Psychological Effects of End-Of-Life Care
As people approach the end of their lives, they with their families and their caregivers, face many tasks and decisions. They may be psychological, spiritual, or medical in nature, but all end-of-life choices and medical decisions have complex psychological components, ramifications, and consequences that have a significant impact on the suffering patients and their caregivers. Hospice is a special healthcare option for patients and families faced with a terminal illness. At Hospice there’s a multidisciplinary team of physicians, nurses social workers, bereavement counselors and volunteers that work together to address the physical, social, emotional and spiritual needs of each patient and family members (“Hospice”). The main focus of Hospice is to address the issues that are most important to the patients’ needs or wants at the end of his/her life. The term “Hospice” comes from medieval times when it referred to a place of shelter and rest for weary or ill travelers on a long journey (Hospice). The name was first applied to specialized care for dying patients by Physician Dame Cicely Saunders, who began her work with the terminally ill in 1948 and eventually went on to create the first modern hospice—St. Christopher’s Hospice—in a residential suburb of London (National). Her lecture, given to medical students, nurses, social workers, and chaplains about the concept of holistic hospice care, included photos of terminally ill cancer patients and their families, showing the dramatic differences before and after the symptom control care. This later resulted in the development of hospice care as you know it today (National). Caregiving is associated with physical, psychological, and financial burdens. Hospice nurses perform many traditional nursing duties such as observing, assessing, and recording symptoms. They still work closely with physicians, administering medications and providing emotional support, although psychologists do not have much of a presence in the hospice movement. Medications that hospice nurses administer and the symptoms they record are not intended to aid a patient in his or her recovery, but rather to make his or her remaining days as comfortable as possible (“Hospice”). Being a nurse of any kind is very difficult, but dealing every day with a dying patient requires an extraordinary temperament, one that symbolizes great caring and patience (“Career”). It can be especially trying on nurses to attend patients who are as young as or younger than the nurse themselves are. Palliative care highlights the total well-being of the patient as well as that of loved ones and caregivers. The caregiver is there to listen, support, encourage, comfort and help the patient. Their goal is to prevent, treat, or eliminate discomfort whenever and, however it appears, never about giving up hope (“Career”). Every caregiver may be required to provide a variety of care tasks including physical, emotional, and practical. Research shows that families find personal care to be the most physically and emotionally challenging aspect of caregiving. Emotional care involves listening, talking, reading, or playing music (Collins). Providing the kind and loving companionship that patient may need during the end-of-life process. Handling insurance and other legal matters, taking care of financial concerns such as paying bills, coordinating visits with loved ones, friends and hospice staff is all a part of practical care (Collins). Along with discussing and ensuring that all of the patients’ wishes are carried out if also the healthcare power of attorney (“What”). In 2009; 66 million Americans (3 in 10 U.S. Households) reported at least one person providing unpaid care as a family caregiver (Collins). Under Medicare, hospice is primarily a program of care delivered in a person’s home by a Medicare - approved hospice. Reasonable and necessary medical and support services for the management...
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