The Effects of Hospice Services in the Community - Research Paper Example

 Topic: The Effects of Hospice Services in the Community Introduction: Hospice Services is an all-embracing term from the point of view of health care service seekers and providers. Hospice care can be defined as "a concept of care for patients whose illness no longer responds to aggressive, cure-oriented treatments by providing a comprehensive approach to care of the physical, emotional, social, and spiritual needs of patients and families experiencing life-limiting, progressive illness."(Sherman, 2003) Hospice is a paid service, with the touch of philanthropy, and missionary zeal to serve the patients. It is a medical service, a system that assures physical health and mental peace to the service seeker patient and his family members. Lot of difference exists in taking treatment in the hospital and availing the same at home. “Modern medicine and technology has allowed us to keep people alive beyond their natural dying process, but sometimes at the sacrifice of their dignity, quality of life, and being at home, surrounded by loved ones. Hospice can be there at this time. Hospice does not speed up the dying process. Hospice allows a patient to come to terms with death and the family to accept and grieve. Hospice allows death in the natural course, with family around.”(Hospice….) How does the development of hospice treatment programs benefit the patients, especially those who are terminally ill, and what is their overall impact on the society? Let us first examine the procedural and legal aspect of the hospice services. “Home care and hospice services rendered by nurses are shaped through state statues and have specific nursing requirements for licensure and certification.”(Stanhope 2003, p. 181) But there are many ground level procedural difficulties in implementing the hospice service programs. “Individual rights, such as rights to refuse treatment, and nursing responsibilities, such as the legal duty to render reasonable and prudent care, may appear to be in conflict in delivering home and hospice services.” (p.182) Hospice patients may avail the service as long as their condition demands. This service is ideal for the patients in the last stage of their life. “The development of hospice home care programs has improved the care of terminally ill persons.”(p.964) Sometimes, a stage arrives in the life an individual, even the medical care criteria seems hopeless due to practical considerations. One develops aversion to aggressive, active treatment disciplines. The treatment is no longer effective and the pressure of side-effects is mounting. Visiting the consultancy rooms and emergency wards of the hospital turns out to be tire-some. The patient just wants the quiet company of the family members and would like to spend the time peacefully away from the strict hospital discipline and regulated food prescriptions. The patient has readied his mind to meet the demand s of the nature. The patient wishes to be with the near and dear ones, and everything else are subservient to him. Where hospice service is provided? Hospice is not a place; it is a service. It comes to the family; it is a door-step service. Hospice service is sometimes hired for 24 hours. Apart from providing service actively, during the period which it is hired for, the family members get an opportunity to learn the salient features of its components, which can be carried out by a medically untrained individual without any prescribed medical qualifications. Who provides the care? The patient’s doctor continues to head the hospice team. He is the primary physician. A hospice nurse is the one who manages and oversees patient’s active care. Generally a nurse is available “on-call” basis, anytime during the day/night unless one is engaged for fixed hours during the day/night. “The hospice nurses need a firm foundation in home care skills, knowledge of community resources, and the ability to function constructively as a team member.”(p.976) It is a complete package. The Home Health Aide gives the helping hand to bathe the patient, and take care of patient’s personal needs. The hospice social worker looks after the needs of the caregiver, and makes alternative placements when needed or pre-programmed rotation understands the family dynamics and helps in closure of the services. The hospice Chaplin gives spiritual support in case of bereavement and the hospice Volunteers are there to take care of the miscellany as per the demand of the situation. The bereavement team can be contacted up to 13 months after the death of the patient. How this service is given? Generally, a doctor’s order/recommendation is needed to sign on to hospice. Most insurances cover hospice. It is also covered by Medicare and Medi-Cal.“The hospice reimbursement benefit is optional for the Medicare-eligible client. Hospices may bill for the skilled home care services under regular Medicare Part A benefits if the client does not want to use the hospice benefit. Responding to the perceived cost benefit potential of hospice care and public demand for caring services during end of life, third-party payers are following Medicare’s lead in providing hospice service option.”(p.981) For death and the dying: “Dr Elisabeth Kübler-Ross pioneered methods in the support and counseling of personal trauma, grief and grieving, associated with death and dying. She also dramatically improved the understanding and practices in relation to bereavement and hospice care. Her ideas, notably the five stages of grief model (denial, anger, bargaining, depression, acceptance), are also transferable to personal change and emotional upset resulting from factors other than death and dying.” (Elizabeth….)Death and dying are the ultimate forms of trauma (in fact the one who dies has no trauma at all!) for the affected family. The emotional shock also depends upon the nature of death. The psychological strength of the individual matters much. Elizabeth Kubler Ross Grief Cycle model helps one to understand different types of challenges one has to face at some stage of life. The study of death and dying is known as thanatology and one who practices in this area is known as thanatologist. Conclusion: Hospice care is similar to palliative care. The physical, emotional, social and spiritual needs of the patients and members of the family are taken care of. The need for this type care arises with the experience of life-limiting and progressive illnesses. The essential difference between palliative care and hospice care is—the later begins when the patient has a prognosis of less than 6 months. But this may vary according to the healthcare systems in different countries. The first hospice in the United States was established in New Haven, CT, in 1974 by Florence Wald, dean of the School of Nursing at Yale University in New Haven. Initially, in the early 1970s, the face of the hospice was philanthropic. Hospice programs were initiated by volunteers and healthcare professionals who spared their time on honorary basis. The recognition to hospice services as a Medicare beneficiary was given in 1982, in United States. In the year 2002 there were about 2500 hospice programs in the United States, serving about 400,000 people annually. *********** References: Elizabeth Kubler Ross Grief Cycle model, five stages of grief in... Retrieved on June 2, 2010 Hospice Services Retrieved on June 2, 2010 Sherman DW, Matzo LM, Panke J, et al. End-of-life nursing education consortium curriculum: an introduction to palliative care. Nurse Educ. 2003;28(3):111-120. [Context Link] Stanhope, Marcia (Author) Lancaster, Jeanette (Author).Community and Public Health Nursing: Mosby; 6 edition, October 29, 2003. Read More