...Hospice Care in the United States Catherine Harmer HCS.212 Feb.23, 2013 Prof. Mark Miller Hospice Care in the United States Hospice care is one of the best services the health care industry has to offer, and is available to all walks of life. When the patient has reached end of life, hospice provides support to the loved ones as well. “Hospice focuses on caring, not curing and, in most cases; care is provided in the patient’s home. Hospice care also is provided in freestanding hospice centers, hospitals, and nursing homes and other long-term care facilities. Hospice services are available to patients of any age, religion, race, or illness. Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations” (NHPCO, 2011, par.2). Hospice care has evolved over many years and has a lot to offer: Patients are kept as comfortable as humanly possible. For loved ones, finding peace or comfort is likely more achievable when helping their loved ones let go, making the course of grieving and acceptance much less difficult. Caregivers, employees, and volunteers are faced day-to-day with the reality that life as we know it does expire; it is only fitting then, that greater patience and appreciation of self, family, and life in general become more characteristic of the providers than might be otherwise. This facet of health care, one might fear, would require tremendous resilience. On the other hand however, facilitating a...
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...Moore-Ramos 15 July 2013 Hospices Under Federal Scrutiny Investigations by federal agents have found that many hospices, especially in Florida, have systematically billed Medicare for patients not eligible for care or over-billed for “crisis care” that patients did not need. A huge false-billing lawsuit has been launched against Miami-based Vitas Healthcare, one of the nation’s largest hospice providers, accusing the organization of collecting tens of millions of dollars through unjustified and inflated bills (Lamendola). The suit came after four years of investigation in which the government found that eleven smaller hospices had been over-billing. Those hospices had to pay $88 million in settlements. And in January the government joined a lawsuit accusing Hospice of the Comforter near Orlando in phony billings at an estimated $11 million. The federal Inspector General’s office overseeing Medicare has placed hospice overcharges among one of its investigative projects for the year. They have also proposed tightening billing codes that hospices have used to increase Medicare payments six-fold since 1998 (Lamendola). Paul Ledford, executive director of the Florida Hospice & Palliative Care Association says that although hospice has escaped scrutiny over the years, they are getting more attention now. He does not think that hospices in Florida are committing fraud but that instead they are big targets for the government due to the fact that hospices are huge in Florida due...
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...The Effects of Palliative Care on Other Family Members Tonya Kerney McKendree University The Effects of Palliative Care on Other Family Members Family members of patients who are in palliative care experience emotions including hopelessness, guilt, and sadness. They are often physically exhausted and may become ill themselves. Many experience depression. Family Caregiver Alliance (as cited in McMillan et al., 2006) has estimated that over fifty million Americans assist a family member with a disability or illness on a regular basis. Of these ill patients, many require extensive care from family members. Caregivers of cancer patients especially experience very high stress levels. They are often burdened with physical exhaustion, emotional distress, and financial worries from loss of time at work to care for their loved one (Emanuel & Emanuel, as cited in McMillan et al., 2006). The purpose of the study I reviewed was “to determine whether hospice plus a coping skill training intervention improved family caregivers’ quality of life, burden, coping, and mastery, compared with hospice plus emotional support and usual hospice care (McMillan et al., 2006, p. 214)”. To participate in the study, caregivers had to be caring for adult cancer patients, both had to give consent, both had to be able to read and comprehend English, both had to have achieved at least a sixth grade education, and both had to achieve a minimun score of seven on the Short Portable Mental Status Questionnaire...
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... Serenity and the Importance to Nursing Practice THE CONCEPT OF SERENITY 6 References Beckstead, J.P., Conley, C.E., Kruse, B.G. (2005). Psychometric Properties of the Serenity Scale: Journal of Hospice and Palliative Nursing, November/December Volume 7, 337-344. Chinn, P.L., Kramer, M.K., (2004). Empiric Knowledge Development: Explaining and Structuring. Yvonne Alexopoulos. Melissa Boyle , Kristin Hebberd (6th Edition), Integrated Knowledge Development in Nursing (pp.54-90). St. Louis, Missouri. Dictionary.com, (2010). An Ask.com Service. Retrieved on January 25th, 2010 from http://dictionary.reference.com Get Palliative Care, (2010). What is Palliative Care. Retrieved on January 25th, 2010 from http://www.getpalliativecare.org/home/ . THE CONCEPT OF SERENITY 2 Incorporating the concept of serenity within nursing practice has been proven to be very beneficial when applied to patient care. The concept of serenity can have different meanings to different people. How one goes about obtaining serenity may vary greatly with each individual. The idea of serenity, of inner peace is desired by many. Nurses can assist patients with obtaining and maintaining this important concept. This paper will identify the concept of serenity...
