Hospice Care and Catholic Ethics
Is Hospice care consistent with Catholic bioethics? Chapple, in her discussion of the topic "Hospice care" in Catholic health care ethics, argues that ultimately the answer is yes, but she acknowledges that there are levels of difficulty in answering the question (Chapple 2009). The ethics of Hospice care present us with a complicated question, insofar as Catholic teachings on end-of-life care have at times provoked public controversy -- the most noteworthy example within recent memory was the Congressional and Presidential intervention in Terri Schiavo case, which brought Catholic teachings about medical intervention at the end of life into national debate and discussion. The Schiavo case was about a straightforward case of euthanasia, and to a certain degree Catholic teachings about hospice care resemble (in their logic about the nature and purpose of human life and death) the Catholic teachings about larger end-of-life issues. The ultimate lesson…...

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References

Catechism of the Catholic Church. Accessed 18 March 2013 at: http://www.vatican.va/archive/ENG0015/_INDEX.htm

Chapple, HS. "Hospice care." In Furton, EJ Cataldo PJ and Moraczewski AS. Catholic health care ethics: a manual for practitioners. 2nd Edition. Philadelphia: National Catholic Bioethics Center, 2009.

Gawande, A. "Letting Go: What Should Medicine Do When It Can't Save Your Life?" The New Yorker. August 2, 2010. Accessed 18 March 2013 at:  http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande#ixzz2Nxoxy3kI 

Pope John Paul II. "To Participants in the 19th International Conference of the Pontifical council for Health Pastoral Care." L'Osservatore Romano, English language edition. 24 November 2004. 6. Accessed 18 March 2013 at: https://docs.google.com/viewer?a=v&q=cache:UxsPB9YKUdUJ:www.lifechoicehospice.com/sites/lifechoicehospice.com/files/LCH-028_Catholic_Hosp.pdf+catholic+view+of+hospice+care&hl=en&gl=us&pid=bl&srcid=ADGEESi1P6zIukv2v0SOqYtsbX5GcBTApzyN6GkARX42h1JfgnPoHCG7E1Ohdq9hnEW5P_b6G40sJflNESmCqwEAw8iPqQzM_HoJZPPj5KPH6MRoeXyav_G3Y8kSGm7oR0vCIYewjnKZ&sig=AHIEtbRWuO9dVLtlu9B0sUtukIj_f45dBg

In fact it is federally mandated that hospices must give the patient every option available to them in order to efficiently manage pain, "the federal guidelines regulating hospice require the hospice to make every reasonable effort to assure that the patient's pain is controlled," (Hospice Patient's Alliance, 2008).
Hospice services are sophisticated and rely on a number of professionals to help comfort and ease the pain of patients who have chosen to enter into a hospice care program. There is an entire structural hierarchy of care professionals which is designed to help the patient and family members along every step of the process. First and foremost comes the immediate medical staff which will be making medical decisions in regards to pain management and other forms of medical treatments. These staff members include doctors and trained nurses. Physicians are responsible for administering effective pain management methodologies, and are therefore very important…...

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Works Cited

American Cancer Society. "What is Hospice Care? www.cancer.org.2008. 24 May. 2008.  http://www.cancer.org/docroot/ETO/content/ETO_2_5X_What_Is_Hospice_Care.asp?sitearea=ETO 

Harrison, Irene. "Hospice Care." Cancer Supportive Care Programs.

A www.cancersupportivecare.com.2007. 24 May. 2008.  http://www.cancersupportivecare.com/hospice.html 

Help Guide. "Hospice Care: Full Service Support at Home or in a Facility." www.helpguide.org.2008. 24 May. 2008.  http://www.helpguide.org/elder/hospice_care.htm

Who provides the care is dependent upon the patient and the type of care their illness requires. Also, some families are more active in taking care of end of life patients than other families.
Indeed, hospice care providers have a significant number of responsibilities as it relates to taking care of the patient. The type of illness that the patient has can increase or decrease the number of responsibilities of the hospice care providers. In any case, hospice care providers provide services tat ensure the comfort of the patient and they also attempt to make the emotional and psychological issues associated with dyeing, more palatable for the patient.

