Hospice A Vital Department In A Community Hospital Term paper
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General Purpose of the Department:
As we have learned, the hospice idea is not new. Literally meaning "given to hospitality," hospices provided comfort, kindness, and
nourishment to people in need hundreds of years ago. Today, hospices offer comfort to people as they near the end of life's journey.
Hospice is a special way of caring for people with terminal illnesses and their families. It is a multidisciplinary health care program that
is responsible for palliative and supportive care with consideration of the patient's and families wishes. Hospice focuses on care, not cure.
Hospice care is important because it provides many benefits that aren't possible in a traditional acute or long-term health care setting.
Within hospice, the family of the patient is directly involved in making decisions and helping their loved one. Hospice also gives the
patient to have a great amount of control by deciding where they want to spend the rest of their lives. It can also help make choices
about advanced directives which we will discuss shortly.
Major Functions of the Department:
Hospice is a very unique department because it truly looks at the "big picture" and treats a spectrum of patient needs equally. Special
attention is given to:
Physical needs - this is the first and foremost function. Within hospice you are dealing with a patient that has been given a diagnosis of
having 6 months or less to live. For many patients, relieving pain through medication is an important part of hospice care. I have
provided you with a list of ways that patients are made more comfortable. A goal of hospice it to help patients use their physical abilities
as fully as possible.
Social Needs - Sometimes little things make all the difference to people. Although these patients may not be as active as before their
illness, you can see on your handout a list of things that they probably still enjoy. Hospice can help to make these things happen, as well
as provide assistance with practical issues like putting finances in order.
Emotional Needs: Hospice can help patients cope with loneliness, isolation, and the fear of being abandoned. This is outlined on your
handout as to how the hospice staff accomplishes this. Hospice also helps friends and families of the patient express their emotions
through group and bereavement counseling.
Spiritual Needs - the realization that a person's spirituality is of a daily concern to the patient has led hospice care to this area. Hospice
tries to organize the types of care outlined on your handout. Members of the clergy can also help family and friends who are in need of
spiritual support.
As you can now see, there are many areas of patient care that hospice has a direct focus on. This now brings me to the subject of the
people involved: the staff.
Staffing of the Department:
As with all departments, the actual number of staff will vary by facility. However, there are required members of the staff that must have
certain qualifications. For instance, there must be nurses to do in-home care. These nurses can be either RN's or LPN's depending on the
level of patient care involved. In addition is a staff physician who consults with the patient's primary care physician and helps to oversee
the patient care plan. In addition, there are is a staff psychiatrist and a psychologist who do individual and family counseling, volunteer
visits, holiday programs, support groups, and learning about loss and grief. Some hospices help with funeral arrangements. Also part of
the hospice team are the hospice coordinator or director, other consulting physicians and specialists, a member of the clergy, a social
worker, a dietitian, a pharmacist, therapists who perform physical and occupational therapy. Also there are home care aides and
volunteers. Hospice members offer care for patients on-call 24-hours a day.
Depending on the patient's needs at the time, hospice care is provided in a variety of settings including the patient's home, inpatient
facilities including a nursing home, or a combination of venues.
.
Special Requirements:
Staff needs to be oriented in the special situations that arise in dealing with a patient in their own home. Respect for the patient and
their surroundings is of utmost importance. Being empathetic to even the smallest of concerns is the mark of a well-trained care-giver.
There must be an emphasis on maintaining a quality of life that the patient as well as the family feel comfortable with.
Since the patient is treated by such a wide variety of workers, there are weekly case management meetings which are mandated by
Medicare, but often also influenced by hospital policy to ensure quality of care. It is at this time that information is shared by all who
have had contact with the patient and any concerns are addressed. This helps for the staff to work out their feelings as well - because in
hospice care where you may treat a patient for a year or more, bonds begin to form.
Reports, Statistics, and Records:
I would like to spend a bit of time on this subject in consideration of the nature of our program. As director of the hospice program, one
duty that would fall on you is the compilation of statistics, the submitting of reports, and the overseeing of the legal medical record.
Since hospice keeps it's own legal medical record on their patients, their relationship with the medical record department is very limited.
If a hospice patient checks in to the hospital, there must be a release of information from hospice to the hospital in order to share
information.
Upon death, however, the hospice record is integrated with any hospital records into one main file which is archived according to
hospital policy on deceased charts.
Statistics compiled by this department include those reportable to the Montana Hospital Association such as number of referrals and
number of Medicare patients....
MLA Style
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