Primary Goal For Hospice Care

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.

The term “hospice” goes back to medieval times where it was referred to as a place of shelter and rest for the ill or weary travelers on a long journey (NHPCO, 2016). In 1948, the term was referenced to by Dame Cicely Saunders, a physician, for dying patients (NHPCO, 2017). Saunders created the first modern hospice program, St. Christopher’s Hospice, located in a suburb of London. However, it wasn’t until a visit to Yale University, in 1963, Saunder’s gave a lecture on the concept of hospice care. During the lecture, she emphasizes the differences before and after symptom control care. Thus, this lecture was the stepping stone for the advancement of hospice care.

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

Hospice is a process to end-of-life care and a kind of support facility for terminally ill patients. It provides comforting care, patient-centered care and related services. Comforting care relieves discomfort without improving the patient’s condition or curing his illness. Hospice is extended in a healthcare facility or at home. Its objective is to provide compassionate, emotional, and spiritual care for the dying patient.

1.1 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.

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.

Rather, the hospice staff and the patient understand the patient is going to die and no further treatment options are available. Therefore, hospice care centers direct their attention towards providing a dignified ending to a patient’s life by delivering comfort and emotional support through a palliative care approach designated to alleviate pain and emotional distress. For example, at Hospice of Dayton, each patient residing at the care facility is provided their own room where their family is able to stay with them and the patient is able to receive the pain management and emotional support they need to die a little closer to peace and security. Additionally, at Hospice of Dayton, there are full-time doctors, nurses, counselors, and religious support-staff that provide patients the physical treatment they need to minimize their pain, as well as the emotional support they need to live the last moments of their life with dignity and emotional well-being. Most importantly, Hospice of Dayton because of its volunteers. Volunteers provide the invaluable service of listening, crying, and laughing with those who may not necessarily have someone to spend time with, while they undergo their long, arduous, and painful experience of

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

Our end of life care is offered by a multi-discipline team that supports patients and manages illnesses. Throughout the process, our team provides the emotional, physical and spiritual support that patients need to feel comfortable. Our services include medical social services, supportive nursing care, bereavement support, volunteer support, medical equipment, pain management and respite care.

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).

Palliative care is an umbrella term for any medical treatment that manages the pain, symptoms, and side effects of a chronic illness. This support can be provided any stage of the illness, alongside curative treatment, such as dialysis, chemotherapy, radiation, blood products, antibiotics and respiratory/circulatory support (Kelley and Morrison 2017). Hospice, by contrast, is a system of interdisciplinary care that provides services ranging from symptom management to bereavement services for patients and their families that generally have less than six months life expectancy (Hui et al 2013). Both palliative care and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive their illness.

Hospice is a component of palliative care. A person does not necessarily have to be dying in order to see a palliative care specialist. This is where the service is often underutilized in the hospital. In the 18 months I have been a nurse, I have cared for many patients with chronic illnesses who have dealt with symptoms that have severely impacted their quality of life. Most of the time, it seems as though the patient’s care providers are interested in treating the patient’s acute problems. My experience has been that the symptoms are often overlooked or are being treated in a manner that is to the dissatisfaction and discomfort of the patient.