...Hospice care The term was from the medieval times when it referred to a place of shelter and rest for weary or ill travelers on a long journey. The name was first applied to specialized care for dying patients by physician Dame Cicely Saunders, who began her work with the terminally ill in 1948 and eventually went on to create the first modern hospice—St. Christopher’s Hospice—in a residential suburb of London. Sanders idea of specialized care for the dying to the United States during a 1963 visit with Yale University brought on the thought of helping the ones that couldn’t help them self and more and day were limited. To help them go in peace. It been an ongoing thing since the 1963 and still used to day Hospice is a type of care and a philosophy of care that focuses on the palliation of a terminally ill or seriously ill patient's symptoms. These symptoms can be physical, emotional, or psychosocial in nature. Hospice care focuses on bringing comfort, self-respect, and tranquility to people in the final years of life. Patients’ symptoms and pain are controlled, goals of care are discussed and emotional needs are supported. Hospice believes that the end of life is not a medical experience, it is a human experience that benefits from expert medical and holistic support that hospice offers. The concept of hospice has been evolving since the 11th century. Then, and for centuries thereafter, hospices were places of hospitality for the sick, wounded, or dying, as well as those...
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...are better prepared to handle the death of loved ones. In our society, we tend to shy away from thinking about death. The terminally ill generally die in institutions (hospitals and nursing homes), away from their homes. Therefore, we are seldom exposed to people dying. Many people in our society seek to avoid thinking about death. They avoid going to funerals and avoid conversations about death. Many people live as if they believe they will live indefinitely. Fortunately, the hospice movement has been developing in recent years in an attempt to foster death with dignity. A hospice is a program that is designed to allow the terminally ill to die with dignity—to live their final weeks in a way they want. Hospices originated in the Middle Ages among European religious groups that welcomed travelers who were sick, tired, or hungry (Sullivan et al., 1980). Hospices serve patients in a variety of settings—in hospitals, in nursing homes, in assisted-living facilities, and in the dying person’s home. Hospices provide both medical and social services, Children should not be sheltered from death. Funerals help children learn that death is a natural process. Taboos against talking about death and dying need to be broken in our society. You may find that tactfully initiating discussions about death and dying with friends and relatives will be helpful to you, and to people close to...
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...Hospice Care The hospice care movement was born out of the concern for doing something for terminally ill and dying patients. Once medical care services for our terminally ill patients were no longer of benefit and our physicians could do no more, we had to turn to another source of care. One of the main objectives of the medical staff is to prolong life at all costs. When the medical staff no longer has the upper hand or mastery over disease and death, that’s when alternative care, such as hospice care can be provided. The hospice practice as it is today and as it was in the past focused on the control of pain for the terminally ill. Hospice care not only manages pain control but it also focuses on the physical, psychological, social and spiritual needs of the patient and their families. Hospice care focuses on reducing high hospital cost for the terminally ill too. Once the hospice care movement was accepted into our society, society was ready to talk about death and dying and caring for terminally ill patients. Our society was ready to support the hospice care movement in whatever way thy could. Committees were formed to discuss how to treat the terminally ill. This committee wanted to get involved. The community got involved as well as some of the other health care systems. Some of the health care systems wanted to develop hospice care at their facilities. Helping our terminally ill patients through the hospice care movement began to spread. Hope...
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...Hospice Care Hospice Care Hospice is a medical organization that helps care for patients who are near the end of life from a terminal illness. This is a group of professional health care workers that are there to take care of the patient and the patient’s family. They work as a team to make sure these patients have as less pain and problems dealing with the end of life as possible. They provide the family of the patient with the knowledge of how the dying process works. They will inform the patient and family stage by stage of what is happening. They will let the family members know the details of the sounds a person may make when the process begins so the family is well aware of what is going to happen. Although hospice helps the family deal with the loose of the patient, hospice caregiver’s main focus is to make the patient feel comfortable, by easing any discomfort possible during the process of dying. They also help the patient pass with as much dignity as possible. Hospice can start caring for a patient as early as six months, the physician of the patient has to recommend for services to be start. A patient may be on hospice for as little as a few days, no matter the length the services and care given is always important for the patient and family. Most of the patients on hospice are older, however hospice services will be provided to any patient in their final stages of life young, middle age or old. Many patients dealing with the final stages of their illness receive...
