The Question of Hospice Services in England - Coursework Example

Header same on all pages) A Detailed Plan of Proposed Critical Literature Review England’s Terminally Ill Children and Their Families: The Questionof Hospice Services versus Hospital Care? Attitudes toward Hospice versus Hospital Care for Children In The United Kingdom (Student Name Here) (University Name Here) In partial fulfillment of the requirements for (Course name and number) Instructor’s Name Date Abstract In the United Kingdom many children’s hospice services offers support to dying children and their families unlike the care they receive in a hospital. Children are eligible for hospice service all the way from infancy to early adulthood. By providing help at home, or in a building constructed for the purpose of hospice care, they provide highly trained staff members to help children and their family members through the emotional challenges of a life threatening illness. More important, they help the child and the family make the most of the time they have left together.1 (Craft, Sir Alan) This is opposed to hospital care and treatment, which is usually ill-prepared to help with either the emotional side of this issue, or with comfort issues facing children, in which hospice caregivers have become expert; nor do hospitals historically do well with helping the dying child and their family to live their lives fully up to the moment of death and separation. In fact, in most instances pediatric physicians waste time trying futilely to save the life of the child even when they are cognizant that there is no hope of recovery.2 ( Levetown, 2001) In England, hospice services are provided free to families and their children. Each service relies on charitable donations and fundraising efforts by the hospice service. Organizations and companies are also solicited to help in this worthwhile welfare program. England’s hospices have become so successful that the only rely on government assistance for five percent of their total funding. 3 (Rushton, Cynda Hylton, Pediatric Palliative Care: Coming of Age) This is opposed to the United States, in which, for example, the highly touted Ronald McDonald House program, asks each patient’s family to furnish 19 percent of the funding for their hospice stay.4 (Wikipedia, the Free Encyclopedia) So what exactly does a hospice service do? In England providers realize that when a child is given a diagnosis that offers no hope of recovery, the family often feels isolated and alone. They also realize that some of the diseases which strike these children may take months or even years to run their full course. If the child is at home or in the hospital it becomes a relentless cycle of medical care and nursing around the clock. It is a place where energies, emotions and even love are exhausted.5 (Goldman, Anne 2001 pp183-193) Conversely, pediatric hospices are based in the belief that life is for the living. The burden of care is taken from the child’s family and given to an entire care team so that the family may enjoy the little precious time they have left together. Hospices also offer a full range of pediatric palliative care which will depend on, not only the specific needs of the child, but for their parents and siblings as well.6 (Children’s Hospice International) End-of-life hospices attempt to accommodate all of the needs of the dying patients and their family’s. Scholars have coined and defined the term “quality of dying” as dying in the place of one’s choice.6 (Tang et al. June, 2003) Despite a lack of empirical data, surveys conclude overwhelmingly that most people, including children, would not choose to die in the hospital because hospitals are not equipped with the holistic tools of a hospice to take care of them or to treat them in the best manner. Worse yet, as recently as the year 2000, the New England Journal of medicine reported that children suffering from illnesses that had little chance of recovery were, in the last months, also afflicted with terrible pain, and attempts by hospital pediatricians to control their pain was often unsuccessful. In addition, in an interview study between 1990 and 1997 of the parents of 103 dying children in two Boston hospitals, nearly half of the children died in the hospital and almost 90 percent of these died in considerable pain according to their parents.7 (Wolfe, Klar, Levin 2000) In contrast, pediatric hospice caregivers are completely focused on the needs of the child, and their care team not only takes care of their palliative issues but fills the dying child’s life with warmth, games and activities. In the United Kingdom, palliative care has become a national referendum. For example the government says, “No terminally ill child in England should be forced to go to a hospital for specialist care.” The Department of Health also supports the need for a broad range of palliative care services: “Care should be tailored to individual needs…and should include the option of care at home. The body also calls for the greater used of nurse-led service in the community to save children (from) unwelcome travel to a hospital. They go on to say that “seriously ill children should be cared for in an environment that makes them feel as comfortable as possible.”8 (ACH 1997) ACH (Association of Children’s Hospitals) chief executive Barbara Gelb says, “It is vital that those responsible for commissioning children’s care services understand the importance of children’s hospice services and the role they play in our society. Primary care trusts need to be working in close collaboration with (these) services to ensure that life-limited children and their families are receiving the highest possible standards of care available to them.”9 (Gelb, Barbara, ACH) Method & Procedure The world-wide Internet was found to be a crucial tool to approach this study. By using a search engine to enter key words and phrases, the prevalence and commonality of the issues were soon discovered. The following bulleted phrases were introduced into the search engine, and are followed by how many so-called “hits” came up were for each topic. The results were rich in content from valuable sources such as: The New England Journal of Medicine, The ACH, The World Health Organization, and many scholarly works written by nurses, doctors and PhD’s from around the globe. Note: The words (and the United Kingdom) were introduced into the engine at the end of most phrases: (Annette, you may want to put in your own site hits here as well) Hospice Care and the U-K 2.1 million hits Information on the Ronald McDonald House 200,00 hits Ethical Arguments for and against Hospice Care 65,400 hits Hospice Care Controversy 169,000 hits “”in the U-K 69,000 hits Palliative Care in the U-K 1.9 million hits etc Conclusion In conclusion, it has been determined that Hospice care is a much preferred source of treatment for dying children and their families in the United Kingdom. Moreover, in comparison of the U-K’s resources to other countries around the globe, it was discovered that the U-K had a more thorough understanding of the crucial need for comprehensive Hospice services. In contrast, systems such as the paid insurance program in the United States have not yet reached a conclusion on whether or how to pay for this preferred approach for assisting terminally ill children and their families, and families are forced, at least in part, to be financially responsible for some of these services. Finally, England appears to have well-coordinated and comprehensive charitable effort, which has resulted in the federal government only having to provide 5% of the total cost for palliative care in the entire United Kingdom. Discussion There was one main limitation in performing this research. Apparently there is little to no empirical data in which to call upon to quantify statistics regarding hospice over hospital care. There is however, a lot of anecdotal and somewhat casual surveys from which to draw valuable information. The theoretical inferences of this work have been found to be quite sound, as resource after resource reports that families and children prefer hospice care over hospitals during the course of a terminal illness or at the end of life. Citations and References 1. Craft, Sire Alan, President of the Royal College of Pediatrics Child Health (No year given) 2. Leveton, Marcia The Children’s International Project on Palliative/Hospice Services. An interview by Al Romer: Innovations in End-Of-Life Care. Practical Strategies and International Perspectives, Volume 2. Solomon MZ, Romer et al. 2001, pp 183-193. 3. Rushton, Cynd Hyton, Pediatric Palliative Care: Coming of Age Editorial 4. Wikipedia, The Free Encyclopedia 5. Goldman, Anne. Importance of palliative care for children is being increasingly recognized. BMJ 2001; pp 322:324. 6. Tang, Siew Tzuh RN, DNSc, When Death Is Imminent: Where Terminally Ill Patients Withy Cancer Prefer to Die and Why. Cancer Nursing; June 2003 pp263: 245-251. 7. Wolfe J, Grier He, Klar N. Levin SB, et al. Symptoms and suffering at the end of live in children with cancer. New England Journal of Medicine 2000; pp 342 : 326-333. 8. Gelb, Barb Association for Children, 2001 Read More