...In this case study of a 78-year-old African American female, who lives with her husband Willie, in a rough part of town. Jane was admitted to hospice on December 23, 2017, for changes in the level of health-related illness. He had been living at home on hospice before going to the hospice facility. She had been living at home with her husband when he had hypertensive heart disease, acute or chronic systolic, unspecified atrial fibrilla, diabetes, major depressive disorder, cardiomyopathy, undefined, and angina pectoris, vague. There was some debate whether there had indeed been a change in the level of health-related issues. Jane, was currently not receiving the medication prescribed to her on a daily basis which caused some complication in...
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...Hospice Creation of Hospice Hospice care is 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. The term “hospice” ( from the same linguistic root as “hospitality”) can be traced back to medieval times when it referred to a place of shelter and rest for the weary or terminally ill on a long journey in 1948 (History of Hospice Care, 2012). The name of the physician was Dame Cicely Saunders who treated the terminally ill and eventually went on to create the first modern hospice, named St Christopher’s Hospice, in a residential suburb of London. (History of Hospice Care, 2012). Ms. Saunders introduced the idea of specialized care for the dying to the United States of America during a 1963 visit with Yale University. Her lecture, given to medical students, nurses, social workers, and chaplains, about the concept of holistic hospital care, included photos of terminally ill patients and their families, showing the dramatic differences before and after the symptom control care (History of Hospice Care, 2012). Ownership In 2010, there were over 5000 hospice programs nationwide (Facts and Figures: Hospice Care in America, 2012). The majority of these facilities are freestanding agencies constituting 58 percent of all hospice centers (Facts and Figures: Hospice Care in America...
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...paper explores the areas of physical (medical), financial and emotional preparation. Palliative care options such as hospice will be explored. Additionally, this paper will provide an educational awareness plan for...
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...healthcare. The careful scientific evaluation of clinical practice became a prominent focus during the second half of the 20th century.1 More recently, attention has been paid to methods of determining which of multiple proven approaches to a healthcare problem works best for which patients.2 Evidence-based practice encompasses implementing the best-known practices into the clinical setting using a scientific approach. It evolved from evidence-based medicine, which was developed in Canada to teach medical students. “Evidence-based medicine has been defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”3, p. 3 The National Quality Forum’s report A National Framework and Preferred Practices for Palliative and Hospice Care Quality is a consensus report that is a first step toward introducing evidence-based measures into palliative practice on a formal, national level.4 The Agency for Healthcare Research and Quality (AHRQ) supports organizations in their efforts to improve the quality and efficiency of healthcare by facilitating the use of evidence-based research findings in clinical practice.5 The nursing discipline has also embraced evidence-based practice over the past 25 years, initially through its support of “research utilization,” the integration of research into nursing curricula, and the education of nurse scientists. Sigma Theta Tau International, the Honor Society of Nursing, considers evidence-based...
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...early years workers valuing people as individuals. All of the Migrant Helpline staff are effectively trained and know what to do automatically and so do not unnerve the client or make them feel uncomfortable by making obvious mistakes or faults if trying to communicate them. Migrant Helpline staffs also know efficient background information on each client. This is through referral forms. Referral forms are used to write down all the client details. Case booklets are filled in by all professionals, a detailed admission section and daily notes added from medical note to family details, patient’s concerns etc. case conferences held to set up support for patients going home. All written information must be sensitive and with agreement of the clients, who can see them at any time. . A follow up consultation may be needed, where questions can be answered. Stress and being upset are barriers to good communication, as is confusion and being emotionally distressed. Multi skilled professionals all work together to meet the client needs. Case workers, voluntary organizations, social workers and managements staff meet regularly to discuss and to make new plans. How client confidentiality can be maintained. Most people in caring professions and roles are aware of the need for confidentiality, but we must not assume that the client will know about this, or expect it. Some clients will have heard stories of confidentiality being broken and if they are worried about this, it could prevent...
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...Hospice Care HCS 212 December 12, 2012 Hospice Care Hospice is a very special type of healthcare that offers comfort and support for patients and families that are facing a terminal illness. The focus is put on making a patient comfortable with a quality of life instead of a cure. The main goal is for a patient to have comfort and free of pain, with the hope that they will live each day as fully as possible, allowing people to live the remainder of their life with comfort and dignity. Hospice services are available for people that can no longer benefit from curative treatments, and are different from other types of care. You may require more help than you are used to which can be both good and bad. The life expectancy for these individuals is normally six months or less, but sometimes they do live past six months. These patients are encouraged to try and live as much of a normal life as possible and to the fullest as possible as well, they do not have to confined to a bed or stay at home 24/7. A multi-disciplinary team of physicians, nurses, pharmacists, social workers, dietician’s, hospice certified nursing assistants, clergy, therapist and bereavement counselors as well as volunteers who all work together as team to address the physical, mental, emotional, spiritual, and social needs of each and every family member. This care is provided in their own home no matter what age...