In addition to the issues that arise for the patient, caring for a loved one that is terminally ill is also extremely difficult for family members. As was mentioned previously in the discussion the purpose of a hospice is to serve both the…...

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References

Csikai, E.L. (2004). Social Workers' Participation in the Resolution of Ethical Dilemmas in Hospice Care. Health and Social Work, 29(1), 67+.

Egbert, N., & Parrott, R. (2003). Empathy and Social Support for the Terminally Ill: Implications for Recruiting and Retaining Hospice and Hospital Volunteers. Communication Studies, 54(1), 18+.

Forman Walter B..

Published 2003. Hospice and Palliative Care: Concepts and Practice. Jones and Bartlett Publishers

However, they are often emotionally isolated and are unable to determine whether or not they are loved by their family members or whether they will be missed after passing on. This often happens because the family members are not directly involved in providing hospice care to their patients. Hospice care can be a great way of strengthening the connection between the terminally ill patient and their loved ones and family members. It is thus essential for hospice care professionals to support interactions between patients and their family members for the latter to make extra efforts to make them feel that they are loved.
Conventional medical care institutions often fail to provide adequate care to terminally ill patients because professionals at these institutions do not understand the crucial part that family members play in the last moments of the terminally ill patient. This is part of the case that is put…...

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Works cited

Armstrong-Dailey, Ann. Hospice Care for Children. Oxford: Oxford University Press, 2001. Print.

Coleman, a.M. "End-of-Life Issues in Caring for Patients with Dementia: The Case for Palliative Care in Management of Terminal Dementia." Am J. Hosp Palliat Care 29.1 (2012): 9-12. Print.

LaPorte, Marianne, and Deborah Witt Sherman. Palliative Care Nursing: Quality Care to the End of Life. Berlin Heidelberg: Springer Publishing Company, 2010. Print.

Sachs, G.A., J.W. Shega, and D. Cox-Hayley. "Barriers to Excellent End-of-Life Care for Patients with Dementia." J. Gen Intern Med 19.10 (2004): 1057-63. Print.

Hospice and Attitudes Towards Death
Attitudes towards dying, death, and bereavement are very dependent upon culture. Some cultures embrace death as a natural part of the life cycle and do not attach fear to death. Other cultures are very fearful of the topic of death and treat it like a taboo. "In many preliterate societies, the dead are imbued with special powers and considered potentially harmful to the living. Many customs and funereal rituals surrounding death represent efforts to ensure the well-being of the community" (Quadagno, 2008). However, individual attitudes towards death and dying can vary within a community. Modern society certainly reflects a wide range of feelings towards death and dying. Some people still avoid the topic of death as a taboo, while others are much more comfortable with the idea.

One of the most interesting movements in modern medicine has been the hospice movement. After years of medicine seeking to…...

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References

Devi, P.S. (2011). A timely referral to palliative care team improves quality of life. Indian J.

Palliat Care, 17(Suppl): S14-6.

Quadagno, J. (2008). Aging and the life course: An introduction to social gerontology. New York: McGraw Hill.

Tan, Y.S., & Cheong, P.Y. (2011). Experiences in caring for the dying: a doctor's narratives.

Children believed that death is more like sleep and the dead may or may not return. Children between five and nine years of age belonged to the second group. Maria observed that children belonging to the second group perceived death as an irreversible phenomenon but still thought of it as an avoidable one. Death for these children represented a certain shadowy or skeletal figure who could possibly be evaded with some luck and intelligence. According to the author only the last group of children representing the ages of ten and above fully understood death as an inevitable eventuality for everyone. Thus Maria Nagy classified children's perception of death as a measure of their age. [Lewis R. Aiken]
However, studies, which were conducted much later in the United States, showed different results. These studies showed that the interpretation of death by children is not limited by their age alone and their…...

