Hospice nursing can be difficult. Many times nurses transitioning into hospice care face struggles they would not encounter in other specialties. However there is a level of recognition involved in hospice care as it necessitates better care of patients and a stronger connection to the job and self. Many nurses working in hospices have detailed their work experiences in reflective essays and even journal articles. "Chapter members are nominated by peers in recognition of their contribution to oncology nursing and to ONS, both locally and nationally. The timing of the award prompted me to reflect on my nursing values and the steps that led me to where I am today" (Thompson, 2013, p. 673). This essay will include the experience of one community health nurse by the name of osalind and her struggles and triumphs in hospice nursing.
esearch has gone into hospice care and community SPCs. An article by Levin,…...
mlaReferences
Levin, P.F., Swider, S.M., Breakwell, S., Cowell, J.M., & Reising, V. (2013). Embracing a Competency-Based Specialty Curriculum for Community-Based Nursing Roles. Public Health Nursing, 30(6), 557.
Luckett, T., Davidson, P.M., Lam, L., Phillips, J., Currow, D.C., & Agar, M. (2013). Do Community Specialist Palliative Care Services That Provide Home Nursing Increase Rates of Home Death for People With Life-Limiting Illnesses? A Systematic Review and Meta-Analysis of Comparative Studies. Journal of Pain and Symptom Management, 45(2), 279.
Meier, D.E. (2011). Increased Access to Palliative Care and Hospice Services: Opportunities to Improve Value in Health Care. Milbank Quarterly, 89(3), 343.
Rosser, M., & King, L. (2003). Transition experiences of qualified nurses moving into hospice nursing. Journal of Advanced Nursing, 43(2), 206. doi:10.1046/j.1365-2648.2003.02695.x
Kubler-oss became an advocate of the hospice concept, and testified before Congress in 1972, where she advocated patient care at home for those with terminal illnesses. This helped lend support to the growing call for hospice care in America. After her testimony, hospice legislation was introduced in Congress in 1974, but it did not pass. It did however, bring the idea to light, and the movement began to spread across the country.
The first American hospice was Hospice of Connecticut, which opened in 1973. It began as strictly a home-care program that provided visiting nurses to help care for terminally ill patients in their own homes. Many early home-care hospice units, like the Hospice of Connecticut, turned into full-fledged freestanding facilities that could take care of dozens of patients in their facilities at once, but they still offered home-care alternatives for patients, as well. As the hospice concept has developed,…...
mlaReferences
Editors. "History of Hospice Care." National Hospice and Palliative Care Organization. 2008. 14 March 2008. http://www.nhpco.org/i4a/pages/index.cfm?pageid=3285
Munley, Anne. The Hospice Alternative: A New Context for Death and Dying. New York: Basic Books, 1983.
What Is Hospice Care?." The Hastings Center Report 33.2 (2003): 6+.
Government Regulations and Hospice
Government Regulations Affecting Health Care in Hospice
Hospice
Regulations Affecting Health Care in Hospice
Impact of rules on Hospice services
Annotated Bibliography
This paper focuses on how government regulations impact hospice. The paper starts off with an introduction to the hospice system that was revived by a nurse, Cecily Saunders, who then went on to become a physician, establishing one of the first modern hospices. The concept of total pain is explained in some detail. The body of the paper then includes the studies that have been conducted on patients and caregivers in hospice systems as well as on people who died after they were diagnosed with terminal illness resulting in death in six months following the prognosis. The overall conclusion that can be drawn here is that while in Japan there is a marked need for improving the Day hospice system, the American hospice industry is acting as a mature competing…...
mlaWorks Cited
American Medical Directors Association. (n.d.). White Paper on Palliative Care And Hospice In Long-Term Care. Retrieved March 10, 2012, from American Medical Directors Association: http://www.amda.com/governance/whitepapers/palliative_care.cfm
Carlson, M.D., Morrison, R.S., Holford, T.R., & Bradley, E.H. (2007). Hospice Care: What Services Do Patients and Their Families Receive? Health Services Research, 42(4), 1672-1690.
Centers for Medicare & Medicaid Services. (2008). Medicare and Medicaid Programs: Hospice Conditions of Participation; Final Rule. Federal Register, 73(109), 32088-32220.
