...The aim of this essay is to explore an aspect of care that a client group receives whilst in the community setting. The chosen aspect of care will be palliative care delivered to those patients who have been told they have a non-curative illness but are not yet at the end of life. The stage of the illness of the client group chosen is one where the patient is managed at home because there as there is nothing anyone can do to make things better (Calman-Hine Report 1998). The essay will also briefly describe three different professional groups involved in providing palliative care. It will then go on to discuss how good communication and collaborative working between these professional can provide the best quality of care of the patient and how poor communication can compromise the patients quality of care. Palliative care can be defined as the overall care of patients whose disease does not respond to curative treatment. The aim of Palliative care is to improve as much as possible the quality of life of patients and their families facing a life-threatening illness. This can be achieved by providing pain and symptom relief, spiritual and psychosocial support from diagnosis to bereavement (WHO 2002). Patients with life threatening illness may require care from a variety of different specialists and services at a number of points in their illness; this will include both statutory and non-statutory organisations (National Health Service Executive 1998). To ensure that all...
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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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...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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...According to the Centers for Disease Control and Prevention, most people say they would prefer to die at home, yet only about one-third of adults have an advance directive expressing their wishes for end-of-life care. Among those 60 and older, that number rises to about half of older adults completing a directive. The last 20 years have seen a significant shift in location of death from the community to hospitals and care homes. Those aged over 85 years account for the biggest rise in hospital and care-home deaths. Barriers to advance care planning include, • Lack of awareness: While advance directives are supported by state laws, there is still no clear process to allow an individual’s wishes to be known and ensure that care is tied to those documents. • Denial: A key part of the problem is our society’s denial of death and dying, and of being in a circumstance in which we are unable to make our own decisions and speak for ourselves • Confusion: Concern that emphasizing palliative and end-of-life care options could interfere with doing whatever it takes to help patients extend their lives as long as possible. • Cultural Differences: The majority of Medicare beneficiaries of all racial and ethnic groups say that in the event of a terminal illness with less than a year to live, they would want to die at home and would not want to receive life-prolonging drugs with uncomfortable side effects or mechanical ventilation to extend their life for a week or a month Among community-dwelling...
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...Current Business Research Project RESEARCH AND EVALUATION Current Business Research Project Reporting Characteristics of Cancer Pain: A Systematic Review and Quantitative Analysis of Research Publications in Palliative Care Journals by Senthil P. Kumar used descriptive methods of research to discover the number of research journals of the pain experienced in cancer patients toward the end of life. The research delved into the end-of-life care journals published from 19 facilities from 2009 – 2010 (Kumar, 2011). The study involved finding the percentage of research journals for end-of- life cancer patients’ pain in comparison to actual number of research findings. The data collection methods involved a search of Journals that had terms such as hospice, end-of-life, supportive, and palliative in the titles (Kumar, 2011). A total of 19 journals included in the study, which had a total of 2600 articles researched in the study. The studies uncovered articles concerning cancer pain, of which most were categorized into ‘original articles’ and ‘review articles’. Original articles were separated to studies of quality and also of quantity. Quantitative studies were grouped according to the study designs. Once the findings of the number of articles study designs were computed, the total number of journals pertaining to end-of-life pain of cancer patients was determined. Later categorization of articles were sort into groups such as those related mostly to...
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...to mark the occasion of World Hospice and Palliative Care Day. The rally consisted of the president of Ashic Foundation Salma Choudhury, AVC volunteers, who are students from various universities and schools, and the parents of the children present in the Foundation. The rally started from the Ashic Palliative Care Unit (PCU) in Dhanmondi 3/A and went up to City College. Again, the rally began from Dhaka National Museum and continued all the way across University of Dhaka to the Press Club where members from the Bangladesh Cancer Society joined in the event. AVC achieved its purposes of creating a human chain and rallying on the streets on that very day. AVC wanted to share its vision of increasing the availability of hospice and palliative care throughout Bangladesh by creating opportunities to speak out about the issues involved. The second aim was to raise awareness and understanding of the needs – medical, social, practical, spiritual – of disease-stricken people and their families. The third was to raise funds to support the cause. While the rally was on, many took interest and AVC volunteers exchanged meaning conversations with countless people – stating the dire importance of better hospice and palliative care in Bangladesh, demonstrating how every single person can be of great help by contributing even little, giving away informative leaflets, etc. This rally was a motif to celebrate and support hospice and palliative care in Bangladesh. For the AVC, although everyday...
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...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, 2012). They are...