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...The roots of hospice care began in the 1960s as a benevolent movement to provide dying patients more time with their families in a dignified manner. The hospice industry is now a fourteen-billion-dollar industry, run primarily by for profit industries. Hospice facilities play a crucial role in delivering palliative services to patients and their families. In the United States, about half of all deaths happen in a hospice program. When a patient is certified by their primary care physician and a hospice medical physician that they are terminally ill and has six months or less to live, they are then qualified to receive hospice benefits. Hospice care encompasses nursing, home health aide, social worker, and counseling services; most hospice care is provided in the home setting. As part of the health care industry, hospices are also subject to negligence cases. Negligent tort cases can arise when there is an “unintentional failure to live up to accepted standards of behaviors”. The four key elements to any negligence case are duty of care, breach of duty, harm, and causation. A legal study of various hospice negligence cases will be conducted to...
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...Hospice Care LaToya L. Howard HCS/212 January 1, 2013 Denise Brown I first heard about hospice from a co-worker a few years ago when that co-worker was preparing to check her mother in hospice and she was in her forties. As she discussed with me her mother had a drug addiction problem her entire life. At that time I had never heard about hospice and I became interested in learning more about it. “Hospice is a special concept of care designed to provide comfort and support to patients and their families. Patients are referred to hospice when life expectancy is approximately six months or less. Hospice care can continue longer than six months if needed but requires physician certification” (Kinzbrunner, BM, 2002, p. 29-45). As I researched on the internet I found out during the 1960’s, Dr. Cicely Saunders began the modern hospice movement by establishing St. Christopher’s Hospice near London Street. According to Saunders (1975), the word “hospice” originated from the Latin word “hospitium” which means guesthouse. It was originally used to describe a place of shelter for sick travelers returning from religious pilgrimages. In addition to this information there have been more than 4,700 hospice programs in the United States. As I learned from my previous co-worker hospice care is there to make the patient’s life more comfortable as they prepare for their end of life and to provide support...
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...and we should obey this as we would not be here if it was not for God. Exodus 20:13 says “you shall not commit murder” It is wrong to take away the sacred gift of human life, killing is always wrong. The Roman Catholic Church believes that there are other ways of dying in peace instead of voluntary euthanasia. They understand that dying can be a frightening and a hard time for a lot of people but there are better alternatives to euthanasia; this is where the hospice movement is introduced. If the patient chooses palliative care instead of euthanasia then the hospice can provide a peaceful death for them. They will give them all the facilities and emotional facilities that are needed to relieve the patient in their final months. In this way they able to die without pain and also with dignity. They will not have to go to a whole other country so that someone can kill them. If the patient goes to a hospice, in their last days they don’t have to do anything and they can be surrounded by the people they love. By going to a hospice it shows God that you respect him and go at the time he...
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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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...Hospice and Attitudes toward Death Unitie Mance Soc 304: Social Gerontology Kristin Bachman February 27, 2012 A dying man needs to die, as a sleepy man needs to sleep, and there comes a time when it is wrong, as well as useless, to resist. Stewart Alsop Death, dying and bereavement finds a way of impacting everyday living. Images of real or fictional death are often while watching television or movies. Death can impact people on a personal and a cultural level. This essay will entail how cultural attitudes toward dying, death, and bereavement have changed. While examining hospice, the care obtained, and its role in this shift. Cultural attitudes toward dying, death, and bereavement have changed. There are enormous variations across societies and over time in attitudes toward death. Some societies engage in death avoidance while others celebrate the communion between the living and the dead. In the United States there has been an immense change in the process of dying from past centuries to the present. “This change is partly due to a shift in the average age of death and the association of dying with old age” (Aubrey, 2007). It is also caused by a change in the causes of death. At one time most people died from critical illnesses that struck quickly. Now people are more likely to die from a chronic illness that leads to a slow death. The setting for death has also changed. Most deaths in the past occurred in the home. Now death typically takes place in a medical setting...
