Hospice Essays (Examples)

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ANA Nursing Code of Ethics ANA Code

Words: 1795 Length: 5 Pages Document Type: Essay Paper #: 61337630

ANA Nursing Code of Ethics

ANA Code of Ethics Applied to Current Practice Philosophy

The objective of this study is to discuss provisions one through nine of the ANA Code of Ethics and apply it to the current practice philosophy. A well this work will discuss provisions seven through nine of the ANA Code of Ethics and apply it to the current practice philosophy and answer how the two relate. The differences between professional responsibility and accountability in the nursing practice will be discussed and examples provided. Finally, this study seeks to answer after what has been learned in addition to readings and self-assessment activities what can be implemented in the practice that would strengthen this experience for one's peers and in terms of self-development on the Novice to Professional continuum.

The American Nurse Administration Code of Ethics Provision One states that the nurse practices, in all professional relationships "with…… [Read More]

References

Bamford, M, Wong CA and Laschinger H (2012) The Influence of Authentic Leadership and Areas of Worklife on Work Engagement of Registered Nurses. J Nurs Manag 2012 26 Apr. Retrieved from:  http://www.ncbi.nlm.nih.gov/pubmed/?term=nurse+ethics 

Butts, JB (nd) Ethics in Professional Nursing Practice. Chapter 3. Jones and Bartlett Publishers. Retrieved from:  http://www.jblearning.com/samples/0763748986/48986_ch03_pass3.pdf 

Code of Ethics for Nurses with Interpretive Statements (2010) Nursing World. Retrieved from: http://nursingworld.org/FunctionalMenuCategories/AboutANA/Leadership-Governance/Nursing-Code-of-Ethics.pdf

Dahnke, MD (2009) The Role of the American Nurses Association Code in Ethical Decision Making. Holist Nurs Pract 2009. Mar-Apr;23(2):112-9. Retrieved from:  http://www.ncbi.nlm.nih.gov/pubmed/19258853
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Health Care System Has Focused on the

Words: 2963 Length: 11 Pages Document Type: Essay Paper #: 36873509

health care system has focused on the prevention and cure of disease and illness. When people got sick, every bit of energy and finances went into trying to figure out how to stop it. This was true even when the patient had a disorder or a disease that was deemed incurable. For many years when someone got a disease in which there was no cure, it did not change the method of treatment. The medical community, the family and the patient continued to try every possible avenue to stop the progress. Often times the patient would submit to painful and disorienting treatments, because they didn't want to disappoint their family members or their doctors. At the same time the medical community was expanding the length of life so that many people were living longer than ever before. These two things began to clash. At what point do people stop trying…… [Read More]

References

Public health system suffers from chronic underfunding http://home.aigonline.com/content/0,1109,16263-694-ceo,00.html

NEWS FROM AROUND AFRICA http://www.hospicecare.com/Newsletters/july2003/page8.html

Healthcare & Medical Market in Morocco http://www.tradepartners.gov.uk/healthcare/morocco/profile/overview.shtml

What is Hospice? http://www.hospicefoundation.org/what_is/
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Program Budget and Cost Analysis

Words: 4858 Length: 16 Pages Document Type: Essay Paper #: 97749747

Program Budget and Cost Analysis

Line-Item Budget for an in-Service Dementia Care Training Program

Florida now requires all direct-care staff working with dementia patients to receive specialized training. The curricula offered must be vetted by the Training Academy of the University of South Florida's Policy Exchange Center on Aging, otherwise assisted living facilities, nursing homes, adult day care, and hospices will be unable to accept patients with dementia into their facilities. In order to meet these statutory requirements and improve patient care, an in-service training program in dementia care will be instituted for a hospice facility located in Florida.

The Hospice House in Cape Coral, Florida maintains 36 beds for patients with terminal illnesses. On average, a little over 60% of the residents suffer from dementia at any one time, which is consistent with national trends (Williams, Hyer, Kelly, Leger-Krall, and Tappen, 2005, p. 98). The number of patients tends…… [Read More]

References

CMS (Centers for Medicare & Medicaid Services). (n.d.). Hospice Center. CMS.gov. Retrieved 13 Mar. 2012 from www.cms.gov/Hospice/Downloads.2011_Aggregate_Cap.pdf.

Goyder, Judith, Orrell, Martin, Wenborn, Jennifer, and Spector, Aimee. (2012). Staff training using STAR: A pilot study in UK care homes. International Psychogeriatrics, published online ahead of print, p. 1-10. Retrieved 13 Mar. 2012 from http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8473487.

Hobday, John, V., Savik, Kay, Smith, Stan, and Gaugier, Joseph E. (2010). Feasibility of internet training for care staff of residents with dementia: The CARES® Program. Journal of Gerontology Nursing, 36, 13-21.

Hyer, Kathryn, Molinari, Victor, Kaplan, Mary, and Jones, Sharmalee. (2010). Credentialing dementia training: The Florida experience. International Psychogeriatrics, 22, 864-873.
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Individual Case Analysis Terri Schiavo

Words: 1880 Length: 4 Pages Document Type: Essay Paper #: 14967734

Ethics

The Terri chiavo case was an unusual incident where a person who should have been removed from life support long ago was sustained due to federal and public intervention. The case instigates moral and ethical questions of decision to end life as well as the limits of autonomy in surrogate decision making. Torke et al. (2008) argue that guardian judgment is often used as decision-making when a patient lacks the cognitive abilities to decide treatment for herself. urrogate decision-making, however, has its own flaws and should be replaced by something more rational. Using the Terri chiavo case as base, the following essay argues that the decision whether or not to prolong a patient's life (or indeed any decision revolving on an incumbent or cognitively disabled patient) should focus on the patient's dignity and individuality rather than on his or her autonomy.

The Terri chiavo Case: background

The Terri chiavo…… [Read More]

Sources

Ditto, PH (2006) What would Terri want? On the psychological challenges of surrogate decision making. Death Studies, 30: 135 -- 148,

Lazzaerini, Z et al. (2006) Legal and policy lessons from the Schiavo case: Is our right to choose the medical care we want seriously at risk? Palliative & Supportive Care, 4, 145-153

Mathes, P (2005) Terri Schiavo and End-of-Life Decisions: Can Law Help Us Out? MEDSURG Nursing, 14 Issue 3, p200

Torke, AM et al. (2008) Substituted Judgment: The Limitations of Autonomy in Surrogate Decision Making J. Gen Intern Med. 23(9):1514-7.
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Deaf Community and Its Need

Words: 3490 Length: 13 Pages Document Type: Essay Paper #: 23751505

Equally destructive is the attitude that communicating with the Deaf person may involve more time and effort than one wishes to expend" (Zieziula, 1998, p. 193).

