Long Term Care -Hospice
Hospice is a process to end-of-life care and a kind of support facility for terminally ill patients. It provides comforting care, patient-centered care and related services. Comforting care relieves discomfort without improving the patient’s condition or curing his illness. Hospice is extended in a healthcare facility or at home. Its objective is to provide compassionate, emotional, and spiritual care for the dying patient. The origin of the word “hospice” in medieval times meant “way station for weary travelers” (Perry). The first hospices were run by members of religious orders in the medieval times that cared for weary travelers whom found refuge with them until their death. Modern hospices are believed to have started in the United Kingdom in the mid-19th century in Dublin, Ireland. Roman Catholic Sisters of Charity provided a clean and caring place for the terminally ill. The name hospice was first applied to the care of dying patients by Mme Jeanne Garnier who founded the Dames de Calaire in Lyon, France, in 1842. The name was next introduced by the Irish Sisters of Charity when they opened Our Lady's Hospice in Dublin in 1879 and St Joseph's Hospice in Hackney, London 1905. The practice became popular in England, Asia, Australia and Africa. It was only in the early 70s that the hospice concept was introduced and accepted in the United States through the efforts of physicians Cicely Saunders and Elisabeth Kobler-Ross. These practices included effective pain management, comprehensive home care services, counseling for the patient, and acceptance of death as the natural end of the care delivery by health care professionals, bereavement counseling after the patient’s death, and continued research and education (Wexler & Frey). Quality care at the end of life soon combined with grief counseling and bereavement care. The government stepped in to contain health-care costs when reimbursement for inpatient hospitalization was significantly reduced. Home-based hospice care also became popular as a more inexpensive alternative to hospitalization or care in a nursing facility (Wexler & Frey). The hospice concept was not immediately accepted by conservative health professionals. The concept emphasizes caring more than curing. It also allows interaction with complementary and alternative medicine practitioners. A hospice’s primary function or service is to enable the patient and his family to accept death as a natural part of the life cycle (Wexler & Frey, 2004). In addition, it provides pain management and psycho-spiritual support and complementary and alternative therapies. Approximately 80% of hospice patients are in the terminal or end-stage of cancer. Traditional medical facilities provide pain medications when requested, a hospice administers these medications regularly and before they are needed. The intention is to prevent pain from recurring. Furthermore, the problem of addiction and other long-term consequences is not a concern in the case of terminal illness. The concern is to provide effective relief to the greatest degree possible (Wexler & Frey). A second major service of a hospice is to relieve physical, psychological, emotional and spiritual discomfort to the patient’s family and others close associates (Wexler & Frey, 2004). It relies on members of the clergy, pastoral counselors, social workers, psychiatrists, massage therapists and other trained volunteers to alleviate the discomfort. A hospice also provides grief and bereavement counseling and support groups to assist family members in expressing or resolving emotional tensions. And it allows the use of complementary and alternative therapies, in addition to conventional medicine, in the control of symptoms and in improving the patient’s well-being. A 2002 study conducted on the inclusion of such therapies showed that patients who received them expressed more satisfaction with hospice care than those who...
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