Christakis, N.A., & Escarce, J. j. (1996). Survival of Medicare patients after enrollment In hospice programs . The New England Journal of Medicine, 172-179.
health care system has focused on the prevention and cure of disease and illness. When people got sick, every bit of energy and finances went into trying to figure out how to stop it. This was true even when the patient had a disorder or a disease that was deemed incurable. For many years when someone got a disease in which there was no cure, it did not change the method of treatment. The medical community, the family and the patient continued to try every possible avenue to stop the progress. Often times the patient would submit to painful and disorienting treatments, because they didn't want to disappoint their family members or their doctors. At the same time the medical community was expanding the length of life so that many people were living longer than ever before. These two things began to clash. At what point do people stop…...
mlaReferences
Public health system suffers from chronic underfunding http://home.aigonline.com/content/0,1109,16263-694-ceo,00.html
NEWS FROM AROUND AFRICA http://www.hospicecare.com/Newsletters/july2003/page8.html
Healthcare & Medical Market in Morocco http://www.tradepartners.gov.uk/healthcare/morocco/profile/overview.shtml
What is Hospice? http://www.hospicefoundation.org/what_is/
Community Dementia Care and the Chronic Care Model
nd-Stage Dementia valuation Proposal
Health Promotion Plan for Community nd-Stage Dementia Care: The Chronic Care Model
Health Promotion Plan for Community nd-Stage Dementia Care: The Chronic Care Model.
In 2013 an estimated 5.0 million Americans over the age of 65 suffered from Alzheimer's disease (Alzheimer's Association, 2013). Although the U.S. Centers for Disease Control and Prevention (CDC) considers dementia/Alzheimer's to be the fifth leading cause of death among adults 65-years of age or older, careful examination of Medicare claims data revealed that dementia is probably right behind cardiovascular disease as the second leading cause of death for this age group (Tinetti et al., 2012). Most of these patients would prefer to die at home, not only because of comfort concerns, but due to the higher quality of care that tends to be provided by informal and paid caregivers in this setting (reviewed by Teno et al.,…...
mlaEloniemi-Sulkava and colleagues (2009) evaluated patients at baseline using the Barthel Index and Neuropsychiatric Inventory (NPI) (see Appendix). The Barthel Index (Stone, Ali, Auberleek, Thompsell, & Young, 1994; University of Iowa Healthcare, n.d.) and NPI (Cummings et al., 1994) were administered again at 6 and 12 months into the study and will be used in the current study to track ADL and BPSDs using the same intervals. PQOL will represent a composite score obtained using the Color Analog Scale for pain (Santos & Castanho, 2013) and the Quality at the End of Life Scale (QUAL-E) (National Palliative Care Research Center, 2005) (see Appendix). In cases of severe cognitive impairment, completion of the QUAL-E may depend on family caregivers. FCQOL will be evaluated using the Zarit Burden Scale (Regional Geriatric Program Central, 2014) (see Appendix). The success of the intervention, as perceived by family caregivers and providers, will be assessed using the questionnaires developed by Morita and colleagues (2013). The goal of these questionnaires will be to evaluate how effective the community palliative intervention was in improving the knowledge and skills of palliative care, increasing access to specialized services, coordinating care services, and increasing deaths at home. This evaluation will be performed following the death of the patient or the end of the study period, whichever comes first. The validity and reliability of the questionnaires developed by Morita et al. (2013) have not been evaluated, but should prove informative and provide context for the other findings.
Discussion
A review of interventions designed to improve the quality of community palliative care has revealed mixed findings, but the trend is in the desired direction of reducing the number of patients dying in hospital wards, ICUs, and hospice facilities. CCM has garnered the interest of researchers interested in improving palliative care outcomes for patients, family caregivers, and providers alike, and have begun to study the efficacy and quality of interventions, including CCM. This proposal provides justification for implementing CCM for end-stage dementia patients residing at home and details an evaluation strategy that can be implemented to determine the efficacy, effectiveness, and quality of the care provided. In contrast to many other studies, however, this proposal places equal value on the experiences of patients, family caregivers, and providers alike, in addition to the more common outcome measures of BPSDs and institutional admissions. The methods of data gathering will involve the review of patient records and several instruments designed
Day treatment programs can provide services at less cost because the patient goes home at night after being treated during the day, which often is used for rehabilitating chronically ill patients (Sharfstein, Stoline, & Koran, 1995, p. 249). The mere fact of having more choice benefits some patients by giving them more say in their care.
Patient-focused care involves a method for containing in-patient costs for hospitals and for improving quality by "restructuring services so that more of them take place on nursing units rather than in specialized units in other hospital locations, and by cross-training staff on the nursing units so that they can do several 'jobs' for the same small group of patients rather then one 'job' for a large number of patients" (Kovner, 1995, p. 186). Kovner notes a number of barriers to this type of care. One reason has been that hospitals have not had to…...
mlaReferences
Doctors Say Managed Care Strains Patient Relationships (1997, June 9). Westchester County Business Journal 36(23), p. 24.
Kovner, a.R. (1995). Hospitals. In Jonas's Health Care Delivery in the United States, a.R. Kovner (ed.), pp. 162-193. New York: springer Publishing.
Moore, G.T. (1991,
April 24). Let's provide primary care to all uninsured Americans ? now! JAMA, pp. 2108-2109.