Moreover, and perhaps one of the most important challenges related to this issue, a large percentage of deaf individuals do not trust the hearing society. "Historically, the dominant hearing culture has relegated deaf people to social categories such as "handicapped" and "outsider." The history of oppression and exclusion of the deaf community -- although with important variations depending on the countries -- and the ignorance and rejection of the natural and preferred means of communication of many of them is a well-known and many times denounced phenomenon," (Munoz-Baell & uiz, 1999, p. 1).

Finally, there is a real deficiency of information in Deaf culture regarding hospice and its related services. Finding appropriate facilities can be a time-consuming and frustrating process.

The program: breaking down…… [Read More]

REFERENCES

Berke, J. (2009). Deaf Awareness Week. Retrieved April 10, 2010, from the About.com Website: http://deafness.about.com/cs/events/a/deafawareness.htm

Deaf Community Health Workers Provide Education and Support to Deaf Patients, Facilitating

Access to Linguistically and Culturally Appropriate Care, Improving Patient Health

Knowledge and Adherence to Recommended Care. (2005.) Retrieved April 10, 2010, from the AHRQ Health Care Website: http://www.innovations.ahrq.gov/popup.aspx?id=2757&type=1&name=print
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Communication Nurse to Doctor

Words: 1938 Length: 6 Pages Document Type: Essay Paper #: 19907074

Communications

Effective communications between doctors and nurses has always been a high priority in the medical field, especially in an arena such as a hospital, health clinic or hospice. Communicating effectively between the nurses and the doctors is especially important in a hospice setting due to the fact that the patient is usually suffering the most; both with the physical and the emotional pain and suffering that is being experienced as the patient nears death.

One recent study determined that "doctors and nurses have different but complementary roles in what, when and how treatment choices are negotiated with patients" (Mccullough, Mckinlay, Barthow, Moss, Wise, 2010, p. 482) and the treatment choices when facing death are decisions that should not be taken lightly, either by the involved nurses or the doctors. The decisions taking place in the hospice setting will often determine how much pain and suffering the patient will endure…… [Read More]

References

Basch, E.; (2010) The missing voice of patients in drug-safety reporting, New England Journal of Medicine, Vol. 362, Issue 10, pp. 865-869

Bezzina, A.J.; (2009) Prevalence of advance care directives in aged care facilities of the Northern Illawarra, Emergency Medicine Australia, Vol. 21, Issue 5, pp. 379 -- 385

Byrnes, J.; Braden, J.; James, G.; Broadus, T.; Owen, R.; (2011) Implementing an electronic medical record (EMR) in an integrated delivery system Sharp Healthcare (SHC) San Diego, California, accessed on September 25, 2011 at http://proceedings.amia.org/1alo2n/

David, S.E.; Ahmed, Z.; Salek, M.S.; Finlay, A.Y.; (2005) Does enough quality of life related discussion occur during dermatology outpatient consultations? The Journal of Dermatology, Vol. 153, pp. 997 -- 1000
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Life Care in the United

Words: 1208 Length: 4 Pages Document Type: Essay Paper #: 20114513

However...generally a vast difference exists between what healthcare providers understand and what laypersons are able to comprehend. This immeasurability of knowledge was evident in the participants' narratives and was exacerbated by the conveying of "false hope" or "false optimism" to patients and patients' family members.

Seconding Robichaux's argument is ackstrand's (2006) findings that hospital-based EOL programs are not the "ideal" form of healthcare that elderly patients should receive, according to a survey of nurses. For the nurses, "no patient should face death alone," which ultimately happens when patients are confined in a hospital facility receiving palliative care. Comparing ICU EOL care against the hospice and nursing home care programs, 'dying with dignity' is remote in this kind of program, since "[t]he ICU is no place to die. It would be nice to have a comfortable, quiet, spacious room for those who are dying. Let everyone in and let the rest…… [Read More]

Bibliography

Anderson, R. (2003). "Nursing home quality, chain affiliation, profit status, and performance." Journal of Real Estate Research, Vol. 25, Issue 1.

Backstrand, R. (2006). "Providing a "good death": critical care nurses' suggestions for improving end-of-life care." American Journal of Critical Care, Vol. 15, Issue 1.

Elliot, D. (2006). "Determining the financial impact of hospice." Healthcare Financial Management, Vol. 60, Issue 7.

Imhof, S. (2005). "What do we owe the dying? Strategies to strengthen end-of-life care." Journal of Healthcare Management, Vol. 50, Issue 3.
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Nursing Literature

Words: 1675 Length: 5 Pages Document Type: Essay Paper #: 48611587

McMillan, S.C., & Small, B.J. (2007). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients. Oncology Nursing Forum, 34(2), 313-21.

Are there any HIPAA concerns that are evident in this study?

Both caregivers and patients were required to sign informed consent documentation in order to participate in the study. Were any concerns related to HIPAA indicated in the protocol or procedures for conducting the study, those concerns would need to be delineated in the consent documents and explained to the participants. Since caregivers were an integral component to the hospice care and quality of life measures for patients, patient privacy could be maintained just as with any other medical or healthcare services.

What methods were put in place to ensure that the subjects were giving true informed consent?

The inclusion criteria and protocol for participating in the study required that patients and caregivers both be…… [Read More]

References

McMillan, S.C., & Small, B.J. (2007). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients. Oncology Nursing Forum, 34(2), 313-21.

Rosedale, M., & Fu, M.R. (2010). Confronting the unexpected: Temporal, situational, and attributive dimensions of distressing symptom experience for breast cancer survivors. Oncology Nursing Forum, 37(1), 28-33.
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Ethics as a New Graduate of Six

Words: 1279 Length: 5 Pages Document Type: Essay Paper #: 28819049

Ethics

As a new graduate of six months working night shift on a small cancer unit, I am faced with a dilemma. Mr. V has been in and out of the unit several times over the last few months. He has liver cancer and has gone through several episodes of chemotherapy. His wife has been staying with him since his admission. There are two RN's on this unit.

Mr.V recently joined the hospice program. His current admission is for pain control with orders to start a morphine drip to be regulated for pain control.

The only set parameters indicated by hospital policy are to decrease the drip when respirations are less than twelve breaths per minute. Mr. V has requested that the drip be increased several times during my shift. Even though he does not appear to be in any discomfort, I increase the drip. On my final round of…… [Read More]

Bibliography

Strevy, S.S. Myths & facts about pain. RN, 42-45. 1998, February.

