Friedman Assessment Model

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General Description of the Community.
Target area being assessed by the author is hospice service in Sioux Falls and surrounding areas provided by Avera Mckennan. Hospice care is end-of-life care provided by health professionals and volunteers Hospice care provides medical services, emotional support, and spiritual resources for people who are in the last stages of terminal illness. Although most hospice patients are cancer patients, hospice accepts anyone regardless of age and type of disease.

The goal of hospice treatment is to keep patient comfortable and improve quality of life. Hospice care tries to manage symptoms so that patient's last days may be spent with dignity, surrounded by his/her loved ones. Hospice care is family-centered: the patient and family are both included in the care plan and emotional, spiritual and practical support is provided depending on the patients wishes and families needs. Hospice is not so much a place, as it is a philosophy of care with a family-centered approach that considers the patient and family to be the unit of care (Lattanzi-Licht et al., 1998).

Avera Mckennan Hospice Services are the main focus of author. Avera McKennan's Home Hospice and Palliative Care program office is located in the Dougherty Hospice House. Through this program, they provide hospice services in a variety environments: hospice care in the home setting, hospice care in an assisted living facility, hospice care in a skilled nursing facility and also, in Dougherty Hospice House. The Dougherty Hospice House is a unique sixteen bed hospice facility located on the Prince of Peace campus. This place provides a home like setting with specious rooms for patient and sleeping accommodations for family members. It also has a meditation room, wireless internet, beautiful meditative garden, large dining and family room for families to gather, and library. Dougherty Hospice House and its surrounding property are tobacco free environments.

About 80% of all hospice care is provided in private homes, nursing homes, independent and assisted living facilities (Caffrey, C. et al., 2011). If hospice care provided in patient's home, a family member will look after their loved one much of the time. Someone form hospice team will usually visit patient once or twice a week assessing a patient and addressing current health issues. Avera McKennan Hospice team consist of 25 people including nurses, social workers, spiritual advisors/chaplains, nursing assistants, trained volunteers, pharmacist and medical director. In case of emergency home hospice patient can call the 24-hour hospice number for advice. A nurse usually can come to patient's house at any time of the day or night or give an advise over the phone.

Based on the patient's circumstances and stage of care, a hospice interdisciplinary team (IDT) may provide variety of services. Registered nurses assist patient with management of discomfort, pain and side effects of previous treatment ( nausea from chemotherapy). Also nurses help educate both patient and family about what is happening. The nurse is a link connecting patient, family and physician. Home health aids provide extra support for personal care such as bathing, shaving, dressing and eating. Trained hospice volunteers offer assistance with everyday tasks such as shopping, babysitting, and carpooling. They are being available to listen to the patients and families and offer compassionate support. Primary doctor approves plan of care for hospice patient and works with hospice team. A hospice medical director who has expertise in symptom management and end-of-life care is available to the attending physician, patient and family, and hospice team as a great resource and consultant.

Chaplains, priests, or other spiritual counselors help patient and family explore the meaning of the death, and perform religious ceremony specific to the patient. Respite care can be provided by inpatient hospice to give family a break...
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