DorlandHealth

Each day thousands of people across the country receive beneficial care and support from hospice and palliative care providers in hospitals, senior living communities, assisted living facilities, nursing facilities, hospice residences or at home. Yet most individuals do not understand all the unique services offered by hospice and palliative care providers and when to access these services.

Hospice

Since 1974 more than 13 million people and their families have been served by the nation’s hospices. Considered to be the model for quality, compassionate care, hospice involves a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes. Unlike most health care, expert support and caregiver training is provided to the patient’s loved ones, enabling them to cope with the impending death of the hospice patient and meet the care needs of their family members or friends.

Could These Three Words Change the Way We Provide End of Life Care?

As most case managers on the frontline already know, hospitals have become environments where medical intervention is meted out to debilitated patients approaching the end of life. The indignities of noxious and often painful treatments, such as feeding tubes, catheters, and testing with no therapeutic goal, make comfort impossible for these patients. In addition to their high cost, these common life-prolonging interventions can result in greater debilitation and a host of costly complications including hospital-acquired infections, decubitus ulcers, mental deterioration, serious drug reactions and persistent pain and discomfort. The current hospital-based, medical model functions within a system that appears to devalue those precious final days while utilizing life-sustaining interventions that often deny dignify and peace. There must be a better way to pass through this final stage of life.

The Patient Self Determination Act of 1990 mandated that hospitals provide every patient with written information on the right to be involved with treatment decisions. The advanced directive has become the primary tool to express end-of-life preferences and case managers or social workers are often called upon to help patients and families through the process of determining end-of-life decisions. Ideally, each patient who enters the health care system would have an advanced directive that outlines the parameters of care desired and their own definition of a “good death.”