C. Junkerman and D. Schiedermayer, Practical Ethics for Students, Interns, and Residents, 2nd Ed, Frederick, MD: University Publishing Group, 1998.

American Nurses Association. Code for Nurses With Interpretive Statements. Kansas City, MO: the Association. 1985.

Strevy, S.S. (1998, February). Myths & facts about pain. RN, 42-45.
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Rating 3 Although the Paragraph

Words: 2097 Length: 6 Pages Document Type: Essay Paper #: 77426525

These included guidelines fom the Austalian National Beast Cance Cente and the Austalian National Cance Contol Initiative; an updated systematic eview of the eseach evidence, and a consensus by the Clinician -- Patient Communica-tions Woking Panel of the Pogam in Evidence- Based Cae of Cance Cae Ontaio.

The eliability of these studies also lends cedence to the outcome measues in that the study gains intenal validity due to the fact that the pocess measues matched the objective of the study.

The fact, howeve, that only 33 paticipants esponded endes the sample small and detacts fom its eliability making it difficult to eplicate to othe instances. This endes the outcome measues uneliable.

On the othe hand, simila online and offline eseach, both quantitative and qualitative, time and again, indicates the impotance of communication in tems of hospice patient cae. Cance patients, it is shown, too pofit fom impoved docto-patient communication (e.g.…… [Read More]

references

Significant news should be given carefully, one-to-one, in a quite place

Communication should be honest and optimistic, showing concern for patient and willingness to be there for him or her

Use memory heuristics, such as visual aids, or recording the consultation to help patient remember details.

Allow patients to express feedback and articulate their feelings
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Quality Improvement Project the Medical

Words: 1818 Length: 6 Pages Document Type: Essay Paper #: 64704282

In terms of communication within the hospice setting, this might occur by means of communicating with patients and their families to determine whether they experience their care setting in an optimal manner. If this is not the case, strategies are implemented to address the commonly experienced difficulties.

CONCLUSION

In conclusion, communication is a vitally important part of any care setting. Patients and their families must feel that they are the recipients of patient-centered care, and that they receive sufficient information to help them through difficult times. It is suggested that the PDSA model will be an effective way to accomplish this, along with process mapping. A logical sequence of steps must first address the underlying reasons behind the lack of effective communication among staff and patients. This can relate to the stress factors and harsh work schedules that practitioners often face. To work in such an emotionally eroding environment makes…… [Read More]

References

IHI.org. (2011). Improvement Methods. Retrieved from: http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/HowToImprove/

Leavitt, M.O. (2009). Report to Congress on the Evaluation of the Quality Improvement Organization (QIO) Program for Medicare Beneficiaries for Fiscal Year 2006. Retrieved from: http://www.cms.gov/QualityImprovementOrgs/downloads/2006RtCQIO.pdf

Melinkovich, P. (2011). Adoption of Rapid Cycle Improvement Process From Toyota Increases Efficiency and Productivity at Community Health Clinics. AHRQ. Retrieved from http://www.innovations.ahrq.gov/content.aspx?id=1807

Victorian Quality Council. (2007, June.) Process Mapping. Retrieved from: http://www.health.vic.gov.au/qualitycouncil/downloads/process_mapping.pdf
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Intervention Nursing Research Using the Cope Intervention

Words: 569 Length: 2 Pages Document Type: Essay Paper #: 70400760

Intervention

Nursing esearch

Using the COPE Intervention for Family Caregivers to Improve Symptoms of Hospice Homecare Patients: A Clinical Trial

This study was designed to test an intervention for hospice caregivers in order to help them better manage symptoms experienced by patients with cancer. The authors maintain that research indicates caregivers are unable to accurately assess and report the intensity of symptoms and overall quality of life (QOL) of patients with cancer and patients in hospice care.

Three symptoms, pain, dyspnea, and constipation, are commonly are seen in patients with advanced cancer. However, the author's site research that asserts that these symptoms are assessed inadequately and managed poorly in many patients. Pain and dyspnea have been found to create symptom distress, significantly affecting patient QOL.

The authors claim that caregivers must develop the skills needed to function effectively as part of the healthcare team. Building the knowledge base and teaching…… [Read More]

References

McMillan, S.C. & Small, B.J. (2007, March). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients: A clinical trial. Oncology nursing forum, Vol. 34, Issue 2, 313-321. Retrieved January 20, 2012, from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=3&hid=14&sid=b3e07ee7-388a-4d19-97ef-163b481297fd%40sessionmgr15
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Quality Improvement Project

Words: 501 Length: 2 Pages Document Type: Essay Paper #: 72384595

Caregiving to Elderly People

In this document, interactive caregiving training is briefly discussed.

Caregiving to Elder People

ecent developments at the medical industry and more health conscious diet increase the life expectancy. According to the Census, 36.3 million Americans were 65 and over in 2004 and the numbers are expected to increase as 71.5 million in 2030. Aging brings serious memory problems, emotional and physical declines along with the natural changes of inner and outer organs. Taking a good care of an elderly person with memory loss, dementia and Alzheimer's disease is a very demanding job requiring serious physical and mental efforts. Therefore, intellectual and mental training of the caregivers is very important. The physical work caregivers undertake is very hard including bathing elderly people, feeding them, running errands and trying to understand what they really need. The result of this long-term care is exhaustion, anxiety and depression. egardless of…… [Read More]

References

Practice Guideline for the Treatment of Patients with Alzheimer's disease and Other Dementias" American Psychiatric Association. October 2007. http://www.psychiatryonline.com/pracGuide/loadGuidelinePdf.aspx?file=AlzPG101007. Retrieved 2007-12-28.
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Jewish Client When Discussing Medical Care With

Words: 376 Length: 1 Pages Document Type: Essay Paper #: 44599599

Jewish Client

When discussing medical care with Sara, one must keep in mind that she is alone now, having been married for 50 years, but now widowed. She seems to have a rather active social circle, and is more of a middle-of -- the road practitioner of Judaism. Her belief system is likely sensitive to end-of-life issues, but she seems to be a candidate for hospice, rather than palliative care due to her age and the progression of her illness.

In response to Sara's initial decision to have surgery and treat the cancer with chemotherapy, medical personnel would be required to allow her this choice, but ensure that the principles of fidelity and benevolence are followerd. In other words, tell Sara the truth about odds and any prognosis, as well as side-effects. Inform her in a way that is non-paternalistic so that she may make up her own mind about…… [Read More]

REFERENCES

Edgedorf, L. (2005). Medical Ethics. New York: Greenhaven Pres.

