Hospice: Understanding and Caring for End-of-Life 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
Q1: Complete the following table, describing the needs you would have to consider when planning the different aspects of end of life care for an individual
The aim of a hospice is to improve the quality of life of the dying
Getting prepared for death can be an exhausting experience for the patient and their family. It is very important that the patient not only knows what they want as far as their right to receive or reject treatment and medications or knowing whether they want to receive palliative care at home or in a hospital setting to include the advantages and disadvantages of each. The main focus of this paper is to give the reader an in depth look on how an end of life crisis affects a patient and their family. Ella is a breast cancer patient who just came out of remission and is at the end of her life.
Caring for patients at the end of life is a challenging task that requires not only the consideration of the individual as a whole but also an understanding of the
Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.
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
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.
Long-term care is a result of people having terminal conditions, disabilities, illnesses, injuries, or being elderly. The purpose of long-term care is to provide services to people and to aid people at a time in their lives when they cannot depend on themselves to maintain daily activities. There are many variations of long-term care available – such as home care, adult day care, and independent and assisted living, personal care facilities, nursing homes, and hospice.
One of the few inevitabilities in our life is death. Whether there is more after death is up to interpretation but there is no arguing that at some point, every life must come to an end. Sociological studies and the evolution of hospice care have brought this inevitability to light and provided important dialogue about death and the dying process, particularly as they relate the impact of social and professional relationships an end term patient may have at the time they are dying. A study was conducted was conducted by Dr. Karen Steinhauser that polled end care patients about what was important to them leading up to the time of their death. This poll found that 90% of these patients found it important to say goodbye to important people and 86% of patients found it important to resolve unfinished business with friends and family. From these findings it can be inferred that one of the most important things to people as they near the end of their lives is to find peace and leave this earth with no regrets. This can be summed up by the word closure, which is defined as a feeling that an emotional social or personal relationship or traumatic experience has been resolved. Reaching closure is often closely interrelated with the various personal connections, professional relationships and social status we accrue over our lifetime, and there are a number of avenues for achieving a feeling of closure. This concept is illustrated when we look at how one reaches closure when examining
Our society finds it difficult to talk about dying and euphemisms are the norm. It is typical for both doctors and patients to be hesitant to initiate a discussion on dying. Focus instead is often more often placed on interventions and actions for managing symptoms. This avoidance can leave patients and their families unprepared for the inevitable death. (Schapira, 2010) It also often results in requests for therapies which may be excessive, costly and even painful in the hopes for a cure. One study demonstrates that when patients are aware that they are terminally ill, the majority are able to reach a state of peacefulness and also exhibit lower levels of distress. (Ray, Block, Friedlander, Zhang, Maciejewski & Prigerson, 2006) It is also important that family members are willing to discuss end-of-life options with their loved ones. According to elderly patients, they are most often the ones who initiate these conversations with their
A researcher draws attention on why it is important for patients to have conversations with their doctors and states that, “Medicare’s plan comes as many patients, families, and health providers are pushing to give people greater say about how they die whether that means trying every possible medical option to stay alive or discontinuing life support for those who do not want to be sustained by ventilators and feeding tubes (Belluck).” People prefer to pass away in their house or hospice, or in any situations that patients desire essential medical care. There are four areas that a dying individual needs which are emotional and mental, physical comfort, spiritual issues, and active tasks. Someone who knows that they are close to dying are clearly sad and worried. Having conversations about their emotions might be advantageous. Physical contact with family members and the medical team are more connected and more interactive in cooperating. As patients begin to receive discomfort, it is most likely due to skin displeasure; pain; weariness; temperature reactivity; digestive and respiratory problems (Emanuel). Also, due to spiritual issues, a patient would want to finish things off in a good place with everybody they had associated with. It is also pleasant for patients to practice their religion by praying or communicating with someone in their
Before a diagnostic such as pulmonary cancer, explaining to the patient and family about the services offered by the hospice is a task that should be planned. You must first assess the level of anxiety that presents the patient and try to get it down because only if the patient and family are calmed will be able to pay attention and understand the benefits they will get receiving the services. It is very important that the wife understands the importance of the patient understanding the reality of his condition, we must ensure that she understands this point and allow the patient to participate in the planning of his care. We have to start by telling them that in hospice they will receive services from the multidisciplinary team where they
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.
Palliative care is a system of holistic care aimed to satisfy the requirements of the chronically ill, typically within their home and community rather than as an in-patient1. Hospice is based on the same principles of care, however, it requires that a patient be deemed with six months or less to live and that life-sustaining treatments be ceased, creating an important distinction between the two. Hospice and palliative care both provide comfort, but hospice is for comfort during end-of-life. Pain and palliative care patients have indicated that receiving that care not only reduced their pain that was once intolerable either completely or to a substantial extent, but it also maintained or increased their hope and outlook on life1. In this country, palliative medicine is a relatively new field of medicine. It wasn’t until 2014 that the WHO began to recognize “palliative and end of life care services as essential and integral to health systems worldwide”2.