effectiveness of having an advanced care directive and pain assessment will be evaluated to determine the best effective interventions for Mrs. Mavis and her families care. Interventions that will be discussed through-out this essay include the use of analgesia medication, the use of subcutaneous injections and syringe drivers, emotional support for the family, effective communication, educating the family on Mrs. Mavis’ wishes and the importance of having an advanced care directive. These interventions will be evaluated to ensure they are the best practice for Mrs. Mavis’ care.

Care team members need to be aware of this tendency to overestimate survival, to reduce residents’ and families’ potential distress.