Jewish Home Lifecare (2013). How Does Pallative Care Differ From Hospice Care? Retrieved from: http://www.jewishhome.org/our-services/palliative-care/how-does-palliative-care-differ-from-hospice-care
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Population in the United States

Words: 580 Length: 2 Pages Document Type: Essay Paper #: 55697997

They are noo logner able to live; it is the etchial obligation of the hostpital staff to ensure that they die in peace. t is cruaical, tehore, we work towards and test methods for alleviating pain.

mplementation of 48-hour Pain Management System in Hospice Care

The American Pain Society (APS) issued a set of guidelines in the 1990s intended to standardize and improve pain management, thereby providing a framework for assessing care quality. n January 2001, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) began to assess pain management as part of its accreditation process, through the use of evidence-based standards ( Gordon et al., 2002). n 2002, a set of six consensus pain management standards were revealed by a meta-analysis of 20 research studies from 1992-2001 (Gordon et al., 2002). These were (1) the use of a numeric or descriptive scale to represent pain intensity, (2) frequent pain…… [Read More]

Implementation of 48-hour Pain Management System in Hospice Care

The American Pain Society (APS) issued a set of guidelines in the 1990s intended to standardize and improve pain management, thereby providing a framework for assessing care quality. In January 2001, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) began to assess pain management as part of its accreditation process, through the use of evidence-based standards ( Gordon et al., 2002). In 2002, a set of six consensus pain management standards were revealed by a meta-analysis of 20 research studies from 1992-2001 (Gordon et al., 2002). These were (1) the use of a numeric or descriptive scale to represent pain intensity, (2) frequent pain checks, (3) avoidance of intramuscular analgesics, (4) regular analgesic administration and preferably multimodal in nature, (5) keeping the patient informed about the pain management approach, and (6) treating with the goal of improving function and quality of life.

Such efforts to identify benchmarks or key performance measures (KPM) were intended to address many significant shortcomings related to effective pain management. A series of reports in the 1990s revealed these shortcomings and they included inadequate pain management, lack of coordinated care, and shortsightedness in terms of the long-term costs (Twaddle et al., 2007). In the past, palliative care would also be deferred until it became obvious the patient was dying. In essence,
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Sociology Social Work Questions Explain Why Children in

Words: 3101 Length: 8 Pages Document Type: Essay Paper #: 47993954

Sociology/Social Work Questions

Explain why children in the early-school-aged period may be especially vulnerable to fluctuations in self-esteem and feelings of "worthlessness."

Young children, in the early school aged years are in a developmental stage that is focused on feelings of identity and self-esteem (Nutbrown & Clough, 2009, p 191). It is during the early years of school that children begin to form concepts of identity through a sense of belonging as well as through the demonstration that they are needed by others in their community, and especially those they hold in high regard, peers and teachers. They seek to demonstrate for themselves that they play an important role in their own lives and communities to help them establish a sense of self. In other words they seek almost above all else to establish that they are valuable and have purpose in their community and especially in school as this…… [Read More]

References

Barker, E.D., Tremblay, R.E., Nagin, D.S., Vitaro, F., & Lacourse, E. (2006). Development of male proactive and reactive physical aggression during adolescence. Journal Of Child Psychology And Psychiatry, 47(8), 783-790. doi:10.1111/j.1469-7610.2005.01585.x

Craig, W.M., Vitaro, F., Gagnon, C., & Tremblay, R.E. (2002). The road to gang membership: Characteristics of male gang and nongang members from ages 10 to 14. Social Development, 11(1), 53-68. doi:10.1111/1467-9507.00186

Emanuel, E.J., & Emanuel, L.L. (1998). The promise of a good death. Lancet, 351(9114), SII21.

Hamachek, D. (1990). Evaluating self-concept and ego status in Erikson's last three psychosocial stages. Journal Of Counseling & Development, 68(6), 677-683.
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Model for Community Palliative Care

Words: 1740 Length: 6 Pages Document Type: Essay Paper #: 36797784

Community Dementia Care and the Chronic Care Model

nd-Stage Dementia valuation Proposal

Health Promotion Plan for Community nd-Stage Dementia Care: The Chronic Care Model

Health Promotion Plan for Community nd-Stage Dementia Care: The Chronic Care Model.

In 2013 an estimated 5.0 million Americans over the age of 65 suffered from Alzheimer's disease (Alzheimer's Association, 2013). Although the U.S. Centers for Disease Control and Prevention (CDC) considers dementia/Alzheimer's to be the fifth leading cause of death among adults 65-years of age or older, careful examination of Medicare claims data revealed that dementia is probably right behind cardiovascular disease as the second leading cause of death for this age group (Tinetti et al., 2012). Most of these patients would prefer to die at home, not only because of comfort concerns, but due to the higher quality of care that tends to be provided by informal and paid caregivers in this setting (reviewed…… [Read More]

Eloniemi-Sulkava and colleagues (2009) evaluated patients at baseline using the Barthel Index and Neuropsychiatric Inventory (NPI) (see Appendix). The Barthel Index (Stone, Ali, Auberleek, Thompsell, & Young, 1994; University of Iowa Healthcare, n.d.) and NPI (Cummings et al., 1994) were administered again at 6 and 12 months into the study and will be used in the current study to track ADL and BPSDs using the same intervals. PQOL will represent a composite score obtained using the Color Analog Scale for pain (Santos & Castanho, 2013) and the Quality at the End of Life Scale (QUAL-E) (National Palliative Care Research Center, 2005) (see Appendix). In cases of severe cognitive impairment, completion of the QUAL-E may depend on family caregivers. FCQOL will be evaluated using the Zarit Burden Scale (Regional Geriatric Program Central, 2014) (see Appendix). The success of the intervention, as perceived by family caregivers and providers, will be assessed using the questionnaires developed by Morita and colleagues (2013). The goal of these questionnaires will be to evaluate how effective the community palliative intervention was in improving the knowledge and skills of palliative care, increasing access to specialized services, coordinating care services, and increasing deaths at home. This evaluation will be performed following the death of the patient or the end of the study period, whichever comes first. The validity and reliability of the questionnaires developed by Morita et al. (2013) have not been evaluated, but should prove informative and provide context for the other findings.

