Dying is a scary thing, and most of the time we are unprepared for it to happen. It is scientifically proven that 100% of us will die one day; but with the advances in modern medicine people are starting to believe they can cheat death. A woman in her eighties had kidney failure and end stage respiratory. She had been there for two weeks and mentioned to her kids she did not want to end up like her husband living on machines. But her children couldn’t let her go and got her a permanent tracheotomy, feeding tube, and dialysis catheter. Now she just drifts in and out of consciousness, not saying anything or moving. (Gawande 4) Yet, is lying in a bed being kept alive by machines drifting in and out of consciousness really living? Many end of life patients these days are seeking a new alternative to that nightmare: Hospice care. Hospice care has been around since the 1970’s but has been underutilized until recently. The main goal of Hospice care is to: “provide a peaceful, symptom-free, and dignified transition to death for patients whose diseases are advanced beyond a cure. The hope for a cure shifts to hope for a life free of suffering. The focus becomes quality of life rather than its length”(Nabili). Hospice care is superior to hospital care for end of life patients because it leaves both the patient and their families in a better situation during the final stages of death.
With the economy in such bad shape as it is, medical expenses can sometimes be far too much for regular patients receiving standard procedures even with insurance. So consider the cost of normal end of life patients’ who could be in the hospital anywhere from two weeks to six months. According to a story done by CBS news, it costs nearly $10,000 a day to mainta...
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...Management (AIM) Program: Increasing Hospice Utilization In The San Francisco Bay Area." Journal Of Palliative Medicine 9.6 (2006): 1401-1411. Academic Search Premier. Web. 31 Oct. 2013.
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Gawande, Atul. "Letting Go." The New Yorker. N.p., 2 Aug. 2010. Web. 31 Oct. 2013.
Gott, Merryn, et al. "The Nature Of, And Reasons For, ‘Inappropriate’ Hospitalisations Among Patients With Palliative Care Needs: A Qualitative Exploration Of The Views Of Generalist Palliative Care Providers." Palliative Medicine 27.8 (2013): 747-756. Academic Search Premier. Web. 31 Oct. 2013.
Nabili, Siamak T. "Hospice History, Services and Respite Care Information - MedicineNet." MedicineNet. N.p., n.d. Web. 31 Oct. 2013.
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Many people are unaware of what Hospice does and where they can find one, but Hospices have actually been around since the Middle Ages. People living during the time made shelters where they took in weary people who had no place to go. They called these places “Hospices” (History of Hospice). Later on, Dame Cicely Saunders had an idea to expand these places. Dame Cicely Saunders served as a nurse during World War II (The National Hospice Foundation). After watching all of the soldiers suffering during the war, Saunders was devastated to see all of those men die painful deaths. This sparked the idea for Saunders to create a place where people could peacefully die. She would call this place “Hospice”. The first Hospice was established in London in 1967 (The National Hospice Foundation). After opening the London Hospice, Saunders decided she wa...
Terminally ill patients deserve the right to have a dignified death. These patients should not be forced to suffer and be in agony their lasting days. The terminally ill should have this choice, because it is the only way to end their excruciating pain. These patients don’t have
Being in hospice care is a better alternative than being stuck in the hospital to try to avoid the unavoidable. Common misconceptions about Hospice could include that hospice makes life more miserable; however, a physician expressed his findings in Hospice,“You can only fail a patient if you fail to understand and respond to their needs. We may not be able to cure all of our patients, but if we can make them comfortable in the last moments of their lives, we will not have failed them”..Hospice care gradually emerged in the 1970s, when groups like the National Hospice Organization were formed “in response to the unmet needs of dying patients and their families for whom traditional medical care was no longer effective.”Herbert Hendin, an executive director of the American Suicide Foundations illustrates a story of a young man diagnosed with acute myelocytic leukemia and was expected to have only a few months before he died. He persistently asked the doctor to assist him, but he eventually accepted the medical treatment. His doctor told him he can use his time wisely to become close to his family. Two days before he died, Tim talked about what he would have missed without the opportunity for a
A living will is a type of advanced health care directive, which states an individual’s wishes for health care treatment when he/she is terminally ill. Living wills are often applied to end-of-life decision making when patients are no longer deemed competent to direct care for themselves. The form of living wills can vary widely. But, most address whether or not to use life-prolong medical treatment such as CPR, respirators, and artificial nutrition and hydration. These documents can also contain information about the importance of quality of life for patients and can name a healthcare proxy to make medical decisions in their place. Having a living will allows individuals to state their
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
The first journal article is about advance care planning (ACP) in palliative care. This is of interest due to several clinical experiences and the realization that many families either ignore the patient’s request for end of life (EOL) care or who have no idea of how to plan for EOL care. By reading the research and understanding the methods used, this will allow for insight into how to implement palliative care into clinical practice across different sites. The authors of this original research are Jeanine Blackford PhD, RN, senior lecturer at La Trobe University in Australia, and Annette Street PhD, associate dean of research and professor of cancer and palliative care studies. According to Blackford & Street (2011), this research is important as there are many countries that “report a low percentage of people who have completed an advance care plan” (p. 2022), and ACP is needed upon admission to facilities that offer palliative care. In addition, the purpose of the study is to try and obtain guidance to integrate an ACP model into routine clinical practice in the community. The research question chosen for the analysis of this article is: Is it feasible to implement ACP into routine practice and documentation at multi-site locations in...
Hospice always patient and families the automaty to decide a choice of end of life care. It allows who prefer to end life in their homes, pain free, surrounded by family and loved ones: Hospice works to make this happen. The focus in on caring, not curing. Hospice utilizes an interdisciplinary team of healthcare professionals and trained volunteers that address symptom control, pain management, and emotional and spiritual support expressly tailored to the patient's needs and wishes. Hospice is not “giving up,” nor is it a form of euthanasia or physician assisted
"Hospice Services and Expenses (About Hospice)." Home (Hospice Foundation of America). Web. 23 Jan. 2011. .
The change which is outlined in this paper relates to how early referral of terminally ill patients into a hospice program results in better patient outcomes, in particular, with regard to pain management. PICO format question will be used , along with a supportive body of evidence regarding the fact that early onset into a hospice program is helpful with providing end of life pain control. Hospice programs available, and options associated with them will be discussed as well as common concerns associated with early admission to hospice. The methods used for payment of hospice, and how one qualifies for entrance into a hospice program will be explored. A literature search will be performed and its results detailed within the body of this paper. Recent publications on the subject matter and associated issues such as moral and ethical questions as well as the change question will be discussed. Planning, implementing and evaluation of the change proposed will be explored within this paper.
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
Even though many dispute over the value and usefulness of treatment and care of terminally ill patients, the debate for the most useful care and pain reliever for these patients is the question that most patients, and their families, have to ask themselves daily. Wesley J. Smith suggests that Hospice care for patients with such a horrible illness is a beneficial program and that many patients need to utilize it. Smith also recommends that a valuable care option would be to “allow the terminally ill to enter hospice care without having to give up life-extending or curative treatments”. (Smith 3) With this statement, Smith demonstrates a way that these ill patients can be provided with treatment and also care for the patient’s quality of life.
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Center for Bioethics: University of Minnesota. End of Life Care: An Ethical Overview. 2005. PDF.
Kantrowitz, Barbara. A. A. Tyre, Peg. “The fine art of letting go.” The Reader, 2nd edition. Pearson Education, Inc. 2012: 126-130. Print.