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...The primary aim of my assignment is to look at the issue of end of life care in dialysis satellite units, as these areas tend to be nurse led units. My interest in palliative and end of life care has arisen from the growing number of poorly patients we continue to dialyse, this has proved distressing especially for the patient, who often has unmanaged symptoms and for their families, it is also upsetting for the staff involved in their care, as it is felt nobody is acting as the patients’ advocate and helping the decision to facilitate the withdrawal of what is now an ineffective and unnecessary treatment. One of the latest developments by the Government and Department of health is the concept of Advance Care Planning. I have looked at this from various perspectives and would like to be involved in introducing the process to Sheffield Kidney Institute. In 2004, the number of patients receiving renal replacement therapy in England, Scotland and Wales was 33,511, this figure is sourced from data which has been made available to them from participating renal units throughout the country, the number of patients receiving dialysis since 2000 has risen by 7% (Ansell et al 2005) with it projected to rise by a further 10 percent over the next 5 years (Ansell et al 2005). About 15-29 percent of deaths of patients with end stage renal disease results from a decision to discontinue dialysis (Davison 2006). Importantly we need to explore which patients especially those reaching...
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...end of life care, they and their families are faced with difficult choices. During this time it is important to have a support system. In the case study Janelle decided against medical treatment and relied on her religious belief. Therefore it is necessary to use her personal strengths in interventions and to empower her when intervening. Her self-determination towards treatment should be respected, According to (NASW 2008), Social workers respect and promote the right of clients to self- determination and assist clients in their efforts to identify and clarify their goals. As social workers we will advocate Janelle’s position not to seek treatment to the other members of the interdisciplinary team; in doing so we will explore ways to decrease the tension between her and the other members. Janelle has a strong religious belief that she will be healed. As members of her interdisplinary team we will education her family on the pros and cons of relying on spirituality only for healing. We will communicate with Janelle by being open and honest in planning and assessing care for her and her family. Woodhouse (2011) suggested that effective communication has the potential to engender a therapeutic environment and relationship. Good communication skills are vital for spiritual carers in supporting patients, families, and the multidisciplinary team in dealing with issues such as denial and confusion. According to Amoah (2011), Spirituality is central to palliative care implies that...
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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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...Services Summary Paper Hospice Care Description of the Organization Care 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. Aggressive methods of pain control may be used. Hospice programs generally are home-based, but they sometimes provide services away from home in freestanding facilities, in nursing homes, or within hospitals. The philosophy of hospice is to provide support for the patient's emotional, social, and spiritual needs as well as medical symptoms as part of treating the whole person. Hospice programs generally use a multidisciplinary team approach, including the services of a nurse, doctor, social worker and clergy in providing care. Additional services provided include drugs to control pain and manage other symptoms; physical, occupational, and speech therapy; medical supplies and equipment; medical social services; dietary and other counseling; continuous home care at times of crisis; and bereavement services. Although hospice care does not aim for cure of the terminal illness, it may treat potentially curable conditions such as pneumonia and bladder infections, with brief hospital stays if necessary. Hospice programs also offer respite care workers, people who are usually trained volunteers, who take over the patient's care so that the family or other primary...
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...Three major categories of institutional medical care * Hospital are devoted mainly to acute intensive care of a limited duration. * Nursing homes provide long-term residential care for people who are chronically ill and those whose illness does not require acute, intensive care. * Hospice care is distinguished by its orientation toward the needs of dying patients and their families Rationing-refers to the allocation of scarce resources among competing individuals. In health care it is defined as any system that limits the amount of health care a person can receive. Paternalism- the assumption of parent like authority by medical practitioners, is seen as infringing on a patient’s autonomy or freedom to make medical decisions. Covenantal relationship- which implies a mutuality of interest between provider and patients. Eight principles that are important when delivering bad news 1. Keep it simple 2. Ask yourself, “What does this diagnosis mean to the patient?” 3. Meet on “cool ground” first. Get to know a patient prior to presenting the news. 4. Wait for questions. 5. Do not argue with denial. 6. Ask questions yourself. 7. Do not destroy all hope. 8. Do not say anything that is untrue. Strategies that either curtail or encourage conversation when speaking of death by a caregiver * Reassurance * Denial * Changing the subject * Fatalism * Discussion “Whole person care”- caring for seriously ill and dying patients...
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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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...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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...STUDY GUIDE for C475 Care of Older Adult Objective Assessment Exam questions are taken from the Learning Objectives under the 9 Competencies: #1 Competency 742.1.1: Compassionate and Respectful Care of Older Adults The graduate integrates principles of compassion and respect for patients and their families into the planning and delivery of care to a diverse population of older adults and into advocacy for vulnerable older adults. This topic addresses the following learning objectives: * Recognize the impact of attitudes, values, and expectations about aging. * Describe how the RN’s personal beliefs and values may impact the care of older adults. * Articulate the concept of individualized care as the standard of practice with older adults, considering the right care, at the right time, in the right place and by the right provider of care. * Define Baby Boomers (those born from 1946–1964) reach retirement age (as of 2011) A large group of people born between 1946 and 1964, in the time after the Second World War. * What are the five racial groups listed in your text? African American, American Indian/Alaskan Native, Native Hawaiian/Pacific Islander/Asian, Hispanic, White * How would you perform discharge teaching to an Hispanic patient Teach the family as well because more than likely, pt is going home and family is his/her primary caregivers. * Apply effective and respectful communication strategies in the care of older adults and their...
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