Discussion

A review of interventions designed to improve the quality of community palliative care has revealed mixed findings, but the trend is in the desired direction of reducing the number of patients dying in hospital wards, ICUs, and hospice facilities. CCM has garnered the interest of researchers interested in improving palliative care outcomes for patients, family caregivers, and providers alike, and have begun to study the efficacy and quality of interventions, including CCM. This proposal provides justification for implementing CCM for end-stage dementia patients residing at home and details an evaluation strategy that can be implemented to determine the efficacy, effectiveness, and quality of the care provided. In contrast to many other studies, however, this proposal places equal value on the experiences of patients, family caregivers, and providers alike, in addition to the more common outcome measures of BPSDs and institutional admissions. The methods of data gathering will involve the review of patient records and several instruments designed
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Cross-Cultural Communication

Words: 1450 Length: 4 Pages Document Type: Essay Paper #: 57974514

Ocial Work Practice With Individuals: Engagement Strategies

First I need to get past Mr. Fahza's son in order to get to his father. I need the former's agreement because I need a smooth start. His son agreement would encourage a discussion under the right auspices.

According to The Patient Self-Determination Act (PSDA) of 1990, Mr. Fahza has the right to be informed about his own clinical condition in order to take a decision about continuing with chemotherapy or going to the hospice and die peacefully. This is the strict approach of the western hemisphere.

The religion of Islam believes in death and resurrection of the body and soul, like Christianity. Islam also teaches about how to prepare for death, when aware that death is imminent. Statistics show that a vast majority of the American male population would want to know about the eventuality of dying because of a fatal illness…… [Read More]

Reference list:

Kagawa-Singer, M., & Backhall, L. (2001). "Negotiating cross-cultural issues at end of life." Journal of American Medical Association, 286(3001), 2993-. Available at:  http://ethnomed.org/clinical/end-of-life/Table2.pdf  retrieved: Oct 7th, 2014

Koenig B.A., Gates-Williams J. (1995) "Understanding cultural difference in caring for dying patients." West J. Med. Sep 1995; 163(3): 244 -- 249. Available at:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1303047/?page=4 

Coolen Phyllis R., DNP, MN, RN. (2012)Cultural Relevance in End-of-Life Care. EthnoMed. Available at:  https://ethnomed.org/clinical/end-of-life/cultural-relevance-in-end-of-life-care 

Rizvi, Sayyid Muhammad. What You Should Do Just Before Death. Islam.org. Available at: http://www.al-islam.org/articles/what-you-should-do-just-before-death-sayyid-muhammad-rizvi
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Meaning of Death From Counseling Perspective

Words: 925 Length: 3 Pages Document Type: Essay Paper #: 99637104

friend of mine overcome the desire to kill himself. He was suicidal and made several attempts on his life. Gradually he found the help he needed and today is still alive and healthy and no long suicidal.

I think my culture would find this story inspiring because today despair is everywhere and we see people succumb to it all to often, so when someone overcomes despair, which can be life threatening, is a great blessing to see. I think this would be true for every culture because despair is a universal phenomenon.

Freud felt that there was a death instinct and a life instinct, with the sex drive characterizing the life instinct and self-destructive behavior characterizing the death instinct (Life and Death Instincts, 2016). Thus Thanatos can be defined as the unconscious desire to die -- death being the end goal of life, according to Freud. He felt that this…… [Read More]

References

Doka, K. (2005). Death Awareness Movement. Retrieved from http://feleciamoon50.typepad.com/blog/2011/07/the-death-awareness-movement-description-history-and-analysis.html

Eig, J. (2005). Luckiest Man: The Life and Death of Lou Gehrig. NY: Simon & Schuster.

Escobar, P. (2015). Empire of Chaos. MI: Nimble Books.

Gatto, John. "AgainstSchool." WesJones.com. (n.d.). Web.
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Family Care Plan Nursing Family

Words: 782 Length: 3 Pages Document Type: Essay Paper #: 39760808



Family Interventions

-Mother can attend cancer support groups and receive advice and education through other channels regarding proper methods of providing care and improving quality of life for her husband

-Son can explore employment options as well as discuss various needs and responsibilities with his parents in order to determine his most effective utilization within the changed family dynamic

-Father can provide the levels of self-care that come easily, but should educate himself regarding his condition and ease care by allowing others to help when necessary

Nursing Interventions

-Provide educational materials/answer questions for both mother and father

-Assist son with psychological transition of increased responsibility/familial dependence

-Instruction of proper care techniques for mother and father regarding father's condition

Evaluation

Levels of comfort and competence in new family roles should be easily assessed in regular visits through brief questioning. Monitoring father's health through standard vital sign and other appropriate tests will…… [Read More]

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Leadership Analysis Imagine Studying Your

Words: 1567 Length: 4 Pages Document Type: Essay Paper #: 34828800

This is going to get done by means of using email, text messaging and the Internet to interact with my workers in a professional manner. egardless, I am shaping my staff to change and become better people. I will have to maintain an open mind to their various ideas, and see whether or not they are able to get implemented within the Hospice.

As I strive to become a better leader through using humility, freewill and delegation. I know that I can positively impact others through my hard work. They may want to one day become a Nurse Practioner themselves in any setting of their choosing. The decisions I make could become the deciding factor on whether or not they go further in the medical field. I want to set aside my pride, and become a better servant and transformational leader. This will mean that I strive to put others…… [Read More]

References

Collins, J. (2001). Good to great. New York, NY: HarperBusiness.(Chapters 2).

Collins, J. (2005). Good to great and the social sectors, A monograph to accompany Good to Great. Boulder, CO: Jim Collins.

Goleman, D. Emotional intelligence: Why it can matter more than IQ. New York: Bantam

Books.
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Coping With Death

Words: 642 Length: 2 Pages Document Type: Essay Paper #: 1771925

Death

Linda Wertheimer and Robert Siegel extensively interviewed Helen Payne, an 81-year-old woman dying of leukemia, and family members, regarding the process of coping with terminal illness in a loved one. hey included observations from Payne's oncologist and hospice nurse as well. heir interview shows a wide range of logical and emotional responses exhibited by family members as Payne's illness progressed, and demonstrated just how complex our reaction to such illness can be.

Wertheimer and Siegel are presumably competent radio reporters. heir article was organized around open-ended questions they put to Helen Payne, one of her granddaughters, and medical experts. he result is a compelling narrative reflecting how families handle the complex emotions that occur when a loved one faces death. Family members demonstrated both logical and emotional responses to Payne's situation, although Payne herself accepted the doctor's diagnosis with poise and dignity. Since this article was not research, including…… [Read More]

That anecdote in particular was moving to me because my grandmother did something similar when she was dying. I spent hours sitting by her bedside. One time she drifted off to sleep. When she awoke, she told me that she was ready to die. She had dreamed of heaven, and in the dream, when she got there, was told of her beloved cousin who had died many years before. She was told this cousin was anxiously waiting to see her again. This belief that death would rejoin her with loved ones gave her great comfort.