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Bibliography

1) AAP, (Aug 2000), "Palliative Care for Children', Retrieved March 31st 2008, from, http://aappolicy.aappublications.org/cgi/content/full/pediatrics;106/2/351

2) Lewis R. Aiken, (2000), "Dying, Death and Bereavement', Published by Lawrence Erlbaum Associates, Thanatology, 3) Joseph F. O'Neill, (July 2000), "HIV and Palliative Care," retrieved March 31st from, http://hab.hrsa.gov/tools/palliative/chap1.html

4) AVERT, "United States: AIDS Cases and Deaths by Year," retrieved 31st march 2008, from,  http://www.avert.org/usastaty.htm 

5) Carol K. Sigelman, (2006), 'Life Span Human Development', Published by Thomson Wadsworth

Hospice and Hospital Oncology Unit Nurses a Comparative Survey of Knowledge and Attitudes About Cancer Pain," authors Connie J. Hollen et al. (2000) set out to examine any strengths, weaknesses and misconceptions that affect the ability of registered nurses to care for their patients.
To conduct their research, Hollen et al. (2000) went to 11 community hospices and 7 inpatient oncology units in hospitals around an urban county area in a southcentral state. The researchers then took a sample of 30 nurses working in hospices and 34 nurses from the hospital inpatient oncology units. These "convenience samples" were administered with surveys to determine their inclusion in the study, as well as their knowledge and attitudes about the management of pain in cancer patients.

The researchers used the North Carolina Cancer Pain Intiative (NCCPI) survey. This survey measures the primary components of a subject's knowledge, attitudes, perceived difficulties and demographic information in relation…...

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Works Cited

Hollen, Connie J, Hollen, Charles W, and Stolte, J. 2000. "Hospice and Hospital Oncology Unit Nurses: A Comparative Survey of Knowledge and Attitudes About Cancer Pain." Oncology Nursing Forum. 27(10). November/December.

This will also take the focus away from individual grief by sharing and understanding the concerns of others.
IV. Group structure

A

Recruitment will occur by means of advertisement in a variety of media. The notice boards of medical facilities and pharmacies will be used as a primary advertisement site. Pamphlets will also be available at waiting rooms and at counters of medical venues and hospitals. The local newspaper will furthermore be used for advertising the group, as well as the Internet. The latter will be used on a smaller scale, focusing on local site with relevant content and advertising facilities.

B

The screening process will entail the criteria mentioned above. Advertisements will suggest the criteria, while each woman will be interviewed for a further screening process. In addition to the already determined criteria, all women need to be fairly mentally stable apart from the grieving process. uicidal, homicidal or psychotic persons will neither…...

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Sources

Carson, Tracy (2005). Emotions Associated with Grief. Rochester Funeral Homes.  http://www.rochesterfuneralhomes.com/Resource_Guides/grief_counseling.html 

Egbert, Nichole (2003, Spring). Empathy and social support for the terminally ill: Implications for recruiting and retaining hospice and hospital volunteers. Central States Speech Association, Communication Studies.

Ford-Martin, Paula Anne. (1999). Group Therapy. Gale Encyclopedia of Medicine. Database: FindArticles.com

Gross, Donalyn. (2004, Sept.). Missing: death education for nursing facilities; Staff need to be trained in comforting dying residents, their families, and themselves. Nursing Homes, Medquest Communications. Database: FindArticles.com

Rather than giving over control to medical experts to cure disease, the dying person is empowered by the interdisciplinary team of hospice practitioners to guide and direct the time that remains." 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…...

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Bibliography

Doka, Kenneth J. (2005) Facing Illness and Loss: Caring for Someone Who is Dying. Hospice Foundation of America, Caregivers Corner. Online available at http://www.hospicefoundation.org/hospiceInfo/dearabby/caring.asp

Hospice Foundation of America

1621 Connecticut Ave. NW, Suite 300

Washington, DC 20009 www.hospicefoundation.org

Hospice Staff, Volunteers, and Hospice Patients
There are very few critics of the Hospice organization, and rightfully so. Who could criticize such a helpful, vital organization? Indeed, if Hospice wasn't available to provide their pivotal services, then who would be there? A key reason for the value of the Hospice group is that there is a general acceptance among thoughtful people that Americans do not handle death very well. And when death hits someone in his or her family suddenly, or even when there is a long-term illness in the family, leading inevitably to death, most families are not prepared. Hospice delivers humanitarian care and nurturing to not only the terminally ill, but also to their loved ones, before and after the passing.

Meanwhile, the specific services offered through the interdisciplinary team of medical professions and trained volunteers that make up Hospice include the following: medical and personal care visits; inpatient…...