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...Prison Hospice Care Program The “baby-boomer” generation is increasingly getting older as they reach their 50’s, 60’s and 70’s, at a time when most will start experiencing more health problems that will require some kind of doctor’s care, hospitalization or possibly some kind of end-of-life care. Although this is a normal process that all people will eventually go through, it can be difficult and challenging for those who are in prison. Not all prisons are set up to care for inmates to receive palliative or hospice care, even those that are set up to do so, can face difficulties. Not only do these facilities face challenges; the inmates can also find themselves dealing with emotional and physical situations, but may be limited to what type of care they may receive. The number of people in prison has reached a population of approximately 7 million in 2014 (Bureau of Justice Statistics, n.d.). In federal prisons alone, there were 195,947 inmates as of May of 2016. In March of 2016, there was an estimated 4,609 inmates that were 65 years old or older (Federal Bureau of Prisons, n.d.). The need for hospice care for prisoners is increasing at an alarming rate as criminals are given 20 plus years or life sentences as most states have eliminated the death penalty. According to the National Hospice and Palliative Care Organization (NHPCO), approximately 3,000 inmates will die of natural causes each year ("End of Life," n.d., p. 1). Those numbers greatly increase when you add...
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...Despite high levels of satisfaction expressed by hospice employees when compared to employees in other sectors of health care, hospice social workers have the lowest job satisfaction compared to other professionals on the hospice interdisciplinary team (Casarret, Spencer, Haskins, & Teno, 2011; Monroe & DeLoach, 2004). Job satisfaction amongst health care employees contributes to the retention or tenure of qualified and experienced employees (Fritzsche & Parrish, 2005; Head, Washington & Myers, 2013; Kobayshi & McCallister, 2013; Miller, 2008). High turnover has been shown to be associated with decreased job satisfaction among direct care hospice workers and has also been shown to compromise quality of care for hospice patients (Dill & Kagle,...
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...all of the things that could be and so urges him “burn and rave at close of day.” This concept of fighting until the end seems to make a lot of sense. Why would someone want to go gentle into that good night of their death when medicine is as advanced as it is today? Today, doctors can intravenously feed you when you are unable to eat. Doctors are able to administer several drugs that can prolong life even in the case of a terminal illness. Doctors can even intubate...
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...American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care Elizabeth Joy Gifford University of San Francisco, lgiffman1@aol.com Follow this and additional works at: http://repository.usfca.edu/dnp Part of the Nursing Commons Recommended Citation Gifford, Elizabeth Joy, "The Experience of African American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care" (2009). Doctor of Nursing Practice (DNP) Projects. Paper 14. This Project is brought to you for free and open access by the Theses and Dissertations at USF Scholarship Repository. It has been accepted for inclusion in Doctor of Nursing Practice (DNP) Projects by an authorized administrator of USF Scholarship Repository. For more information, please contact zjlu@usfca.edu. COMPREHENSIVE EXAM 2 Section I: Introduction Statement of the Problem Although 60% of African Americans in the United States have stated that they would want hospice care when they are dying (AARP, 2003), they only comprise 8% of all hospice enrollees (NHPCO, 2007), despite the fact that they represent 13% of the total population in this country (U.S. Census Bureau, 2008). In fact, hospice care in this nation has always been underutilized by African Americans (Connor, Elwert, Spence, & Christakis, 2008). In the San Francisco Bay Area, among Medicare-certified hospice agencies that submit data to the State of California, only 2% of all the hospice enrollees...
