Hospice in the United States Hospice is a concept of caring borrowed from medieval times, where travelers, pilgrims and the sick, wounded or dying could find rest and comfort. The contemporary hospice offers a program of care to patients and families facing a life threatening illness encompassing medical, nursing, spiritual, and psychological care. It is more than a medical alternative, it is an attitude toward death and the process of dying. Terminal disease is managed so patients can live comfortably until they die. The hospice program in the United States has evolved in part as an attempt to compensate for the inadequacies of the present medical system, particularly in caring for patients with a terminal illness.
The end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
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.
Palliative care is medical or comfort care that reduces the severity of a disease or slows its progress, but does not provide a cure (Dreeben, 2007). Different people have different needs when life is ending. Working with the incurable may sound depressing but death is a certainty and what we do each day for these patients as physical therapist assistants, matters. Providing care effectively and appropriately has a huge impact on the patient, therefore acquiring the ability to comfort and care for a patient at such a critical stage in life, is an amazin...
On average 56 million people die each year and 60% of them would benefit from Palliative Care. With increased patterns of chronic disease and aging population this gives Palliative care the need to become a Public Health Issue. On the discussion of Palliative care The World Health Organisation states that “Many countries have not yet considered palliative care as a public health problem and, therefore, do not include it in their health agenda ... it is essential to promote a public health approach in which comprehensive palliative care programs are integrated into the existing health systems and are tailored to the specific cultural and social context of the target populations’ (2002). Palliative Care is such a broad field and many people associate it with Cancer patients and the older generation, however Palliative Care covers every terminal illness and a specialist Palliative Care system is in place to care for children. (WHO)
The New England Journal of Medicine reports that early introduction of palliative care was shown to be effective in prolonging the life of lung cancer patients. Whether it is a terminal illness, chronic condition, recovery from surgery or physical rehabilitation, palliative care has expanded benefits still being discovered. It appears that whatever the ailment may be, there are beneficial results in pain control, treatment of symptoms and discomfort of side effects. It is also effective in alleviating the physical and mental stress that accompanies those
We as health care professionals need to work side by side with the families to provide the best care and decisions that are right by our patients. We have to be mindful of the cause and effect our course of treatment depicts for our patients. No individual wants to live in pain or misery, we all want to be healthy and happy and are willing to go great lengths to achieve this goal. Death is the final stage of life, but as we live and get older we start to prepare for death as to not fear death but accept it. Health care professionals may benefit from the opportunity to acknowledge, normalize and integrate death and dying into the continuum of life, both for themselves as well as their patients. (Sinclair, 2011) With advancements in technology and medicine we are living longer and fuller lives, and given time quality of life will only continue to improve.
Gawande’s book is very pertinent to the present day and has by many accounts sparked a national discussion on end-of-life care and how we treat our elderly. With elderly people accounting for a greater proportion of the American populace and as people start living even longer than they do now, end-of-life care will become and remain a major issue faced by doctors, patients, their families, and the healthcare system. Additionally, with our greater focus on improving patient outcomes while getting the most value for our healthcare dollars, end-of-life care is a major area that healthcare systems and hospitals will focus on, as it accounts for a large portion of their budget. As a response to the need to take care of our aging population, hospice care and palliative medicine are some of the newer specialties in the medical field that have been increasing in popularity and more research needs to be focused in these areas to better understand how to improve patient outcomes.
To “live as fully and comfortably as possible” is a key phrase in the care and treatment of a patient under hospice care. Hospice care focuses on the comfort and quality of life for a person with a terminal illness. The focus is not on a cure. A hospice care provider wants to help the patient be as pain free and comfortable as they can be, so that they can live the rest of their life as fully as possible. Unfortunately, more often than not, patients with terminal illnesses are viewed to be too frail to participate in occupations (Russell, M., & Bauh-Lampe, A., 20016). It is also true that people facing the end of their life feel helpless or depressed, lose their ability to participate in a lot of the daily activities they once enjoyed, and experience a loss of dignity. (Badger, S., Macleod, R., & Honey, A. 2016). However, with hospice care, many patients are able to find some degree of comfort, safety and control over their lives during their final days.