Research Paper On 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.

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.

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

In contrast to the costs of standard medical care, hospice care provides an alternative that is both cost effective and caring. Unfortunately, it is actually difficult to quantify the cost savings associated with hospice care due to the fact that comparing costs during the last year of life are impacted by the variability in the length of hospice use. A study at Duke University went to extensive lengths to provide a comparison that provided an effective method for accurate comparisons. The comparison showed a reduced average Medicare expenditure of $2,309 per person from the time hospice care was initiated in comparison to the same situation handled through standard medical methods (Taylor, Ostermann, Houtven, Tulsky, & Steinhauser, 2007). The amount of cost savings varied depending on the primary health condition and the

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

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).

Palliative care is a relatively new concept, stemming from the hospice movement of the 1960s. This type of care focuses on the quality of life of its patients at any time in their treatment process. Palliative care is a concept that is often used synonymously with hospice care. Although it can be congregated with hospice care, they are not the same thing. Thus, it can easily be misunderstood. Sherner (2015) explains that both clinicians and people alternate palliative care and hospice. Unfortunately, she says, these people believe that palliative care implies the patient is refusing curative care. The purpose of this analysis is to explore the concept, clarify the meaning, and differentiate the concept of palliative 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).

Hospice care has not been around for very longs but it is one of the fastest growing medical fields in the country, with over 1.58 million patients being cared for in 2010 alone. Hospice is an important part of caring for terminally ill patients and helps the families and loved ones to grieve.

Recommendations for this program would be to solve the issue of double billing and holding the hospice agencies accountable. They are choosing to get paid for the healthcare but end up outsourcing specific jobs. Health care providers should make patients aware of their palliative options, instead of pushing curative treatment. Providing the option of hospice to individuals sooner will all them to have a more positive experience with hospice.

From a personal perspective, I think hospices may change and vary based on the type of ownership. For-profit organizations are usually advanced in technology and they care about their quality of care. However, non for-profit organization will not be advanced in technology and their quality of care will not be Haigh as in the for-profit organizations. People usually prefer to get treatments on for-profit organization because of the quality of care they will

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.

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