In doing more formal research on this topic, it would be interesting to see if it is typical for those in say, the eightieth or ninetieth decades of life to accept the prospect of impending death more easily than their family members can.

Wertheimer, Linda, and Siegel, Robert. "All Things Considered." National Public Radio, 1997.
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Health Care A the Different

Words: 2409 Length: 9 Pages Document Type: Essay Paper #: 52518976

Day treatment programs can provide services at less cost because the patient goes home at night after being treated during the day, which often is used for rehabilitating chronically ill patients (Sharfstein, Stoline, & Koran, 1995, p. 249). The mere fact of having more choice benefits some patients by giving them more say in their care.

Patient-focused care involves a method for containing in-patient costs for hospitals and for improving quality by "restructuring services so that more of them take place on nursing units rather than in specialized units in other hospital locations, and by cross-training staff on the nursing units so that they can do several 'jobs' for the same small group of patients rather then one 'job' for a large number of patients" (Kovner, 1995, p. 186). Kovner notes a number of barriers to this type of care. One reason has been that hospitals have not had to…… [Read More]

References

Doctors Say Managed Care Strains Patient Relationships (1997, June 9). Westchester County Business Journal 36(23), p. 24.

Kovner, a.R. (1995). Hospitals. In Jonas's Health Care Delivery in the United States, a.R. Kovner (ed.), pp. 162-193. New York: springer Publishing.

Moore, G.T. (1991,

April 24). Let's provide primary care to all uninsured Americans ? now! JAMA, pp. 2108-2109.
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Dealing With Difficult Patients Translation of Evidence and Best Practice

Words: 3786 Length: 10 Pages Document Type: Essay Paper #: 75591008

Difficult Patients

Mitigating isks from Dementia

Providing adequate care for an individual suffering from dementia presents many difficulties for nurses. Patients with dementia often have debilitating conditions such as Alzheimer's or similar neurologic diseases which are progressive, thereby making it challenging for them to remember, think lucidly, communicate effectively or complete activities of daily living. Furthermore, dementia can cause rapid variations in mood or even modify personality and behavior. With the tremendous number of elderly in society more and more nurses are required to care for patients with progressive dementias. It is imperative that a diagnosis be reached early in the course of the cognitive impairment and that the patient is closely monitored for coexisting morbidities. Nurses have a central role in assessment and management of individuals with progressive dementia. This essay provides some evidence-based practical strategies for managing the behavioral problems and communication difficulties often encountered in this population.…… [Read More]

Reference List

Aud, M.A., Oliver, D., Bostick, J. And Schwarz, B. 2011. Effectiveness of Social Model Care Units for Dementia. International Nursing Research Congress 2005.

Care, N.D. 2010. Teaching and Learning. Pulse. Winter Edition.

Fletcher, S. And Zimmerman, S. 2010. Trainee and trainer reactions to a scripted dementia care training program in residential care/assisted living settings and nursing homes. Alzheimer's Care. 11(1): 61-70.

Goodman, C. 2011. The organizational culture of nursing staff providing long-term dementia care is related to quality of care. Evidence-Based Nursing. 47:1274-1282.
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How to Handle Compassion Fatigue

Words: 1807 Length: 5 Pages Document Type: Essay Paper #: 42320986

Combating Compassion Fatigue

There are a number of warning signs for the concepts that fall under compassion fatigue. Perfectionists put themselves at risk, as do people who are naturally self-giving and those who are overly conscientious (Bush, 2009). Those who deal with a high level of stress in their personal lives, and people who do not have much social support, also struggle with compassion fatigue (Bush, 2009). Each one of these areas into which people fall is very important when it comes to how they handle care giving and/or whether they begin to lose the compassion they have for others. The common warning signs that come with perfectionists are those that are specifically related to their desire for control, and their need to do everything correctly. If they fail at something, or if things do not turn out just the right way, they can end up feeling very lost, angry,…… [Read More]

References

Bush, N.J. (2009). Compassion fatigue: Are you at risk? Oncology Nursing Forum, 36(1): 24-28.

Coe, B.G. (2010). Program to combat compassion fatigue. Hospice Management Advisor, 15(9): 102-103.

Espeland, K.E. (2006). Overcoming burnout: How to revitalize your career. Journal of Continuing Education in Nursing, 37(4): 178-184.
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Medicinal Marijuana a Humanitarian Medical

Words: 1160 Length: 4 Pages Document Type: Essay Paper #: 66080757

Evidence largely suggests that the subject in question would have been given a well-established pain-management strategy otherwise lacking had marijuana been available. Unfortunately, this plentiful, profitable, easy-to-grow and highly accessible substance has been demonized and victimized by hostile propaganda even as dangerous and deadly substances such as tobacco, alcohol and antidepressants remain highly proliferated.

From the combination of my experience and my value system, I must implore you to reconsider your position on the subject. You needn't simply take my work on the matter. Please conduct some actual research through peer-reviewed medical journals and I am confident you will find overwhelming critical evidence to support my position. Further, please consider, as will be detailed in the fact sheet hereafter, that the your political concerns over the position are unfounded. Public support for the legalization of marijuana has never been higher, and is largely a product of the view that it…… [Read More]

The United States has demonstrated itself on the whole to be increasingly more receptive to decriminalization on a state by state basis. To date, 14 states have joined a growing list of those in which medical marijuana is legal. Florida is, in this regard, behind the more progressive nations in the Union. (MPP, 1)

Research suggests that marijuana is anatamocially beneficial as a therapeutic substance for a wide array of health maladies. According to Ogborn et al. (2000), "There are indications that marijuana is sometimes used to alleviate pain from cancer, to reduce nausea from chemotherapy, to mitigate the wasting syndrome of AIDS, and for the treatment of glaucoma, epilepsy, multiple sclerosis and a variety of other disorders.1,2 A few studies have suggested that the medical use of marijuana is common among people with HIV / AIDS3,4 and those with certain psychiatric conditions." (p. 1)

Evidence suggests that any of the health hazards which are currently related to marijuana use
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Care Rural Settings Continuum of

Words: 690 Length: 2 Pages Document Type: Essay Paper #: 7683624

As well as expanding patient's abilities to obtain primary care, virtually, telemedicine can enable patients in isolated locations to see specialists. When rural patients are connected to a hospital network such as the Grinnell egional Medical Center, they are able to access high-quality physicians through some of the more advanced healthcare technology available, although this is not always possible in a local healthcare system with fewer physicians and less access to high-level technology. Technology can still enable patients in a variety of settings to keep track of vital signs such as heart rate, blood pressure, and blood sugar, and to alert their physician immediately if their readings are abnormal.