The Foundation called specific attention to the prospect of institutional and policy-level strategies to increase the participation of under-represented minorities in the health professions. In response, the Institute Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Healthcare Workforce came out with a report, entitled "In the Nation's Compelling Interest: Ensuring Diversity in the Health Care Workforce." The Committee consisted mostly of academicians, two of whom represented the nursing profession.
In its report, the Committee recognized the importance of increasing racial diversity among health professionals in order to improve access to care, greater patient choice and satisfaction and better educational experiences for practitioners, among other benefits. It also recognized the lack of strategies in reducing institutional and policy-level barriers among health profession educational institutions or HPEIs. In response to the lack, the Committee recommended that health professions education make a clear stand and mission on the…...
mlaBIBLIOGRAPHY
AHRQ (2007). The national healthcare disparities report, 2006. Agency for Healthcare
Quality and Research, Medscape. Retrieved on June 18, 2009 from http://www.medscape.com/viewarticle/552271
www.medscape.com
Alabama Nurse (2004). ANA Review: Institute of Medicine report on workforce diversity,
The death of elderly individuals takes place in different circumstances and settings such as painless death at home or painful death in a healthcare facility. Social workers have an important role in planning end-of-life care as part of providing essential social support to elderly individuals. The role of social workers in this process is attributable to the significance of their professional practice in a multidisciplinary palliative care team in hospice and hospital settings (Watts, 2013). Since the death of elderly individuals occurs in a variety of conditions and settings, social workers need to plan for end-of-life care. The planning and delivery of end-of-life care helps in helping the elderly cope with serious illness, face mortality or manage the process of dying in an effective manner.
One of the major functions of social workers in their role in planning for end-of-life care is providing psychosocial and practical support to individuals who are…...
PATIENT & HEALTH POFESSIONAL PESPECTIVES
Patient & Professional Perspectives
Quality of care is a massive concern when it comes to healthcare in general. The issue is so multi-dimension and complicated. Even further, there are a lot of ideological bents and perspectives that further shape and form the issue as it exists today. A significant part of the paradigm mentioned above would be the perspectives of both patients and healthcare professionals as it relates to the aforementioned quality of care. Obviously, there are going to be some differences and similarities when talking to any large swath of patients or healthcare providers. The differences could be huge divides in some cases due to what is being expected being too different than what is able to be delivered given the resources or even the perspective or opinion of the healthcare professionals or providers. While there is no simple or neat answer to how to construct…...
mlaReferences
Bagchi, A., af Ursin, R., & Leonard, A. (2012). Assessing Cultural Perspectives on Healthcare Quality. Journal of Immigrant & Minority Health, 14(1), 175-182.
doi:10.1007/s10903-010-9403-z
Butala, N. (2010). Perspectives on efficiency and quality in an ever changing system:
Healthcare 2010. The Yale Journal Of Biology And Medicine, 83(2), 93-95.
Family Interventions
-Mother can attend cancer support groups and receive advice and education through other channels regarding proper methods of providing care and improving quality of life for her husband
-Son can explore employment options as well as discuss various needs and responsibilities with his parents in order to determine his most effective utilization within the changed family dynamic
-Father can provide the levels of self-care that come easily, but should educate himself regarding his condition and ease care by allowing others to help when necessary
Nursing Interventions
-Provide educational materials/answer questions for both mother and father
-Assist son with psychological transition of increased responsibility/familial dependence
-Instruction of proper care techniques for mother and father regarding father's condition
Evaluation
Levels of comfort and competence in new family roles should be easily assessed in regular visits through brief questioning. Monitoring father's health through standard vital sign and other appropriate tests will determine level of care; questions determine quality of life.…...
WEEK DISCUSSION 1Week 5 Discussion Board PostingThe discussion question this week revolves around a monthly town hall meeting held by the local library to educate 100 residents on community health. The presenter is required to develop a presentation or program demonstrating ways of improving the communitys health. This assignment details the key points to include in the presentation.To begin with, the program needs to include a definition of key terms and services (Griffith & White, 2019). Since the participants are local residents who may not have knowledge about community and population health, it may be prudent to begin by defining key terminologies. In this regard, the presenter may need to define and explain community health, population health, hospice care, advocacy, health promotion, and health community, among other key terms.Secondly, the program needs to identify the specific health needs of the community as determined by needs-assessment exercises or results of epidemiological…...
mlaReferencesGriffith, J. R., & White, K. R. (2019). The well-managed healthcare organization (9th ed.).American College of HealthcareJackson, T., et al. (2022). Engaging stakeholders and communities to improve respiratory health in Asia. Journal of Global Health, 7(12), Doi: 10.7189/jogh.12.01001Jamison, D. T., Gelband, H., & Horton, S. (2017). Disease control priorities: World Bank Publications.
