Dying in America


Book Description

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.




Approaching Death


Book Description

When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."




Fast Facts for the Hospice Nurse


Book Description

An on-the-go reference for hospice nurses and those interested in end-of-life care, this practical guide covers the essential elements in the compassionate and holistic care of terminally ill patients and their families. Nurses care for patients facing end-of-life issues in every practice specialty and, as the U.S. population continues to age, the need for proficiency in end-of-life skills will become increasingly important. Fast Facts for the Hospice Nurse: A Concise Guide to End-of-Life Care is an invaluable resource that provides emotional, administrative, and palliative support, whether in a hospice, long-term care facility, or acute care setting. This vital go-to text clearly and concisely lays out not only how to care for patients facing end-of-life issues, but also how to engage in self-care and cope with occupational stress. Beginning with an overview of hospice care, including its history and philosophy, this book offers a timeline of the growth of the hospice movement in the United States. Subsequent sections include up-to-date information on the clinical responsibilities of the hospice nurse in addressing the physical, psychological, and spiritual needs of terminally ill patients and their families in a culturally sensitive way. This book also outlines the administrative duties of the hospice nurse, including hospice documentation, a review of hospice regulations, and quality management. The closing section focuses on occupational stress in hospice nursing and how to engage in self-care. This text can serve as a useful clinical resource and also as a reference for nurses seeking hospice certification from the Hospice and Palliative Credentialing Center. Key Features Organized within the context of the scope and standards of practice of the Hospice and Palliative Nurses Association. Addresses key points about issues unique to hospice nursing and highlights evidence-based interventions Addresses important Medicare regulations and reimbursement Offers numerous clinical resources to assist with hospice nursing practice Serves as a concise study resource for hospice nursing certification




Hospice and Palliative Care


Book Description

Offers a comprehensive overview of the practice of hospice, as well as the challenges faced by and the direction of the hospice movement. This book provides chapters that address key topics such as the goals and importance of community involvement, outcome measurement, and the manner in which hospices address death, grief, and bereavement.




Hospice Coordinator


Book Description

The Hospice Coordinator Passbook(R) prepares you for your test by allowing you to take practice exams in the subjects you need to study. It provides hundreds of questions and answers in the areas that will likely be covered on your upcoming exam.




Improving Palliative Care for Cancer


Book Description

In our society's aggressive pursuit of cures for cancer, we have neglected symptom control and comfort care. Less than one percent of the National Cancer Institute's budget is spent on any aspect of palliative care research or education, despite the half million people who die of cancer each year and the larger number living with cancer and its symptoms. Improving Palliative Care for Cancer examines the barriersâ€"scientific, policy, and socialâ€"that keep those in need from getting good palliative care. It goes on to recommend public- and private-sector actions that would lead to the development of more effective palliative interventions; better information about currently used interventions; and greater knowledge about, and access to, palliative care for all those with cancer who would benefit from it.




The Crisis of US Hospice Care


Book Description

Exploring the failure of hospice in America to care for patients and families at the end of life. Hospice is the dominant form of end-of-life care in the United States. But while the US hospice system provides many forms of treatment that are beneficial to dying people and their families, it does not encompass what is commonly referred to as long-term care, which includes help with the activities of daily living: feeding, bathing, general safety, and routine hygienic maintenance. Frequently, such care is carried out by an informal network of unpaid caregivers, such as the person's family or loved ones, who are often ill-prepared to offer this type of support. In The Crisis of US Hospice Care, Harold Braswell argues that the stress of providing long-term care typically overwhelms family members and that overdependence on familial caregiving constitutes a crisis of US hospice care that limits the freedom of dying people. Arguing for the need to focus on the time just before death, Braswell examines how the relationship of hospice to familial caregiving evolved. He traces the history of hospice over the past fifty years and describes the choice that people dying with inadequate familial support face between a neglectful home environment and an impersonal nursing home. A nuanced look at the personal and political dimensions that shape long-term, end-of-life care, this historical and ethnographic study demonstrates that the crisis in US hospice care can be alleviated only by establishing the centrality of hospice to American freedom. Providing a model for the transformative work that is required going forward, The Crisis of US Hospice Care illustrates the potential of hospice for facilitating a new way of living our last days and for having the best death possible.




Palliative Day Care


Book Description

There has been a steady growth in the provision of day care services for people with life-threatening illnesses who live at home. This book includes details of the range of therapies and services that a multi-disciplinary team can provide to address the physical, emotional, psycho-social and spiritual needs of these patients and their families, thus enabling them to remain in their own homes.