This article will focus on the psychological and social challenges facing an individual with a terminal disease and his or her family members.
Hospice, hospital hospice care provider and hospitality? The word “hospice” derives from the same linguist root as hospital and hospitality. The term goes back to medieval times when it described a place of shelter and rest for weary travelers on long journeys. Hospice was first used to describe specialized care for terminally ill patients in 1967 when the modern hospice movement began in England. Today the term “hospice” refers to a steadily growing concept of humane and compassionate care that is focused on the patient rather than the disease.
The VITAS Innovative Hospice was the pioneer care for adult and pediatric (Comfort Care) patients with a range of life-limiting illness. Today hospice care has moved the focus to providing care primarily in the patient’s homes; but also inpatient hospice, nursing homes and assisted living.
Hospice care focuses on relieving physical and psychological suffering, and improving the quality of life when a cure is no longer possible; the patient has six months or less to live if the illness follows its expected course. Pain control and symptom management, as well as emotional, spiritual, and practical support, are components of hospice care, which is directed by the patient’s own physician.
The goal of hospice care is to ensure that the patient is able to remain comfortable at his or her home, in control of personal and medical choices, while family members are supported as caregivers. Hospice Care Services include, in-home care provided by the Hospice interdisciplinary team, directed by the patient’s physician. Relief from pain and management of other symptoms, medications and equipment related to the illness, emotional support for the entire family, spiritual support and counseling, as requested. Additional services provided are bath and personal hygiene care, education on how to care for the patient and on the nature and course of the illness, volunteer support for caregiver and respite time, alternate levels of care, depending on medical needs, grief and bereavement support, and help with accessing other useful community services.
Numerous health professionals are involved in providing hospice care. The hospice team includes, a Medical Director, which oversees treatment by the hospice team and coordinates patient care with the patient’s physician, a Registered Nurses Case Manager responsible for managing physical care and coordinating other services. A Spiritual Care Coordinator assists in identifying spiritual concerns, and offers counseling, a Certified Home Health Aide will assist with personal hygiene needs, and a Bereavement Counselor supports the patient and family, and continues grief support with the family members for approximately 12 months after the patient’s demise.