Who provides the care is dependent upon the patient and the type of care their illness requires. Also, some families are more active in taking care of end of life patients than other families. The social worker can greatly impact the ability of patient to die in the manner they wish.
Indeed, hospice care providers have a significant number of responsibilities as it relates to taking care of the patient. The type of illness that the patient has can increase or decrease the number of responsibilities of the hospice care providers. In any case, hospice care providers provide services tat ensure the comfort of the patient and they also attempt to make the emotional and psychological issues associated with dyeing, more palatable for the patient.
In addition to the issues that arise for the patient, caring for a loved one that is terminally ill is also extremely difficult for family members. As was mentioned previously in the discussion the purpose of a hospice is to serve both the patient and the family of the patient.
The family must be educated concerning the condition of the patient and how to care for them. In addition, if the patient has a long-term debilitating illness such as Alzheimer's disease, the family may have to be educated concerning the needs of the patient and the progression of the disease (Jennings et al., 2003). Additionally the family of a patient often requires access to mental health professionals because of the stress and depression that may occur as a result of caring for a loved one or dealing with the inevitability of death (Jennings et al., 2003). The hospice care is also there to assist the family when the patient dies. Many hospice programs provide bereavement counseling and may even assist with funeral arrangements. All of these services are extremely valuable to the family when they are losing someone that is loved (Jennings et al., 2003).
Most hospice care programs hold family conferences. The first family conference usually takes place when hospice care first begins (Forman, 2003). During the initial conference difficult emotional issues are discussed and the patient identifies various caregivers within the family who will be responsible for making decisions (Forman, 2003). The family conference is also important for the hospice care givers because it allows them to see the family dynamics and whatever communications problems that may be present within the family (Forman, 2003). Having this information allows the caregivers to bridge some of the communications gaps that may already exist within the family (Forman, 2003).
The author points out that at least one member of the interdisciplinary team must be present during the family conference.
Although hospice care workers such as nurses, doctors and psychologist are the most prominent members of the interdisciplinary team, social workers also play an important role in hospice care as it relates to patients and their families. According to an article found in the journal Health and Social Work, social workers are often needed in a hospice care situation to assist families in dealing with ethical dilemmas related to patient care (Csikai, 2003). Ethical dilemmas may include the type and dosage of pain medication that the patient will receive. In addition ethical dilemmas may be inclusive of the patient desire not to be on any life sustaining machines or vice versa (Csikai, 2003). The article further states
Other frequently discussed issues were families' denial of the terminal illness and that families might not be following the patients' wishes, which could cause or increase the risk of patient-family conflict (another identified common issue). Social workers can provide significant input into the resolution of these issues and discuss with other team members strategies they can use during home visits with patients and families. The resolution of these difficulties in hospice might make a critical difference in whether the patient has a " ...
Hiring hospice care providers
As a result of the type of care that is provided by a hospice program, hiring employees to work at a hospice program can be a difficult and complex undertaking. The difficulty associated with hiring the proper people exist because hospice care can be stressful and emotionally taxing on caregivers. Just because of nurse is equipped at working in a hospital or some other type of medical facility, they may not have the capacity to work in a hospice care program.
Nurses and nurses' aids are extremely important in the process of caring for end of life patients. These individuals are usually responsible for administering medicines. Taking care of patients' hygiene needs and making sure that the patient is comfortable. Other individuals such as doctors, and therapists also play a significant role, but nurses and their assistants are usually with the patient the most; in some cases the patient spends more time with these individuals than with their family. For this reason it is extremely important for these individuals to be properly trained and have the empathy to work in a hospice program.
According to Forman (2003) all hospice care workers must be carefully screened and must have credentials that exceed simply being trained in a certain field. An individual seeking a position in a hospice program should have an n interest in assisting terminally ill patients, but if they seem to have an obsession with death and dyeing it may be an indication that the individual is not right for the job. In addition, the person seeking the position should not be going through the grief process in their own life (Forman, 2003). The author points out those who have gone through losing a loved one can be a valuable asset in helping families (Forman, 2003). However, if an individual is still dealing with the death of a loved one, they may not be ideal for hospice care (Forman, 2003).