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References

Ascribe Business & Economics News Service (2004, February). Hospice Effective in Delivering Quality Care to Dying Americans According to Current Research;

Hospice Serving Record Number of Terminally Ill Patients, Families. National Hospice and Palliative Care Organization.

Fleming, Skye O'Neil; & Malespina, Joan. "Care for the dying in America: two perspectives." JAAPA-Journal of the American Academy of Physicians Assistants, 16, 11-16.

Hannay, Jayme (2000). National Survey of Hospice Volunteers and Staff. Retrieved April 20, 2004, from The Robert Wood Johnson Foundation Web site:

Freedom and Moral esponsibility in Hospice and Palliative Services
The different ethical theories

Decision making within the medical field and provision of palliative services is influenced by three ethical theories. The theories are respect for autonomy, beneficence, and non-maleficence. espect for autonomy asserts that a patient should be allowed the option of decision making. This principle will value the patient's intrinsic worth as an individual allowing them to make a decision that is in their best interest (Holland, 2013). In order for healthcare professionals not to interfere with patient autonomy, they should respect the decisions made and actions taken by the patient. The respect for autonomy will require a doctor to give the patient full information regarding their illness without using jargon. Autonomy is vital for decision making especially for patients with incurable progressive illness, where treatment decisions are unclear and are dependent on the patient's personal values and preferences. espect for…...

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References

Andersson, G.B., Chapman, J.R., Dekutoski, M.B., Dettori, J., Fehlings, M.G., Fourney, D.R., . . . Weinstein, J.N. (2010). Do no harm: the balance of "beneficence" and "non-maleficence." Spine, 35(9S), S2-S8.

Holland, S. (2013). Arguing About Bioethics. Abingdon, Oxon OX14 4SB: Taylor & Francis.

Murray, J.S. (2010). Moral Courage in Healthcare: Acting Ethically Even in the Presence of Risk. Online Journal of Issues in Nursing, 15(3).

Ross, J.R., Capozzi, J.D., & Matava, M.J. (2012). Discussing treatment options with a minor: The conflicts related to autonomy, beneficence, and paternalism. The Journal of Bone & Joint Surgery, 94(1), e3 1-4.

Hospice care is a kind of philosophy and care that centers on the palliation of a patient who is seriusly or terminally ill. Hospice care includes tending to the patient's pain and symptoms as well as their emotional and spiritual needs. The proposed research examines how referral and admission to hospice care can lead to a reduction in hospital re-admissions. This author proposes to look at current hospital referrals to hospices in 2013 (control) and hospital 30 day re-admission rates of current local level II trauma center for patients with chronic disease. The Proposal is to add "Hospice and Palliative medicine consult" to current standing orders. This literature review will focus on eight articles/reports that recommend palliative care among other things to achieve a high quality of care.
In an article by Smith et al. (2012), the writers address the integration of palliative care services into standard oncology practice during a…...

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References

Abel, J., Pring, A., Rich, A., Malik, T., & Verne, J. (2013). The impact of advance care planning of place of death, a hospice retrospective cohort study. BMJ Support Palliat Care, 3(2), 168-173. Retrieved from  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632964/ 

Brown, R.S., Peikes, D., Peterson, G., Schore, J., & Razafindrakoto, C.M. (2012). Six Features of Medicare Coordinated Care Demonstration Programs that Cut Hospital Admissions of High-Risk Patients. Health Affairs, 31(6), 1156-1166.

Coleman, E.A., Parry, C., Chalmers, S., & Min, S. (2006). The Care Transitions Intervention: Results of a Randomized Controlled Trial. Archives of Internal Medicine, 2006(166), 1822-1828. doi:10.1001/archinte.166.17.1822

Goodman, D.C., Fisher, E.S., & Chang, C.H. (2011). After Hospitalization: A Dartmouth Atlas Report on Post-Acute Care for Medicare Beneficiaries. Retrieved from The Dartmouth Institute website:  http://www.dartmouthatlas.org/downloads/reports/Post_discharge_events_092811.pdf

Change
Improving Hospice Urinary Infection Rates:

An Analysis of Foley Catheter Use in a Hospice Setting

Change is a necessary part of any organization. One critical area that demands change in hospice nursing is overzealous use of Foley catheters. Often these instruments are used when not medically necessary despite their leading to urinary tract infections and antibiotic resistance. In order to change the culture of nursing regarding Foley Catheters, an analysis of the key steps of organizational transformation are presented with a focus on ewin's Force Field Model. Through an understanding of the mechanisms of change, nursing administrators can improve patient outcomes and improve antibiotic efficacy in any healthcare setting.

