In fact it is federally mandated that hospices must give the patient every option available to them in order to efficiently manage pain, "the federal guidelines regulating hospice require the hospice to make every reasonable effort to assure that the patient's pain is controlled," (Hospice Patient's Alliance, 2008).
Hospice services are sophisticated and rely on a number of professionals to help comfort and ease the pain of patients who have chosen to enter into a hospice care program. There is an entire structural hierarchy of care professionals which is designed to help the patient and family members along every step of the process. First and foremost comes the immediate medical staff which will be making medical decisions in regards to pain management and other forms of medical treatments. These staff members include doctors and trained nurses. Physicians are responsible for administering effective pain management methodologies, and are therefore very important in the structure of hospice care, (Help Guide, 2008). Along with the necessary decisions of pain medication, further medical staff is needed for everyday involvement of the patient's life and comfort. Nurses are the professionals who have the most hands-on responsibility for patients within the walls of inpatient facilities. Bereavement counseling and support is also offered to both patients and family members as needed throughout the entire process. This form of counseling can be obtained wither at an inpatient center or through programs which place the patient at home to be cared for.
Another route a patient can choose to take is at-home care. Services called "Home Health Aides and Homemaker Services," (Help Guide, 2008) are offered to assist family members in the in-home care of patients currently enrolled in hospice care programs. These professionals enter into the patient's home to check on conditions and needs, as well as to assist the family in anyway they are needed. Some at-home professionals can also provide life in services which take some of the responsibility of everyday care out of the hands of family members, so they can enjoy their loved ones without having to be involved in the physical needs of the patient. The family plays the largest role within the care of patients who have chosen to stay at home during their treatment. Family members then become responsible for creating a comfortable atmosphere as well as keeping the patient up-to-date with their medications and other treatment needs. However, this intensive care can prove to be a lot for a family to deal with. Therefore, many hospice programs also offer a type of temporary inpatient facilities in order to give the family a "breather," (Help guide, 2008). These programs are commonly known as respite care, and are designed as temporary inpatient services to help take some stress off of the family members who are otherwise involved within the everyday care of the patient.
There are several ways in which pain management within a hospice setting differs from traditional methodologies of pain management. Many of the medications used within hospice care would not traditionally be prescribed for normal pain management. In traditional cases, physicians tend to shy away from strong narcotics unless directly needed due to risks of later addiction and other serious complication. However, within the setting of a hospice, addiction is not a worry for physicians, "Addiction is a problem for those who are not dying," (Hospice Patient's Alliance, 2008). Therefore, they prescribe stronger pain management narcotics without fear of the risks which would pop up in normal medical situations. It is also important to decide which medications should be administered to each individual patient. Pain comes in many forms, not all of which will respond to the same pain medication. Therefore, doctors must choose carefully which medications to be administered based on a case by case basis. If the wrong medication is chosen, there may be unwanted side effects which in fact make the patient's state of life worse rather than better, "Increasing the dose of a medication which is not appropriate does not help, and only increases the adverse side-effects which good medical management tries to avoid," (Hospice Patient's Alliance, 2008). Making the patient as comfortable as possible is the basic fundamental principle of hospice philosophy, so why should any doctor prescribe medications which would only worsen the condition of the patient? The idea behind medication within a hospice setting only further strengthens the idea that each individual is the true focus of the treatment.
Another major element in hospice methodology is the implementation of the family into the care practice. In order to provide the most comfortable experience for the patient involved in the program itself, hospices provide "family-centered care and involves the patient and the family in making decisions," (American Cancer Society, 2008).
Family members are encouraged to participate within the daily routines of care. In many cases, the hospice care is set within the home of a family member. This not only proves beneficial to the patient, but also to the family involved within the care of that said patient, "Care is provided for the patient and family 24 hours a day, 7 days a week," (American Cancer Society, 2008). Research has proven the beneficial nature of family involvement within hospice treatment and decision making. Many hospices around the globe offer family members a key role within decision making, in order to help encourage the decisions made by the frail patients who are in question. Due to the patient being at the center of treatment, the family is essential in the decision making process. However, some research has shown that family members are not as active as they should be, leaving much of the decision making on the patient, which is sometimes unfair.
In many cases, the family is more directly involved with the patient remaining at the home of a family member during the hospice care. In fact, a majority of cancer patients decide to involve themselves within hospice care at the home of a loved one, with family members taking the highest role within their treatment and comfort needs. Many patients are offered the option of receiving hospice care from a variety of professionals, volunteers, and family members from the comfort of their home or the home of a loved one. This at-home care offers the best way to provide the comfortable and relaxing atmosphere while dealing with the final stage of the life cycle, without sacrificing true medical professionalism. As already seen, pain management is the utmost concern for hospice patients, and so patients who decide to undergo hospice care at a residential home must continually stay in contact with their physicians and nurses. There are several reputable Hospice Service providers which aim at maintaining the professionalism of an in-house facility, but within the comfort of one's own home, (Help Guide, 2008). It is in the home where the family becomes the patient's biggest allies in the entire process. Therefore, many cases are recommended to enter into a hospice care program which is centered within the family home. This provides a loving atmosphere for the patient, while integrating constant family contact which is sometimes lost at an in-house facility.
There are several advantages hospice care has to specific individuals who have decided to forgo their traditional medical treatments. As previously stated, in many cases of terminal illnesses, continuing treatment beyond a certain point can become a physical and mental burden for the patient. There comes a time where the treatment is neither working nor inspiring any form of hope within the patient, this results in unnecessary physical and mental pain and suffering. Therefore, the hospice aims at relieving pain as much as possible in order to help preserve the life which is left before the inevitable end part of the life cycle begins. The treatment within hospice care is designed specifically for pain management and patient comfort. With the pain of their disease increasing, the careful administration of strong pain medications ensures that the patient will avoid having to deal with suffering during their stay. Simply continuing on with their treatment may cause avoidable pain and suffering which would only lead to an undesirable condition of life.
Entering into a hospice program is also in no way a sign of giving up. It is a way to comfort the patient as much as possible in order to make life bearable. However, if the patient does show signs of recovery, he or she can be removed from a hospice program and entered back into traditional treatment, "If you get better or the disease goes into remission, you can be taken out of the hospice program and go into active cancer treatment," (American Cancer Society, 2008). There is nothing within hospice philosophy that limits patients from returning back into traditional treatments if their condition betters or if they decide to do so themselves. And once again, in…