In addition to the aforementioned issues it is also important that individuals working in home hospice situations have some additional attributes that are necessary when working in that environment. For instance, individuals that work in home hospice programs must be comfortable working alone for a majority of the time but still sharing information with the entire interdisciplinary team (Forman, 2003).
Good communication is another extremely important aspect of working in hospice care (Forman, 2003). The hospice care worker must have the capacity to talk and listen to the patient, family of the patient and other members of the interdisciplinary team. Good communication allows the interdisciplinary team to come up with the best plan of action for the patient and to discuss the plan of action with the family. If proper communication does not take place the patient and the family may suffer (Egbert & Parrott, 2003).
The purpose of this discussion was to examine death and dying and hospice care workers roles in providing care not only to the patient but also the families of those that are dying. We began our discussion by defining hospice care and providing some background information. The research indicates that hospice care allows terminally ill patients to receive physical, psychological and social care before death. The research also indicates that hospice care is designed not only to assist patients but also their families as it relates to end of life care. We found that hospice care began in England and came to America in the 1970's. The research revealed that Connecticut was the first state to have a hospice care facility and Medicare began o offer hospice care in the 1980's.
According to the investigation hospice care workers are there to assist patients in several ways and to ease the difficulty associated with illness and death. Hospice care most often consists of an interdisciplinary team that includes doctors, nurses, psychologists and social workers. All of these individuals work together to ensure that the physical, emotional, spiritual and psychological needs of the patient and the family are met. In addition to assisting the patient, the hospice care workers are also there to assist the families with the bereavement process after the patient has died. The research also indicates that hospice workers must have certain attributes because of the stressful nature of hospice care.
Overall the research indicates that hospice care workers provide patients and their families with invaluable services and assist the terminally ill in a manner that is not found in a regular hospital setting. It is apparent that the presence of hospice care facilities and workers might continue to expand as people wit some terminal illnesses are living longer.
Csikai, E.L. (2004). Social Workers' Participation in the Resolution of Ethical Dilemmas in Hospice Care. Health and Social Work, 29(1), 67+.
The social worker can greatly impact the ability of patient to die in the manner they wish.
Death and Dying 'My new body was weightless and extremely mobile, and I was fascinated by my new state of being. Although I had felt pain from the surgery only moments before, I now felt no discomfort at all. I was whole in every way -- perfect," (Eadie "Embraced" 30). In her groundbreaking book Embraced by the Light, Betty J. Eadie writes about her own near-death experience to help dispel the
Healthcare The Pilgrims Must Embark addresses specific issues associated with treating persons with AIDS (PWA). The film exhibits the importance of cultural sensitivity and communications in nursing. "Many hospitals are ill equipped to care for the chronically ill, and nursing homes are reluctant to admit PWA," (Adelman & Frey, n.d., p. 4). Creating an independent but assisted living community became the central challenge, focus, and goal of the Bonaventure House. The
Kubler-Ross, Elisabeth. On Death and Dying. Scribner, 1997. A seminal work on the subject of death and dying, Kubler-Ross's book was initially published in the 1960s and remains relevant. On Death and Dying is a commentary on the views toward death and dying held by our culture and therefore illustrates the underlying moral and ideological principles that have guided public policy in the area of right-to-die ethics. Moreover, Kubler-Ross emphasizes
Hospice and Attitudes Towards Death Attitudes towards dying, death, and bereavement are very dependent upon culture. Some cultures embrace death as a natural part of the life cycle and do not attach fear to death. Other cultures are very fearful of the topic of death and treat it like a taboo. "In many preliterate societies, the dead are imbued with special powers and considered potentially harmful to the living. Many customs
Field, Marilyn Jane & Cassel, Christine K. (1997). Approaching Death: Improving Care at the End of the Life. National Academic Press. This work emphasizes the necessity to improve end of life care as a way to help ease fears about death and reduce anxiety which would create a more negative death experience within the nursing home. Additionally, this work shows the negative impact of over treating symptoms that are relating to
2006, p.1). In Anglo culture, extremities of grief may be reserved for close family members, while in cultures where extended family is important, intense grief may be acceptable and expected, even for distant family members There is also greater acceptance of death in the Latino culture as a whole, as manifest in the almost festive 'Day of the Dead' rituals in that nation, in which children often participate, and