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...responsible for the death of their loved one. Others believe that all measures should be taken to help prolong their loved one’s life. No all deaths are the same. Some people pass away peacefully, while others will have difficulty transitioning through the end of life stages and have difficulty with pain. Individual beliefs, religions and cultures are also a large piece of what we must consider in order to plan the appropriate care for the dying patient. Unfortunately, in many instances, patients usually have not had discussions regarding end of life preferences with their doctors, caregivers, and family members. This sometimes leads to decisions being made at the end of life that are not the treatment preferences of the dying person. Hospice is a philosophy that allows nature to take its course, with focus on the greatest quality of life until the end of life. The goal is to provide physical, emotional, and spiritual comfort to the patient as well as provide support to the caregivers. Educating caregivers and families should be done so that they have an idea of what to expect during the dying process and to teach them about the body’s natural way of shutting down. Families will also sometimes insist on feeding the patient or giving them intravenous fluids, not realizing that these actions can also interfere with the natural process and can sometimes cause more pain and discomfort to the patient....
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...As you are dying the last thing you want to do is have to make decisions of what is going to happen to you, so let’s make the decisions before we get to this point. Physicians should make it routine to talk to their adult patients about the options of end of life care and advance directives. These end of life care and advance directive involve: living will, a medical power of attorney (or healthcare proxy), palliative care and hospice care. Allowing these patients to know all the options they have, it could make the end of life care process easier for families when deciding what should be done. I believe physicians and nurses should talk about end of life care and advance directives because everybody should know their options before they get...
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...through undesirable trends and benchmarking. They need to be measurable and be the same for all patients in the survey area. This data will assist us in developing the measures necessary to improve performance standards. A team will be organized that will include the Executive Director of our local hospice as well as the Medical Directors (3), that drive our management force. Defining an action plan to implement proper and effective data collection for our Quality Assessment and Performance Improvement (QAPI) program will entail establishing an overall goal first. This can be monitored regularly through weekly meetings of the team members to determine where they are in the process and what their findings have been so far. Managing Quality Improvement The organization that I work for has an excellent Quality Assessment and Performance Improvement (QAPI) program, not many hospices have a fully functioning program. However, one particular issue needs improved upon, the data collection process now being employed. The company they are using at this time, Deyta, does not seem to be very effective. The manner in which they collect the data using surveys regarding hospice care, appears to be somewhat ineffective in that most people who receive this survey discard it without looking at it and therefore this impacts are ability to improve upon our services with a larger workforce. The data is of no value to us unless it is being used to improve our processes or services...
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...Module 1 Assignment 3 Jennifer Raley My client has agreed to substance abuse treatment for 30 days. Since we do not have a 30 day treatment center in our county, nor in our immediate area, I would have to refer her to OSF in Peoria, Illinois. Peoria is approximately one hour away and is located at: 5409 N. Knoxville Ave. 309-691-1055 I believe this is a good fit because the overall rating is a 4.0 (including environment, food, and success rate). Proctors substance abuse treatment center includes detox services, Dual Diagnoses Treatment, In and Outpatient services, treatment for behavior disorders, a sober living home, schooling, and private rooms. Since my client has a dog, this is a good choice because she will not have to stress or worry about rehoming or boarding her pet because Proctor is also pet friendly. My client does not have insurance, nor a lot of money, so this is a good choice because they accept payments. Proctor serves across the entire Illinois state reaching from central and southern Illinois. My second client is an elderly mother that was recently diagnosed with terminal cancer. I need to find a hospice that services the elderly in our county. I choose Illinois Valley Hospice. Illinois Valley Hospice is located at: 1305 Sixth St. Peru, IL. 61354 815-224-1307 website is www.ivch.org/service-hospice.html I believe this a good choice because their commitment to quality work, and caring staff to help comfort clients and their families at such...
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...Interview of a Hospice Chaplin The Duties of a Hospice Chaplin Michell McGill June 25, 2012 BSHS/302 Tami Frye Hospice Care and Hospice Counseling is a growing profession, which is being incorporated in many hospital and doctor’s offices today. Today there are many private companies who provide these services and they employ Chaplains to assist the patient and the families in making many decisions in reference to end of life wishes. There are many misconceptions as to the purpose of Hospices and the services they provide. The Hospice Chaplin can supply services such as emotional comfort, assist with reconciliation, assist with funeral/ memorial service and any other concerns the patients may have. My own misconception was a reason that I felt the need to research and find out more information. There are many ways to interview an agency, telephone calls, personal interview, and email or an investigative interview as a potential client. I choose an email interview because of the work schedule of the Chaplin and our inability to find a convient time for each of us to meet. . Interview of a Human Service Provider Person Interview (and organization) Kimberly Young-Hardin, MDiv, SCC – Providence Hospice Date of Interview Saturday June 25, 2012 Person Conducting the Interview Michell Walter McGill Hello, my name is Michell W...
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