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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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...Running head: CANCER PAIN MANAGEMENT 1 Cancer Pain Management Lavon R. Williams University of South Alabama Running head: CANCER PAIN MANAGEMENT Cancer Pain Management Cancer is rapidly becoming a chronic illness, and an estimated that 10 million individuals in the United States are survivors of cancer (Sun, Borneman, Piper, Koczywas, & Ferrell, 2008). According to 2008, cancer statistics from the American Cancer Society, about 2 565,650 people die in the United States from cancer every year. Approximately 1.6 million new cases of cancer are expected to be diagnosed in the United States this year (American Cancer Society, 2012). This is why the health care needs of cancer patients are unique, and many are at risk for developing late or long-term side effects and pain from their primary treatments. These long-term effects may also hinder optimal physical, psychological, and cognitive functioning for patients (Sun et al., 2008). Pain is experienced by 30% to 50% of cancer patients receiving treatment and by 70% to 90% of patients with metastatic or advanced disease. In almost every cancer-related case pain is inadequately managed due to a lack of patient and professional knowledge of optimum management (Sun et al., 2008). This paper will discuss how nurses can help provide adequate pain management in advanced cancer patients. Patient and family needs Support for the patient and family may include education and information, coping skills, counseling and psychotherapy...
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...安寧緩和療護的道德研究與探討 中華民國一○一年六月 壹、摘要 本論文的寫作目的，主要是要探討安寧緩和療護的存在所引起道德方面上的爭議。雖然安寧病房之所以會存在，是不想讓那些得了絕症或治療過程極其痛苦的病患繼續受苦，因而放棄治療，讓他們能夠儘可能安詳的走完最後一程；但是從另一個觀點來看，安寧照護也可以被視為消極的間接殺人；若病人無法接受臨終事實，但醫護人員及家屬共同決定不告知臨終事實，依社會工作「案主自決」原則，顯有違專業倫理；當病患意願與醫療理性相左時，如何進行溝通等諸如此類議題，正相繼衝擊安寧緩和醫療團隊、臨終為不可逆事件，即使病人不願或不肯接受實情，但知的權利仍不應輕言剝奪；醫護人員及家屬應如何協商，讓病患有機會參與重大決策，不致覺得只能自己孤獨面對死亡？這些情形非常值得我們探討。 貳、何謂安寧緩和療護 根據世界衛生組織（WHO）的規範，安寧緩和醫療照顧提供罹患無法治癒疾病的病人，積極性的全方位照顧。緩和醫療照顧是肯定生命，視死亡為自然的過程，不提早也不延後死亡，積極提供疼痛及其他窘迫症狀的緩解，提供支持系統，幫助病人盡可能提升生命品質，幫助家人度過病人生病與其身後期間所遭遇的種種壓力。 叄、安寧療護的目的 安寧療護服務的目的是為生命走到末期病患及家屬提供專業團隊服務，經由完整的身、心、靈之關懷與醫療，減輕末期病患的身體疼痛、不適應症及心理壓力，對病患及家屬提供心靈扶持，輔導其接受臨終事實，陪伴病患安詳走完人生最後一程，協助家屬面對病患死亡，達到生死兩相安的境界。 安寧療護以維護末期病人的生活品質和尊嚴為主，大林慈院家醫科陳世琦醫師透露了一般醫院在診療時常常只著重結果，但是卻忽略了病人的感受。「從參與安寧療護以來，一直在學習，也深受感動。」大林慈院家醫科林名男主任表示，希望提供的安寧療護，能夠盡力改善病人的生活品質，讓病人了無遺憾地往生，而家屬也能安心。 「不是放棄，而是勇敢面對生命不可逆的進程。」長期在花蓮慈院心蓮病房服務的家醫科謝至鎠醫師，在花蓮慈院海報展上也說明了安寧療護的重要性，過去進「安寧病房」往往被誤解為「等死」，但事實上，安寧療護是藉由藥物的使用、芳香療法、中西醫照護、藝術治療等方式，用心傾聽患者的心聲，尊重每一個生命，不延長也不縮短患者的生命，讓病人在臨終的過程中帶著尊嚴。 肆、安寧照顧的重要措施 安寧照顧主要對象是末期病人，在國內僅用於癌末病人的使用； 在國外除了癌末患者之外，還包括了愛滋病的病人。這些病人除了 要面對死亡的問題之外，還必須面對身心痛苦的問題。這些問題安 寧照顧又是如何來解決。我們由前述緩和照護的定義，提供了六種措施來解決末期病人的各種問題。 (一)舒適的照護 現代醫療體糸中，無論是在手術、診斷及急救等，皆是重視病情的治癒或延續病人的生命。癌症患者在初期時，有些可以藉著手術及放射性治療而痊癒。但是，病患到了末期時，癌細胞轉移其他部位，不管醫護人員用多先進的醫療技術，也是沒辦法讓病人復原。所以對醫護人員來說容易產生極大的挫折感，而這些絕症的病人，很容易是被放棄的一群。當醫療對末期病人無效時，並不代表對他們的關懷也無效。安寧照顧重視對病人的關心及照顧，強調以照護（care）為主，並且是舒適的照護。另外，安寧照顧在硬體上有舒適的設備，備有洗澡機、休閒室、陽光室、祈禱室、佛堂、咖啡廳、意樂治療室及兒童遊樂區等設施。裏面的設備盡可能不讓病人有住在醫院的感覺，而讓病人感受像居家的環境。在軟體的設備中，安寧照顧有醫療團隊...
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...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). Dame Cicely Saunders continued the hospice care services as she began her duties and established a hospice named St. Christopher's in the suburban...