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...palliative care patients?” Regina Nelson Governors State University Abstract Palliative Care Nurses are at risk of experiencing stressful situations related to symptom management and death. The aim of this paper is to critically examine the current stress nurses face caring for Palliative Care patients. Four Nursing Journals and one Psycho-Oncology were reviewed. There was strong evidence to support that nurse’s experience stress caring for Palliative care patients. Common concerns in the first study were caring for a dying patient; personal level, comfort of the patient, and mediating between patient and family. The second study reported physical and emotional health consequences for nurses who provide hospice and palliative care over extended periods of time. The third study of nursesreported job satisfaction, stressors, coping strategies, and support. The fourth study nurses had 10 themes that conceptualize their work that may enable palliative care workers to remain resilient and effectively buffer or moderate stressful effects. The fifth study reported routinization of care, lack of nursing staff’s availability for emotional engagement, frequent interruptions, quiet afternoons, upbeat and positive culture, and a matter of fact attitude surrounding death and dying ,were all the behaviors that “being with” could not create. Although the report showed nurses able to cope by not “being with” the overall impact is stress related to caring for Palliative care patients. Although...
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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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...Hospice Care Hannae Warren HCS/212 Kristie Racca October 24, 2011 Hospice is a term that is traced back to medieval times; it was a place where tired or sick travelers could find a place of shelter, rest, and care (“History of Hospice Care,” 2010). Since the medieval times hospice care has evolved into a contemporary program that offers patients facing terminal illnesses medical, spiritual, and psychological care. A physician named Dame Cicely Saunders first proposed the thought of specialized care for the terminally ill in 1963, and in 1967 she founded the first modern hospice in a residential suburb of London (“History of Hospice Care,” 2010). This was the beginning of modern day hospice care which provides patients the humane and compassionate care that is beneficial to people that are in their last phases of incurable diseases, so that they may live as much as possible and as comfortably before they pass away (“Hospice Care,” 2011). The Hospice viewpoint is that death is the final stage of life, they support life, and neither rush nor delay death (“Hospice Care, 2011). The ultimate goal of any hospice is to assist patients live their last days on earth as a alert and as pain-free as possible (“Hospice Care,” 2011). Hospice care is helpful when...
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...by providing assisted care if they were wounded or ill. One person was given the title role to become the administer of medicine or the healer of all sick through spirituality (Amitabha Hospice Service Offering Kindness & Clarity, 2000). Death rates for mother and children's were tremendously high, fewer people lived over the age of 40, and most of every resource was devoted to survival. Christianity began to spread in Europe and churches or monasteries which lead to the intake of sick and the disabled. Women who were well off or lost their husbands volunteered to work in the monasteries as care takers. During Medieval times during crusades, travelers discovered places of refuge with the nunneries as well as the monasteries. During the development of medicine and hospitals, the ill patients found treatment at these facilities but as diseases formed and the fear of outbreaks developed family members preferred for the care to take place in the home. The community would then prepare food and provide clothing for the individuals families who were taking care of them. The aftermath of WWII helped healthcare services provide better medicine for the ill which saved a lot of lives. The name hospice originated from the care of the terminally ill patients by Mme Jeanne Garnier and founded The Dames de Calaire in Lyon, France during 1842. Hospice care is an important part of health care usually according to (NHPCO - National Hospice and Palliative Care Organization, 05/1)...
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...type of care will need. Many times a person and their family will turn to hospice care. The meaning of hospice is to provide care to a person who is terminally ill. Hospice does not speed up or postpone death. Hospice is a type of care that provides services to improve the quality of life for the patient and family. Hospice exists in the hope and belief that, through proper care and the encouragement of a caring and sensitive team, patients and their families may be free to achieve some level of mental and spiritual preparation for death that is comfortable to them. The goal is to help keep the person as pain and symptom-free as possible while offering spiritual and supportive counseling to the patient and family members. To receive hospice care, a physician has proclaimed that death can be expected within six months if the disease follows its normal course. This does not indicate that the care can only be provided for six months; hospice can provided the service as long as the person physicians and hospice team certifies that their condition remains life limiting. Hospice care is a family-centered team approach that includes, a doctor, nurse, social worker, counselor, religious leaders, home health aide, trained volunteers and bereavement counselors. They work together focusing on the dying person’s needs. They provide the terminally ill patient comfort, and dignity. Some specific services that are providing as a part of hospice team is palliative care which includes...
