Hospice is a concept of caring borrowed from medieval times, where travelers, pilgrims and the sick, wounded or dying could find rest and comfort. The contemporary hospice offers a program of care to patients and families facing a life threatening illness encompassing medical, nursing, spiritual, and psychological care. It is more than a medical alternative, it is an attitude toward death and the process of dying. Terminal disease is managed so patients can live comfortably until they die. The hospice program in the United States has evolved in part as an attempt to compensate for the inadequacies of the present medical system, particularly in caring for patients with a terminal illness. Hospice care has grown from an alternative health care movement to an established component of the American health care system. The modern hospice movement began in 1967 when Cicely Saunders opened St. Christopher's Hospice in London England. In the late 1960's, several Yale University students invited Dr. Saunders to come speak at Yale. These students were inspired to create a similar service in the United States. They opened the Connecticut Hospice in Branford, Connecticut and pioneered the hospice movement in the United States. This became the nation's first specially designed hospice care center. What is Hospice care? In an attempt to answer, the World Health Organization (WHO) issued a statement in 1990 about the philosophy and techniques of hospice care. A.
Hospice affirms life and regards dying as a normal process. B.
Hospice neither hastens nor postpones death.
Hospice provides relief from pain and other distressing symptoms associated with dying. D.
Hospice combines aspects of psychosocial and spiritual care. E
Hospice offers a support system to help patients live as actively as possible until death. F.
Hospice offers a support system to help the family cope during the patient's illness and during the bereavement process. We can see that the hospice concept is a bio-psychosocial approach to the dying process, concerned with biological, psychological, and social health. Because of its proponents, Hospice is considered a more humane and sensible approach to terminal illness, combining care, comfort, and support of family and friends as the individual faces death. Their concern for dignity and for maintaining quality of life rather than mere quantity lead to the following practical principles as an appropriate approach to care for the dying and their families. The patient must be as symptom-free as possible in order to enjoy the remaining portion of their life as fully and comfortably as is possible.
Physicians, nurses and other health care employees must be easily accessible to the patient and family. The same health care team should provide care for the patient, whether at home or in the hospital. The patient's and family's life style must be preserved, and their life philosophies respected by the health care practitioners. The loneliness, isolation and fears of abandonment are to be expected and should be dealt with accordingly. No one person can fully meet the needs of the dying patient, instead, a multidisciplinary team must be available to deal with any needs the patient or family may have. The patient should be treated as a person, not a disease. The family must receive adequate support to help in coping with the impending loss of a loved one. The terminally ill patient must be allowed to give as well as receive. The self-respect, identity and freedom of the dying patient should be built up. The family must feel a sense of participation in care giving and in the decision-making. The primary care person attending to a patient at home needs support and occasional relief.
Several issues pertaining to hospice care that are worthy of discussion are individuality, quality of life, palliative care, assisted suicide, access to hospice, benefits of hospice care over traditional care, hospice development,...
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