SOC 313 Week 5 Final Paper Where Is The Best Place For Ella

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

.“As medical technology continues to advance and health care choices become more complicated, the preservation of end-of-life autonomy is an increasingly important issue faced by various client populations.” (Galambos, 1998).

A patient barrier might include having limited knowledge surrounding life-support systems and treatment options, thereby hindering their ability to fully comprehend or demand certain interventions. Good counseling is therefore essential to overcoming this barrier in implementing the patient’s true and best wishes (Kroning, 2014, p. 222). Another barrier in implementing advance directives concerns the role and influence of family members and the patient. There may be discordance between the desires of the patient and family, which can result in serious debate and tension if not addressed and taken into consideration. Physicians still may have reservations, as certain demands made by the patient may raise ethical concerns in the future, if the provider feels the interventions being done are no longer medically appropriate.

inpatient care in a skilled nursing facility, hospice, and some aspects of home health. Mrs.

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.

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

Hospice crusade in the United States has advanced over the past 25 years. The focus of hospice is comprehensive physical, psychosocial, emotional and spiritual therapy in people, who are terminally ill and their families. Hospice providers are helping the quality of life by whenever they can, instead of hospitals, protecting patients treated at home from the burden and provide intervention. Hospice nurses are mainly in accordance with the 1983 Medicare Benefits Act, guidelines of the federal program that allows the patient to die in their own home with family and friends at their next offer treatment (Nurses for a Healthier Tomorrow, n.d).

NHHCS stands for National Home and Hospice Care Survey. This survey is designed to gather information on home health and hospice agencies, their services, their patients, and their staff. This survey was first conducted in 1992 and was most recently conducted in 2007. According to the 2007 survey there were 14,500 hospice care and home health care agencies in the United States. Of those agencies 75% only provided home health care, 15% only provided hospice care, and 10% offered both services. The average home health care only agency served 109 patients. The average hospice care agency served 78 patients. A total of 1,036 agencies participated in the 2007. Data was collected on 9,416 current hospice discharges and home health patients

About 90% of hospice services are delivered in the patient's home. Respite for the caregiver is provided and patients can be placed up for medication and symptom management. Patients that are able to visit relatives out of town and still be covered under what the program call "courtesy coverage". Patients are also assigned to hospice programs depending on their illness, the type of cancer, and any other chronic conditions and they provide treatments needed (Byrock, 1998).

(2007) research paper, the authors provided the reader with strong research that was done in two states: Hawaii and Colorado. This article objective is “to determine whether an in-home palliative care intervention for terminally ill patients can improve patient satisfaction, reduce medical care costs, and increase the portion of patients dying at home” (Brumley et al., 2007, p. 993). This study was a randomized, controlled study that included 298 out of 718 ill patients with same demographics. Before, 298 participants were chosen they had to have a diagnosis of cancer, COPD, or CHF and have less than 12 months of life expectancy. Also, these participants had to have a score of 70 on the palliative scale, where 0 was being dead and 100 being normal. One hundred and forty-five patients were in the intervention group that received customary and usual standard care, but they also received a greater quality of comfort measures, quality improvement of life, and they will get their symptoms managed unlike the usual care group. On the other hand, 152 patients were assigned to usual care group, where they only received “standard care to meet the needs of the patient. [...] patients were treated for conditions and symptoms when they presented them to attending physician” (Brumley et al., 2007, p. 995), the

Hospice care is a team of health care providers who take care of patients who are in the last stages of a serious illness (1). For example, patients with cancer, HIV infection, heart disease, dementia, kidney failure, chronic obstructive pulmonary disease, and some neurological disorders (2). This care can be provided by people other than health care providers, it can be done by patient’s family members (2).

Hospice care is a model for the interdisciplinary delivery of care to clients with certified prognosis of six months or less to live. It is a special type of care that emphasis on reducing all dimensions of suffering with a team-oriented approach which includes pain management, symptom control, emotional and spiritual supports that are modified to the client’s needs and wishes. It also addresses the physical, social, economic and practical needs of the client and their families as a whole. Hospice care is covered by most insurance companies such as Medicaid, Medicare, HMOs and private insurance plans and can be provided in the client’s home, hospital and nursing homes and hospice center.

This article compares the amount of terminally ill patients dying at home verses dying in the hospital. In this article, case studies are done comparing family acceptance of death verses non-acceptance. Death can be a difficult subject to talk about, even when there is an obvious decline in a patient’s health. Families may us the defense mechanism of denial to protect themselves from the harsh reality of their loved one’s death. In one of the case studies, it was discussed with family that their loved one had no chance of recovery. The family agreed to keep the patient at home and care for him, along with home health services, during his final days. After his death, however, it was noted by the home health agency that the patient died in the

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.