While some surgeons have even performed procedures through virtual consults, certain aspects of medicine remain challenging to provide rural patients, such as physical rehabilitative services, which may require the patient to travel to receive the full benefit of the services. Patients…… [Read More]

References

Campbell, James D. (2001, May). Introducing telemedicine technology to rural physicians and settings. Journal of Family Practice. Retrieved January 27, 2011 at http://findarticles.com/p/articles/mi_m0689/is_5_50/ai_75244766/

Spath, Patrice. (2011). Community Continuum of Care planning.

Brown-Spath & Associates. Retrieved January 27, 2011 at http://www.brownspath.com/original_articles/cccplan.htm
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Doctorate of Psychology Program

Words: 642 Length: 2 Pages Document Type: Essay Paper #: 97089108

Psychology -- Letter of Application

Thank you in advance for your consideration of my application to be accepted into the Psy D. program at Marshall University. I am competent, committed, and caring undergraduate student at Marshall with a powerful work ethic which propels me to the goal of achieving my doctorate. I am a psychology major with a 3.34 GPA and I will graduate in May, 2013.

I am focusing like a laser on my goal so I may (upon completion of my doctorate) provide sorely-needed professional services to rural est Virginia, where I grew up and have lived my entire life.

Indeed, my parents have lived in southern est Virginia for 36 years; my mother was raised in McDowell County, est Virginia, where, according to the U.S. Census, 35% of the population is presently living below the poverty line -- and 43.4% of those under the age of 18…… [Read More]

Works Cited

Zhang, Zhiwei, Infante, Alycia, Meit, Michael, and English, Ned. (2008). An Analysis of Mental Health and Substance Abuse Disparities & Access to Treatment Services in the Appalachian Region. National Opinion Research Center / University of Chicago. Retrieved December 27, 2012, from http://www.norc.org.
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Nursing Risk for Falls

Words: 1351 Length: 4 Pages Document Type: Essay Paper #: 95849679

isks for Falls

Critical Analysis

'isks for falls' have been an area of concern for medical professionals especially nurses. Statistics have shown that an increasing number of falls in hospitals and hospice settings not only raises question marks on the services provided to the patients along with negative consequences for the healthcare professionals and patients but also increases the overall costs of providing healthcare services. There are various researches which have shown that following clinical practice guidelines (CPGs) has found to reduce the number of falls substantially however the effectiveness of these CPGs is mainly dependent on the experiences of the healthcare professionals and patients after falls along with the impact of social factors such as community obligation, organizational resources, and individual resources.

esearch by Stenberg and Wann-Hansson (2011) has shown that the in order to comply with the provided CPGs, personal experience after the event of falls plays a…… [Read More]

References

Rycroft-Malone J. (2004). The PARiHS framework -- A framework for guiding the implementation of evidencebased practise. Journal of Nursing Care Quality, 19(4), 297 -- 304.

Rycroft-Malone J., Harvey G., Seers K., Kitson A., Mc- Cormack B. & Titchen A. (2004). An exploration of the factors that influence the implementation of evidence into practise. Journal of Clinical Nursing, 13, 913 -- 924.

Rycroft-Malone J., Kitson A., Harvey G., McCormack B., Seers K., Titchen A. & Estabrooks C. (2002). Ingredients for change: Revisiting a conceptual framework. Quality Safe Health Care, 11, 174 -- 180.

Semin-Goossens A., Van Der Helmi J.M.J. & Bossuyt P.M.M. (2003). A failed model-based attempt to implement an evidence-based nursing guideline for fall prevention. Journal of Nursing Care Quality, 18(3), 317 -- 325.
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Nursing and Ethics the Emotional Debate Over

Words: 2128 Length: 8 Pages Document Type: Essay Paper #: 10621242

Nursing and Ethics

The emotional debate over abortion had been mischaracterized in the media, and hence disrupted any positive attempt to make progress in resolving the ethical and medical problems which have been created by the practice. A majority of Americans recognize and desire that abortion should be available when the life of the mother is at risk, or in the cases of rape or incest. However, liberal proponets like to expand this definition under the ubiquitous definition of the 'mothers health' which has been used to justify abortion on demand, for any reason. This latter expanded definition is significantly opposed by a majority of the ameircan population. In the midst of this struggle, comes the person needing medical care, who has neither been properly informed as to the dangers of the paractive, nor adequately counseled as to the options which exist regarding the future of her unborn child. The…… [Read More]

Resources

O'rourke, Kevin. PROXY CONSENT: DECIDING FOR OTHERS October 1980 accessed 23 April 2004. Available from: http://www.op.org/domcentral/study/kor/80100202.htm.

Bernard Lo, (July 2, 1987) "Behind Closed Doors: Promises and Pitfalls of Ethics Committees." NEJM 317;46.

Toward a More Natural Science, (1985) New York: Free Press,; p.211.

Curzer, Howard J. (6/22/1993) Fry's concept of care in nursing ethics. (response to Sara T. Fry, Hypatia, vol. 4, no.2, p.88, 1989) Hypatia.
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Nursing Organizational Change Project Analysis

Words: 2505 Length: 6 Pages Document Type: Essay Paper #: 6658800

Of course, as Medicare beneficiaries increase because of the number of baby boomers, the Medicare program may adjust. However, current hospice figures demonstrate that only about twenty percent of all elderly individuals that die are enrolled in hospice programs.

Implementation and Monitoring

The needs of this new program will require thorough training and once implemented, precise monitoring. "When you approach a problem in the way your work group functions, you're implementing an organizational change. By taking a critical look at your process, and using some theories from organizational design, you can fix the problem -- and change your organization to make quality more likely." (Derby, 1999) The training will be a key because of the potential requirements associated with the Hospice program that may require completely new skill sets for the majority of our staff. The fact is that many of our nurses may not have acquired the necessary skills…… [Read More]

References

Derby, Esther. (2002). Modeling Organizational Change. Retrieved on February 12, 2005, at http://www.estherderby.com/writings/modeling.htm

Hospice Benefits and Utilization in the Large Employer Market. Ed. Beth Jackson, Teresa Gibson, Joline Staeheli. March 2000. U.S. Department of Health and Human Services. Retrieved on February 12, 2005, from http://aspe.os.dhhs.gov/daltcp/Reports/empmkt.htm.

Rubenfeld, M. Gaie, & Scheffer, B.K. (1995). Critical Thinking In Nursing. Philadelphia: JB Lippencott.