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...HOSPICE NETTAH NDUNGU Texas Tech University Health Science Center School of Nursing Hospice Hospice is a comprehensive, medically directed, team oriented program of care that emphasizes pain control and symptom management rather than curative treatment. It directs acceptance of death as a natural part of life and addresses the psychological and spiritual needs of the patient and family. This paper will outline the history of hospice, the effect it has on healthcare today, why it is important to nursing, how nursing is impacted by the availability of hospice services, and finally, what nursing has done to affect change related to hospice. History of Hospice Hospice was first applied to specialized care for dying patients by Dr. Dame Cicely Saunders, who started working with the terminally ill in 1948 (NHCPO, 2015). Dr. Saunders later created the first modern hospice – St. Christopher’s Hospice in a residential suburb in London. Her approach was later introduced to healthcare professionals and chaplains in the U.S in 1963 during a lecture at Yale University. In 1969 Elizabeth Kubler-Ross contributed to the idea of hospice centered care in her book: On Death and Dying which highlighted the five stages of dying and a plea for home care as opposed to treatment in an institutional setting. In 1978, the United States’ Department of Health, Education and Welfare Task Force acknowledged the hospice concept as a means of providing more humane care for America’s terminally...
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...invasive treatment processes. This is when hospice becomes beneficial, the hospice care teams are created to care for and make sure the patient is as comfortable as possible during this scary stage of life as well as making sure the family has wills and counseling in place for themselves if they need it. After further examining hospice care it becomes evident that the involvement of Hospice is beneficial to both patient and family. The term “hospice” can be traced back to medieval times...
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...In this assignment I will be comparing and contrasting the differences between BP and the North London Hospice. These are two extremely different businesses that have completely different aims and ambitions. The first major and obvious contrasts between these two companies are that BP is a limited company whereas the North London Hospice is a charity. BP The brief history of BP BP's businesses are organized to deliver the energy products and services people around the world need right now. BP’s history is full of discoveries, starting in 1908 with oil found in a rugged part of Persia after a long and difficult search. Since then, discoveries large and small have fuelled their progress. Through BP’s two main operating segments, Upstream and Downstream, BP find, develop and produce essential sources of energy, turning them into products that people need. The scale BP work on BP is one of the largest companies worldwide and has total domination in oil and gas industry. BP operate in almost 80 countries, have a staggering 84,600 employees, their economic value is up there with most valuable companies in the world with a worth of $359.8 billion, BP are also operating an outstanding cash flow of £32.8 billion. The endless amounts of statistics that are ‘out of this world’ continue as BP can boast about producing 3.2 million barrels of oil per day and have approximately 17,200 retail sites running worldwide, BP easily have the right to call themselves a world class company that...
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...giving to the fact that African Americans are less likely to pursue hospice care at the end of their lives. This paper will first examine the case for hospice and why it is a valuable resource and one that is consistent with Christian values. Then, I will survey the data regarding African Americans and hospice, particularly looking at considering what the main factors are for the racial disparity of hospice users. I conclude the main factor is distrust for the healthcare system as a result of centuries of medical abuse, experimentation and neglect. In light of this racist healthcare history, I will consider theologically what a Christian response to the racial disparity in hospice care is by using...
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...Hospice Care How much do people know about hospice care and what is involved in it? We research just about every big decision that affects our lives right now. For example we may research what career is best for us and our family, what kind of car best fits our financial needs, what kind of mortgage can we afford over a long period, and more important how is the neighborhood. Research is even conducted on something as small as what is the latest and greatest phone on the market. We spend hours or some times days researching these decisions, but how much time do we spend looking into the last days of our lives? If the average American is like me, they have not done any research about hospice care. My knowledge of hospice care was very limited by personal experience with both of my grandparents. Several years ago both of my grandparents were suffering from terminal illnesses and were placed in a hospice in Los Angeles with only a few months to live. I recall going to visit both of them and remember how poor the facility was. Just like with almost anything involving medical care, you get what you pay for. Neither one of my grandparents were financially at the top of the health care ladder and were both on Medicare like most Americans in their demographic. Hospice care was first established in the United States in 1970 and has become a growing industry since. (Hospice care in the United States, 2011) By 1995, hospices were a $2.8 billion industry with $1...
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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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