Hospice Care: An Inclusive ApproachPosted on September 19, 2014 by ElderCare Resources Phoenix in Blog, Caregiving, Education, Hospice & Palliative Care
What to look for in a hospice program
By Mary K. Spengler
When a loved one has received a life-limiting diagnosis, planning the next steps can be difficult. Curative medical treatment may no longer be an option, yet your loved one continues to need support and care. Hospice is designed to ensure a person who is nearing the end of his or her life remains comfortable and at peace physically, emotionally and spiritually.
Hospice care is becoming more common and readily available in communities across the U.S. The National Hospice and Palliative Care Organization estimated that in 2012, 66 percent of hospice services in this country were provided in patients’ places of residence, including skilled nursing facilities, with the remaining percentage taking place in hospitals and hospice inpatient facilities. Hospices differ in their scope of services offered, so family members should look for key components that will best meet the needs of their loved one and the family.
• A physician medical director oversees and guides the hospice team in the development of patient care plans, and may also serve as the main contact with the patient’s primary physician.A hospice should offer patients and their families, access to qualified health professionals with a broad range of specialties:
• Registered nurses coordinate the medical aspects of patient care, including pain management, equipment and supplies, communication with physicians and education of family caregivers. Some hospices employ RNs with medical specialties such as oncology, cardiac care, pediatrics or geriatrics that enable them to address the disease-specific requirements of each individual.
• Social workers counsel patients and families dealing with psychological and emotional stresses such as anxiety, guilt or depression. They facilitate communication between family members as the family learns to respond to the changing needs of the patient. Social workers also assist in decision-making and arrange for necessary community resources.
• Spiritual counselors work with patients and their families to provide emotional and spiritual support.
• Home health aides, under the supervision of an RN, provide patients with personal care and assist with daily activities.
• Volunteers are special and necessary members of the patients’ care team. They offer many special talents and should be trained in a specific area of service.
Pain, discomfort and other symptoms do not know the difference between day and night. An RN should always be available by phone and ready to make a home visit if necessary. This important service helps to alleviate family and patient stress and enhances patient comfort.
End-of-life care is supportive, with a goal of keeping the patient as comfortable as possible. Patient care frequently focuses on control of pain and disease symptoms. Hospice personnel who keep up with medical and pharmaceutical advances are in the best position to manage each patient’s comfort level through a combination of medications. RNs are particularly skilled in assessing and managing symptoms and scheduling medications to enable patients to remain as alert and free of pain as possible.
Family members are an integral part of caring for a loved one with a terminal illness. A hospice should view the patient and family as a single unit for care, decision-making and support. Family involvement can enhance the patient’s comfort, dignity and quality of life.
Caring for the “whole” patient is an essential feature of hospice. Mind-body complementary therapies like massage, music therapy and reflexology can help ease tension, reduce anxiety levels and improve the overall comfort of the patient.
Caregiver burnout from the isolations and demands of providing care and support is not unusual. Therefore, hospices should be able to provide periods of “respite” care, usually involving a short in-patient stay, to give caregivers necessary relief from the physical and mental stresses they experience.
Following the loss of a loved one, feelings of grief can be intense and unpredictable. Hospices should provide bereavement services for 13 months following the loss of a loved one. Trained clinical social workers talk to family members and assist them in the process of healing and adjusting to their loss.
A comprehensive hospice program strives to bring comfort to patients and families alike, allowing them to share the patient’s end of life with dignity, peace and respect. The hallmark of a good hospice program is the recognition of the uniqueness of each individual and the ability of the team to be guided by the wishes of those they serve.