Social Security Administration. (1993) "Social security programs in the United States." Social Security Bulletin 12/22/1993.
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Global Health Trends and Policy and Politics

Words: 4532 Length: 13 Pages Document Type: Essay Paper #: 13327891

Policy, Politics and Global Trends in Health Sector

Why the Public Policy Issue Was Chosen?

According to the report released by National Priorities and Goals -- aligning efforts meant to transform America's Health care (NQF, 2009; Partnership, 2008). NPP (National Priorities Partnership) came up with 6 priorities. If the priorities are addressed, it could improve the quality of health care delivered to the U.S. citizens. NPP consists of 48 major U.S. health care organizations, which work with NQF (National Quality Forum). It identifies and advances priorities geared at improving health care in the future (NQF, 2009). NPP has identified palliative care as one of the six priorities that can help improve patient-based utilization outcome. This article provides the background to help identify steps to assist match the medical treatment of the patient and family objectives. It concerns itself with access to quality hospice services and palliative care (Meier, 2011). This…… [Read More]

References

AHRQ. (2002). Healthcare Cost and Utilization Project (HCUP): Hospitalization in the United States. Retrieved from Agency for Healthcare Research and Quality: http://www.ahrq.gov/data/hcup/factbk6/factbk6c.htm

American Hospital Association. (2009). AHA Hospital Statistics. Chicago: American Hospital Association.

ANA. (2008). Organizational Affiliate Criteria. Silver Spring: American Nurses Association.

ANA. (2015, December 10). Palliative and Hospice Nursing Panel. Retrieved from American Nurses Association: http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Professional-Issues-Panels/Palliative-and-Hospice-Nursing-Panel
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ADN vs BSN Abstract High

Words: 1434 Length: 5 Pages Document Type: Essay Paper #: 60583369

Patients also say they want to awake and conscious when their pain is managed. The issue is that there are not many U.S. physicians and nurses who are certified to extend palliative care. There are only 33 physicians and only 41 nurses for every 10,000 patients (Peres).

The hospice movement has been changing the face of care for people at the end-of-life stage (Radulovic 2004). Hospices have been providing options and choices to these patients for the last three decades. The hospice movement began in the UK but spread to America in response to the need for more compassionate care for the dying and terminally ill. A hospice is not a place but a concept of palliative and support services for the terminally ill to be cared for primarily at home. A home can be the patient's residence or that of a loved one, a long-term care facility. It provides…… [Read More]

Bibliography

Bone, Roger C. Analysis of Indications for Intensive Care Unit Admissions. Chest:. American College of Chest Physicians, December 1993

Earl, C et al. "Rise in Aggressive Treatment." Trends in the Aggressiveness of Cancer Care Near the End of Life. Journal of Clinical Oncology:. Springhouse Corporation, 2007

Peres, Judith. U.S. End-of-Life Gets Passing Grade. Health Care Benchmarks and Quality Improvement: American Health Consultants, Inc., 2003

Radulovic, Jan.W. Trends in Hospice and Palliative Care in the United States and Kansas. Kansas Nurse: Kansas State Nurses Association, 2004
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Therapeutic Touch Healing Comforting Hands

Words: 2455 Length: 9 Pages Document Type: Essay Paper #: 89316083

Physically, massage or TT eases muscle tension and improves circulation. In turn, it improves digestion and breathing, enhances mental clarity, and encourages better sleep. TT is particularly useful to terminally ill patients in reducing or mitigating pain to the extent of making prescription painkillers unnecessary. Emotionally, TT or massage is a gentle and compassionate experience for the dying. It reduces the sense of isolation by providing him or her with physical connectedness. It can also re-establish dwindling or lost self-esteem and self-acceptance on account of disease. As a result, it contributes to increased quality of life and a much-needed release of emotions. Medicare as yet does not cover massage therapy for hospice settings but an increasing number of group have been lobbying for its inclusion.

Useful Alternatives to Pain and Discomfort Management

These alternatives have shown to be effective in easing spiritual, emotional and psychological pain that contribute to the…… [Read More]

BIBLIOGRAPHY

Aghabati, N et al. (2010). The effect of therapeutic touch on pain and fatigue of cancer patients undergoing chemotherapy. Evidence-based Complementary Alternative

Medicine: PubMed. Retrieved on June 16, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887328

Catlin, A. (2009). Hospice massage: easing the pain of a life-limiting illness (Part 1).

vol 9 # 3, Massage Today: MPA Media Publications. Retrieved on June 19, 2011
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Life Situation Can Create a

Words: 4073 Length: 10 Pages Document Type: Essay Paper #: 47113692

The objective is to impede rumination. 3. In the third stage -- relapse prevention or rehabilitation -- Mr. Thomas will be encouraged to participate in activities (such as hobbies that he enjoys, listening to music, socializing, his work and so forth) and to move towards increased interest in his work, and other components of his life outside of his depressing domestic situation. The whole model would focus around prevention and intervention where prevention aims at reducing the individual's psychobiological vulnerability (via for instance reducing the stress facing Mr. Thomas by enlisting the aid, for instance, of his children and coworkers) whilst intervention seeks to strengthen that same vulnerability (via for instance cognitive-behavioral techniques or other depression-reducing interventions).

oemtiems, conflicts in commucantion occur inthis type sof stiaution when ethical condudresm are invoeld such as a perosn wishing to die whislt eveyroen else wants her to live on, or the gnawing unceratiny…… [Read More]

Sources

Berne, D. Games People Play. Grove Press, Inc., 1954

Couric, K. (2011) The best advice I ever got: Lessons from extraordinary lives. NY: Random House

Goulston, M. (2010). Just listen USA: AMACOM

Jaffe, C. & Ehrlich, C.H. (1997). All kinds of love: Experiencing hospice. New York,
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Rural Healthcare Facilities Context of

Words: 5552 Length: 20 Pages Document Type: Essay Paper #: 48009947

¶ … Rural Healthcare Facilities

Context of the Problem

Twenty-five percent of the total population in the United States are living in rural areas and compared with urban Americans and healthcare facilities in rural areas generally serve low-income, the elderly, and individuals who are less informed and armed with less knowledge concerning health care prevention measures. Moreover, rural individuals accessing healthcare in rural facilities face barriers to healthcare such as fewer doctors, hospitals and health resources in generation and face difficulty in accessing health services.

Hospital closures and other market changes have adversely affected rural areas, leaving State and Federal policymakers, and others concerned about access to health care in rural America. Considerable changes in the health care delivery system over the past decade have intensified the need for new approaches to health care in rural areas. Managed care organizations, for example, may not be developed easily in rural areas,…… [Read More]