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...Hospice care The main goal of hospice care is to aid patients to live their last days as alert and pain-free as possible. Hospice care attempts to manage symptoms so that the person's last days may be spent with dignity and a good quality of life. Hospice care treats the person rather than the underlying disease; it focuses on quality of life rather than length. Hospice care is family oriented; it includes the patient and the family in the care and decision making. The care is planned to cover all 24 hours of a day, and all 7 days of the week. Care is given in the home, a hospital, nursing home, or hospice facility. Hospice care is what we resort to when the patient can no longer be helped by a curative approach, and the patient is expected to live less than 6 months. Hospice is palliative care, which means that the approach is to relieve symptoms, but not to cure the disease; its main purpose is the improvement of the patient’s quality of life. The patient, his/her family and the physician decider when hospice care should begin. Hospice care is managed by an interdisciplinary care team. What it means is that the different disciplines interact and work together towards a common goal. Doctors, nurses, CNA’s, social workers, therapists, and volunteers work together to care for the patient and his/her family. All of these people offer their support based on their individual special areas. Together, they give the patient and their loved ones complete palliative care aimed...
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...Death is one of the most frightening and confusing times a person can go through. Watching a loved one pass away is also one of the hardest trials a person can experience. Many people assume that death is a time of pain and the only thing that they can do is mourn and watch their loved one fade away. But there are programs out there to help not just the dying person but also the families of the dying person. Palliative care and Hospice care are two of the programs in the U.S that are tailored to medical care, pain management, and emotional and spiritual support for the patient and family. At the center of hospice and palliative care is the belief that each of us has the right to die pain-free and with dignity, and that our families will receive the necessary support to allow us to do so. Palliative care focuses on relieving symptoms that are related to chronic illnesses, such as cancer, cardiac disease, respiratory disease, kidney failure, Alzheimer’s and other dementias, AIDS, Amyotrophic Lateral Sclerosis and other neurological diseases. World Health Organization defines Palliative care as “improving the quality of life of patients and families who face life-threatening illness, by providing pain and symptom relief, spiritual and psychosocial support to from diagnosis to the end of life and bereavement” (“WHO”, 2013). Palliative care is accessed at any point during the course of a chronic illness regardless of life expectancy. It is typically provided through regular physician...
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