Hospice: a Branch of Medicine - Essay Example

Hospice Outline Introduction to Hospice Care and its Central Ideology a. What is hospice and why is it a positive alternative to the terminally ill: b. Hospice compared to other options which a terminally ill individual may have: 2. Hospice from a medical perspective: a. Medical benefits of hospice care: b. Those who may be eligible for hospice care: 3. Conclusion Hospice: A Branch of Medicine For those who have been diagnosed with a terminal illness, specialized care such as hospice can be a positive alternative to a situation with little proactive choices. Hospice care is available tot hose who have been diagnosed with a terminal illness and are reaching the final stages of said illness. In many cases, individuals dying from prolonged but fatal diseases such as HIV and Aids, cancer or multiple sclerosis, are able to live out the latter part of their illness with dignity and comfort due to hospice care. The purpose of this paper is to research and examine this very specialized field of medicine which ensures comfort and kindness to the dying. To begin, Hospice care is specifically targeted at those who are within the final 6 moths or less of a terminal illness. Hospice is not only a care program for the terminally ill but is also a program designed to help the family and close friends of the terminally ill, as they transition from a place of watching a loved one die to mourning the death of that loved one. Certainly, it seems as though the notion of hospice is one of bleakness and morbidity; but to those who have benefited form its availability; it has acted as a last resort to getting the most out of life with little time availability. It is important to explain that hospice is actually not a specific place, but is in fact a type of care available to the dying. Depending on the patient and their specific circumstances, hospice may be provided within the home of either the patient or a family member or friend of the patient. If the circumstances of the patient call for a different situation in providing hospice care, a hospice facility or hospital hospice unit may be the preferred location of care. Either way, the patient receiving hospice is guaranteed a dignified death with minimal and controlled pain levels. Hospice is centrifugal to pain management and comfort assurance for its patients. One of the most agonizing aspects for both the terminally ill and their loved ones, is the drawn out process of enduring pain and discomfort on the part of the patient. Hospice is designed to address pain aggressively in order to grant the dying, a remaining existence free of as much suffering as possible, “Choosing hospice is a movement into another mode of care-giving when a terminal illness no longer responds to cure-oriented treatments”(Hospice Foundation of America, 2008). Hospice care is typically a network of volunteers, trained employees of the program, nurses and physicians. Its goals are certainly to provide comfort and relief to the patient as much as possible as well as to seek the spiritual, social and psychological needs of both the patient and the patient’s family and friends. Unlike most branches of medicine, hospice goals are not to prolong life in any fashion. In fact, hospice is not designed to extend a patient’s life or speed up the process of dying. The goals of hospice program are to create comfort and relief for the remainder of the patient’s existence when facing an imminent and untimely death. There are cases within hospice care programs, where patients occasionally make a full recovery and are then expected to live much longer than originally thought. In this case, the patient may opt to discontinue hospice services or simply become ineligible for services due to their improvement of condition. Although any individual who is terminally ill and expected to not survive a time frame of 6 months, only about 1/3 of eligible Americans have chosen or received hospice care prior to death. Not all health insurance plans are designed to adequately cover hospice care and of course, not everyone in the position of hospice qualification can afford such intensive treatment if it is not covered by medical insurance. One very important aspect of hospice which may remain unfamiliar to those who have little experience with the topic, is that knowingly enrolling in hospice care is an absolute resolve to discontinue any type of aggressive medical intervention or care which would otherwise act to attempt to save or lengthen the patient’s life. In other words, for those who are suffering from cancer and have been enrolled in hospice care, any further treatment such as chemotherapy or radiation will have been discontinued permanently while a pain management regimen will act as the only form of medicine taken by the patient. The topic of DNR or advance directives may be a topic discussed with the patient upon intake into a hospice program, if the issue has not previously been resolved between the patient and the attending physician prior to hospice referral and admission. An order known as a DNR (do not resuscitate) can be signed by the patient who has suffered from along