The beginning of life is celebrated. Books and resources are shared among friends and family in preparation for becoming a new parent. So, what happens as one approaches the end of life? Unfortunately, the same care and sharing rarely occurs in those circumstances and many face the prospect of dying unprepared. Though most people state they would prefer to die at home, this is often not where death occurs. Many Americans spend their last days attached to medical apparatus that keeps the body alive, but it does not allow for communication with family and often requires heavy sedation. Additionally, this level of treatment comes at a high price. As a society, we must become as comfortable in addressing the end of life process as we are with the beginning of life. One way that this can be done more effectively is through increased knowledge and use of hospice care. Hospice care is a viable option that provides health care cost savings, comfort to the patient, and support to the caregivers, however as hospice systems become more commercialized, care must be taken to avoid the pitfalls that are inherent in larger organizations.
Hospice care is a relatively young option in the United States, with the first hospice organization founded in 1971 after gaining acceptance in England in the 1950s (Jensen, 2012). Hospice care is provided to those who are diagnosed with a terminal condition that is expected to culminate in death within six months. Unlike regular health care which focuses on curative procedures, hospice services focus on the comfort of the patient in order to ease the process of dying. These services provide benefits to the patient and the caregivers, as well as showing cost savings.
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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...
The controversial act known as the physician aid-in-dying (PAD) challenges us to question our ethical, religious, and cultural values or beliefs. Although it is tragic and perceived as morally inappropriate, suicide is sometimes the only answer. In certain cases this act is a way to end excruciating pain and suffering. The state of Oregon passed a law known as the Death with Dignity Act in 1994. PAD is defined as “a practice in which a physician provides a competent, terminally ill patient with a prescription for a lethal dose of medication, upon the patient's request, which the patient intends to use to end his or their own life” (Braddock, and Tonelli). PAD also raises the question, is it a constitutionally guaranteed right for people to have the power and the medicine to take their own life? PAD, if operating under careful supervision, is an alternative to patients who may have to endure physical, mental, and financial struggles. Doctor Peter Goodwin, a physician from Portland, Oregon campaigned for the Death with Dignity Act, which he called his greatest legacy. Goodwin became a terminally ill patient towards the end of his life. Doctor Goodwin was 83 years old when he took the very medicine that he campaigned so long for. Goodwin was diagnosed with a rare brain disorder, which he had been battling for 6 years prior to PAD.
Final Gifts, written by hospice care workers, Maggie Callanan and Patricia Kelly, includes various stories detailing each of their life changing experiences that they encountered with their patients. Hospice care allows the patient to feel comfortable in their final days or months before they move on to their next life. This book contains the information considered necessary to understand and deal with the awareness, needs, and interactions of those who are dying. Not only are there stories told throughout the book, there are also tips for one to help cope with knowing someone is dying and how to make their death a peaceful experience for everyone involved. It is important that everyone involved is at as much peace as the person dying in the
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
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).
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
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
Horkan, Thomas. "Legislation That Complicates Dying." Eds. Gary McCuen and Therese Boucher. Hudson: Gary McCuen Publications, 1985. 69-72.
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...
After reading the different stories in the book “Final Gifts”, I believe I have a better understanding of the nurse’s role in caring for the needs of the dying patient and how their families need to be guided through this experience. The different stories in this book provide insight into the experiences of the dying as well as how their loved ones cope with their loss. The authors Maggie Callahan and Patrician Kelly, experienced hospice nurses who have extensive exposure to dying patients and their families, through their shared stories, paint a picture of what the dying want. To many, death is a difficult concept.
Hospice Care refers to the focus on quality of care and life rather than treatment and curative options for someone and their disease. This type of care includes not only the patient, but also their family and physician. Dame Cicely Saunders states, “You matter because of who you are. You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but also to live until you die.” With this quote, Saunders reflects what Hospice believes in and their commitment, or duty, for the patient. Patients who are terminally ill can be considered as patients with cancer, diabetes, and many more diseases. Very few cancer patients have a type of cancer that has a known cure, and unlike those patients many other cancer patients possess a type of cancer that is curable today. Terminally ill patients have to choose between continuing treatment or being provided with Hospice Care. Both hope and Hospice means that the patient can have both the benefit from treatments, which give them hope that the disease could be cured or at least reduce the symptoms, and Hospice Care, which provides the patients with relieve of pain and
THOMAS, K. and LOBO, B., 2011. Advance care planning in end of life care. Oxford: Oxford University Press.
Palliative care “focuses more broadly on improving life and providing comfort to people of all ages with serious, chronic, and life-threatening illnesses” (http://www.WebMD.com). Palliative care is not the same as hospice, since it is not only for the dying. According ...
The type of research study, sample size, variables, intervention, measurement method, findings, and conclusion are all mentioned in the abstract. Statement of the Problem The problem explored in the article was stated as a problem statement. In this article, the authors explain the stressful situations of families having loved ones die in the intensive care unit. They also state that this problem is very important because there is poor communication between staff, physicians, and surrogates in the plan of care for end-of-life measures (Lautrette et al., 2007).