" Noted as a serious challenge that is faced by hospice practitioners is that associated with "the legal option of choosing death." (Miller, 2007) Miller additionally reports: "A lethal dose of medication can be obtained (within guidelines) by a terminally ill person in Oregon in order to hasten death. Hospice providers across all disciplines have found that this choice has posed a serious challenge to the underpinnings of their work." (2007) Miller reports a study in which the data "...are based on interviews with interdisciplinary hospice providers from eastern and western regions of the U.S. A total of 12 hospices were visited and 60 hospice professionals engaged in a semi-structured interview. The responses to six open-ended questions were taped and then transcribed. Both the construction of the interview instrument and analysis of the transcriptions were extensions of the constant comparative method of analysis. The themes were conceptualized by the statements made during the interviews about the hospice philosophy and its relation to hastened death" (2007)
Miller reports results as follows: "Three interconnected themes emerged from 60 hospice providers: 1) whether hospice can provide sufficient comfort to eliminate requests for a hastened death; 2) whether an inherent value of life should preclude choice; and 3) if an individual's freedom of choice should preclude the value of life. The responses of the social workers to hastened death within the hospice philosophy were also examined as a subset of the larger data set. The three themes for this group were: 1) the challenges to the role of the social worker within the hospice philosophy when a person chooses to die; 2) how hastened death modified practice principles and professional values; and 3) the emergence of personal struggles with the choice. Implications: The voices represented here are unique in that they are open and free to discuss the dilemmas and challenges that a hastened death poses to hospice care. Co-workers thoughts and feelings differed from one another and also with the official policies of their workplaces, pointing to perceived conflict among hospice providers. Social workers in particular found challenges within their role, their practice principles, and their personal reactions when a terminal person chooses to die. The hospice philosophy of 30 years, coupled with the apparent desire of some U.S. citizens to control the time of their death, may drive interdisciplinary adaptation to care of the dying." (Miller, 2007)
VI. HOSPICE CARE in SANTA CRUZ COUNTY CALIFORNIA
Hospice Care in Santa Cruz County, California information is listed as follows
Hospice Caring Project of Santa Cruz County
940 Disc Drive
Scotts Valley, CA 95066-4544
Fax:
Website: www.hospicesantacruz.org
Hospice care, according to the Santa Cruz County, California website is stated to include the following:
nurse visits regularly to check on the patient and teach the family how to manage the patient's care between visits home health aide provides personal care medical social worker helps with caregiving and planning and offers emotional support to the whole family chaplain is available for spiritual support for the patient and family trained volunteer can help with more practical needs, such as transportation, errands, and companionship
Grief support staff and volunteers provide group and individual support for families for 13 months after the patient's death
Hospice is stated to characterized by the following:
The ability to stay at home or in a nursing home, surrounded by the people and things they love most
Pain and other symptom management so a patient can spend each day in comfort...
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Medical procedures, like chemotherapy and radiation, are frequently used to alleviate pain and symptoms and for cure. Intravenous medications tackle pain but are also costlier than other forms. The appearance of new and costlier drugs blurs the fine line between life-saving and mere comfort-giving. Chemotherapy can shrink a tumor to allow swallowing and radiation can ease or reduce pain. If the hospice is not well financed, one or two
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