Palliative care is a specialty that is relatively new but that has evolved steadily over the past few decades. Its goal is providing advanced cancer patients with end of life care. Its rise was because of the public's growing dissatisfaction and concern with how dying patients were being taken care of in the 1960s and the 1970s (Cole, Carlin & Carlson, 2015). At the time, oncologists were mostly concerned with curative interventions and so did not give the necessary attention to end of life care. According to the studies that were done at the time, medical care that was given to the terminally ill was suboptimal or in some cases did not even exist. The father of palliative care, Dave Cicely Saunders, reported having the same experience. She was the founder of St. Christopher's Hospice, based in the United Kingdom. The facility was the first modern hospice (Cole, Carlin &…...
mlaBibliography
alMahrezi, A., & AlMandhari, Z. (2016). Palliative Care: Time for Action. Oman Med J., 161 -- 163.
Bhatnagar, S., & Gupta, M. (2015). Future of Palliative Medicine. Indian J. Palliat Care, 95 -- 104.
Bruera E, Hui D. Integrating supportive and palliative care in the trajectory of cancer: Establishing goals and models of care. (2010). J Clin Oncol. 28:4013 -- 7
Cole TR, Carlin NS, Carson RA. (2015). Medical humanities: An introduction. Cambridge University Press. 1 stEdition. New York.
Finite Health Care esources
Cutting health care costs is becoming a serious issue for the government and for medical corporations and patients throughout the U.S. today. There are several ways in which these costs can be cut, and one of those ways is to limit the life-extending care that is currently being provided to the elderly (Bond & Bond, 1994). This is not the same as limiting care that would improve their lives, but is only designed to limit the care that prolongs a life that already has little to no quality. However, it is not just the elderly who cost the country a great deal of money when it comes to medical care. Premature infants are also very expensive to keep alive, and an argument could be made that these infants should be allowed to expire, since they were not viable when they were born. It is a conundrum on…...
mlaReferences
Bond J. & Bond S. (1994). Sociology and Health Care. NY: Churchill Livingstone.
Saunders, C.M. & Kastenbaum, R. (1997). Hospice Care on the International Scene. NY: Springer Pub. Co
Nursing Ethics
While most hospitals seem to be well-run and most situations and scenarios are planned for in advance when it comes to what nurses should be doing, should not be doing and why, this is not always the case. Just one example of this would be situations where palliative care is probably or definitely called for in a given situation but there is not a defined or clear protocol as to when the palliative path should be started and what criteria should be used. Indeed, patients that are facing such a situation are typically terminal or they at least cannot be treated for what is ailing them. An easy example to point to would be a cancer patient whose disease is beyond what medicine can do for them. When there is an absence of leadership when it comes to palliative care protocols, it falls to nurses to collaborate, work together…...
These statements can serve as a foundation for essays that explore various dimensions of end-of-life care, including ethical considerations, the impact of technology, the importance of palliative care, and the role of family and caregivers. Each thesis sets the stage for a detailed discussion on its respective topic, allowing for a deep dive into the complexities and nuances involved in end-of-life care and decision-making.
"The implementation of advanced care planning significantly improves end-of-life care by ensuring that individuals' preferences and values are respected, highlighting the need for more widespread adoption of these practices in healthcare settings."
"While technological advancements in medicine have....
1. The role of hospice care in providing comfort and support at the end of life
2. The importance of advance care planning and discussing end of life wishes with loved ones
3. Ethical considerations surrounding end of life decision-making and assisted dying
4. The impact of grief and loss on family members when facing the end of a loved one’s life
5. Cultural differences in beliefs and practices surrounding death and dying
6. The stigma and fear surrounding death and how to approach the topic openly and honestly
7. The role of palliative care in managing symptoms and improving quality of life at the end....
1. The Ethics of Physician-Assisted Suicide: A Philosophical Exploration
Explore the moral and ethical dilemmas surrounding physician-assisted suicide (PAS).
Examine the arguments for and against PAS, considering patient autonomy, dignity, and social justice.
Discuss the role of medical professionals, religious beliefs, and societal values in the PAS debate.
2. The Legalization of Euthanasia: A Comparative Analysis
Compare the legal frameworks for euthanasia in different countries.
Analyze the factors that have influenced the legalization or decriminalization of euthanasia.
Discuss the implications of euthanasia legalization for end-of-life care and society as a whole.
3. End-of-Life Care and Cultural Diversity: Exploring Variations in Attitudes and....
Here are some essay topics related to end of life that you can consider:
1. The ethical implications of end-of-life decisions, such as euthanasia and physician-assisted suicide.
2. The importance of advanced care planning and how it can impact end-of-life care decisions.
3. The role of spirituality and religion in coping with end-of-life issues.
4. The challenges and benefits of hospice care for terminally ill patients.
5. The impact of cultural beliefs and practices on end-of-life care.
6. The role of palliative care in improving quality of life for patients with terminal illnesses.
7. The psychological and emotional effects of caring for a loved one at the....
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