What is hospice? For whom?

You heard the term, ‘hospice;’ sketchy on details, you seem to remember a relationship between ‘hospice’ and ‘terminal illness.’ Further, hospice is an approach to the care of someone terminally ill who has chosen not to have more aggressive treatment to save his life. He now wants care to focus on his comfort.

Often that means no more chemo, goodbye to radiation, no more operations-unless the doctor is certain that they will bring comfort, but they are not intended to cure.

What care is involved? Nursing care involves symptom management and pain control usually. The nurse isn’t a ‘junior doctor’ but if the patient isn’t able to go to the doctor’s office (and most patients chose not to), the nurse visits the patient regularly, (usually twice weekly or more often when needed) and pass on their findings to the doctor and also work closely with the pharmacist. Nurses aggressively treat pain, mouth sores, nausea; and all symptoms the patient experiences.

The nurses’ aide teaches the family how to give physical care; including how to make an occupied bed, efficient bathing techniques, care of the skin, assessing for skin break down and tips on providing care in the home situation. The nurses’ aide is a very valuable second set of eyes and ears for the nurse.

The social worker plays a valuable role as mediator in family matters which can be problematic if family members disagree with the choices of care. The social worker is also able to assist with counseling needs and is able to suggest appropriate community resources; for example, finding caregivers.

The hospice chaplain is assigned to meet the spiritual needs of the patient. It is not uncommon for patients to feel abandoned by their God during this time, but not want to talk to family about it. The chaplain provides that listening ear who frames that discussion and will provide a safe space to have it.

There is another individual on the hospice team: the hospice volunteer. The volunteer has no agenda, no set of questions that he needs to have answered. The volunteer is there to be used by the family as they chose, used to provide respite for the caregivers, oftentimes so the caregiver can attend church or go to lunch or just relax in another room.

In the past, patients in hospice were always patients with cancer and AIDs. These days patients with other diagnoses are seen as long as a patient meets guidelines. Patients who have end-stage congestive heart failure or kidney disease or other illnesses are eligible for hospice services.







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