Introduction

The comedian Billy Crystal once quipped that, "Change. It's such hard work!" Nowhere is this remark more valid than in managing change in the healthcare setting. For effective change, expert planning is required, therefore this paper is going to discuss the strategy of…...

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Lewin, K. 1951. Field theory in social science; selected theoretical papers. Harper & Row: New York.

Marquis, B. And Huston, C. 2006. Leadership Roles and Management Function in Nursing. Lippincott: New York.

Urden, L., & Watson, S.L. 2001. Outcomes of hospital restructuring and reengineering: How is success or failure being measured? Journal of Nursing Administration, 31(4), 203-209.

Hospice affirms life and neither hastens nor postpones death" ("Preamble and Philosophy," NHPCO, 2010). The NHPCO formal mission statement is: "To lead and mobilize social change for improved care at the end of life" ("Mission & Vision," NHPCO, 2010).
Financial and economic statements

Hospices individually operate under a wide variety of financial models, including for-profit and not-for-profit systems. Most use "a managed-care model, with insurance companies providing per visit and per diem reimbursement" (Baxendale & Dornbusch 2000, p.1). "Hospices receive funds from government programs or private insurance, from donations made by the public or other corporations, and from grants donated by charitable foundations...Hospices are not reimbursed on a fee for service basis: rather, hospices are paid, on a basis of how many days the patient is enrolled in the program and received services…In return for payment, Medicare, Medicaid and private insurance companies expect the hospices to provide all services which the…...

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Works Cited

"About NHCPO." National Hospice and Palliative Care Organization (NHPCO).

September 8, 2010.  http://www.nhpco.org/i4a/pages/index.cfm?pageid=3253&openpage=3253 

Baxendale, Sidney J & Victoria Dornbusch. "Activity-based costing for a hospice." Strategic

Finance. March 2000. September 8, 2010.  http://findarticles.com/p/articles/mi_hb6421/is_9_81/ai_n28767403/?tag=content;col1

Bridge/Prehospice Program: Do Hospice Bridge Programs Increase Quality of Life for Terminal Patients by Encouraging Earlier Access to Palliative esources?
The work of Levy, Bemski, and Kutner (2008) entitled "Are Hospices Establishing Pre-Hospice/Palliative Care Programs?" reports that outpatient palliative care programs (OPCPs), sometimes known as prehospice or 'bridge programs' allow for patients to receive comfort care in their home, nursing home, or assisted living facility even if they are not eligible for or are not ready to choose to enroll in hospice care." (p.1)It is reported that the OPCPs in terms of their "prevalence and sustainability…remains uncertain because these programs are, in general, not supported by health care insurance in the United States." (Levy, Bemski, and Kutner, 2008) eported by Levy, Bemski, and Kutner (2008) is a survey that was comprised by an 18-question Web-based survey "created based on input from a team of palliative care/hospice clinical and researcher physicians and…...

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References

Levy, C., Bemski, J., and Kutner, JS (2008) Are Hospices Establishing Pre-Hospice/Palliative Care Programs? Journal of Palliative Medicine. Vol. 11 Issue 3, March 25, 2008. Retrieved from:  http://www.liebertonline.com/doi/abs/10.1089/jpm.2007.0274 

Carlson, M. (2010). Impact of hospice disenrollment on health care user and Medicare expenditures for patients with cancer. Journal of Clinical Oncology, 28(28),

Casarett, D. (2007). I'm not ready for hospice": strategies for timely and effective hospice discussions. Annals of Internal Medicine, 146(6),

Casarett, D. (2001). Patients with cancer referred to hospice vs. A bridge program: patient characteristics, needs for care, and survival. Journal of Clinical Oncology, 19(7),

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....