and painful disease. In the event that the terminal patient suffers from cardiac arrest or another event which places the patient into repertory arrest, the DNR will legally prevent caregivers from administering mouth to mouth resuscitation or other life saving techniques. Obtaining a DNR is not usually a prerequisite of most hospice care programs but it is a topic covered upon intake of hospice patients in order to establish the patient’s wishes as well as to ensure their dignity. Hospice care may be at times, confused with what is known as palliative care. Palliative care is an approach to bettering the life of any individual suffering from serious illness, regardless of impending death or otherwise. Palliative care aims to treat not only pain but other symptoms associated with a patient’s specific symptoms which cause discomfort or stress. Palliative care serves to alleviate symptoms of nausea, shortness of breath, sleeping difficulties and other unpleasant symptoms. In fact, palliative care may be used in conjunction with hospice care within a hospice program. While palliative care is ideal at any point of an illness based on a patient’s needs, hospice care is more of a kind preparation for the final stages of a disease followed by death, “Palliative care (pronounced pal-lee-uh-tiv) specializes in the relief of the pain, symptoms and stress of serious illness. The goal is to improve quality of life for patients and their families. Palliative care is appropriate at any point in an illness. And it can be provided at the same time as treatment that is meant to cure you”(Getpalliativecare.org, 2008). AN approach to understanding hospice care and when it is necessary or appropriate, is comprehending the notion of anticipating the end of someone’s life. A relevant question here may be how doctors are able to predict not only when a patient is nearing death but how soon death may occur for a particular individual. With hits comes the stress of loved ones who are present for end of life symptoms. Symptoms which may predict that death is quickly approaching for an individual are confusion, shortness of breath, restlessness, inability to get out of bed, difficulty in healing, pauses between breaths, loss of appetite, edema in the arms and legs, seeing people who have already died and a general feeling that death is near.(Mayo clinic, 2007). Most of these symptoms are indicative of death within about 2 weeks of the occurrence of death. Medically, this phase of the dying process is called the “pre-active phase of dying”.(Mayo clinic, 2007). As death becomes eminent within a matter of days, a patient may show more definite symptoms which are indicative of death occurring with a time frame of 72 hours or less. This is known as the “active phase of dying”(Mayo clinic, 2007). These symptoms include a bluish hugh to the nail beds and lips, purple coloration on the legs (called mottling), congested breathing, cessation of eating and drinking, agitation and confusion, incontinence and blurred vision. (Mayo clinic, 2007). These symptoms can be stressful to family members and friends of the patient as they anticipate death as being quite near. Hospice care however, is designed to transition not only the patient into a mode of accepting and being prepared for death but also preparing aiding the loved ones of the patient, through the process of the patient’s death. The last phase of dying can be the “sudden burst of energy”(Mayo clinic, 2007). This is often a confusing time for family and friends as they expect to see a full recovery from their loved one but then as quickly as the energy comes, so does death. This is a time which family members are often encouraged o bid a final goodbye tot heir loved one, by a hospice care team. The final burst of energy is simply a part of the dying process and though everyone dies as uniquely as they lived, the general symptoms and phases of dying are relatively expected in the terminally ill. In conclusion, the goal of a hospice care program is not to prolong or sustain life but rather to allow it to extinguish in a humane and kind manner for those who are terminal. Hospice programs are something to consider down the road for any individual newly diagnosed with a disease which may be or may become terminal. Hospice is ideal not only for patient care and comfort but for the family and friends of the patient who endure their own level of suffering along with the suffering of the patient. Works Cited: Caring Connections, 2008, “Grieving a Loss”, retrieved from website at: http://www.caringinfo.org/ Department of Health and Human Services, 2008, “Hospice care”, retrieved from website at: http://www.eldercare.gov/eldercare/Public/resources/fact_sheets/hospice_ca re.asp Hospice Foundation of America, 2008, “When your dying friends need help”, retrieved from website at: https://www.hospicefoundation.org/hospiceInfo/faq.asp Medline Plus, 2008, “Hospice Care”, retrieved from website at: http://www.nlm.nih.gov/medlineplus/hospicecare.html The Mayo Clinic, 2007, “End of Life: Caring for your dying loved one”, retrieved from website at: http://www.mayoclinic.com/print/cancer/CA00048/METHOD=print Read More