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HOSPICE PHILOSOPHY--Care, Comfort & Compassion for the whole family
Hospice is a "special way of caring" for people approaching the end of life in this country. This concept of care is based on hospice philosophy, which addresses the unique needs of people in the final period of life. In 1994, the National Hospice and Palliative Care Organization produced the Standards of a Hospice Program of Care, which describes our philosophy of care:
Hospice provides support and care for persons in the last phases of incurable disease so that they may live as fully and as comfortable as possible. Hospice recognizes dying as part of the normal process of living and focuses on maintaining the quality of remaining life. Hospice affirms life and neither hastens nor postpones death. Hospice exists in the
hope and belief that through appropriate care, and the promotion of a caring community sensitive to their needs, patients and their families may be free to attain a degree of mental and spiritual preparation for death that is satisfactory to them. Hospice offers palliative care to terminally ill people and their families without regard for age, gender, nationality, race, creed, sexual orientation, disability, diagnosis, availability of a primary caregiver, or ability to pay.
A hospice program provides palliative care to terminally ill patients, and supportive services to patients, their families, and significant others, 24 hours a day, 7 days a week, in both home and facility-based settings. Physical, social, spiritual, and emotional care is provided during the last stages of illness, during the dying process, and during bereavement by a medically directed interdisciplinary team consisting of patients, families, professionals, and volunteers.
The National Hospice Organization (NHO) defines palliative care as treatment that enhances comfort, and improves the quality of the patient’s life. No specific therapy is excluded from consideration. The test of palliative treatment lies in the agreement by the patient, the physician, the primary caregiver, and the hospice team that the expected outcome is relief from distressing symptoms, easing of pain, and enhancement of quality
There are many generally accepted myths and prevalent fears related to dying. The Hospice’s special way of caring attempts to dispel the myths and calm the fears. From principle to practice, hospice focuses on living: on quality of life until someone dies.
HOSPICE ADVANTAGE PHILOSOPHY OF CARE
What do all hospice organizations have in common? We all provide great care to our patients, right? But, what about good quality services to the patients family? At Hospice Advantage we are change the way we view and provide hospice care by taking our family support services to the next level. Rather than focusing on providing supportive care to just the primary caregiver,
we focus on providing support to the entire family (including extended family members, close family friends, co-worker, church members etc.)
Our philosophy of care, "Care, Comfort, and Compassion for the Whole Family" means hospice care that provides quality service to not only the patient, but the patient’s ENTIRE family. It is a way of challenging how we provide services to our customers. It is an idea to change the way we view our jobs. It is a way to move beyond, as a company, the traditional view of hospice care.
Our philosophy helps us to focus on the entire family and reaching out to them to provide supportive services. Whether the family needs support in regards to their grief process, education regarding the disease process, help with community resources etc. we are willing to help in whatever way we can. By expanding our philosophy of care to include the entire family
we encompass a "whole family" centered approach to hospice care.
The Healthy Grieving Model
Hospice Advantage operates under the philosophy of "Care, Comfort, and Compassion for the Whole Family." While we ensure quality services are delivered to the patient, we also believe it to be extremely important to provide effective supportive services to family members. The Healthy Grieving Model is the framework from which we formulate our core philosophies of grief which reflect our mission behind the family support services we offer.
The Healthy Grieving Model operates under five key principles;
- Grieving is a normal, natural and individualized process. It is not an illness but an emotional reaction to loss.
- People have the ability to heal from their loss in their own way, and at their own pace.
- The process of healing is greatly enhanced in a caring, accepting environment.
- The support networks built between grieving individuals is a vital component to their healing process.
- The process of grief may begin even before the loss of a loved one occurs.
We offer specialized family support services that are designed to meet any individual’s needs. By taking advantage of our services families begin their journey through the grieving process.
HOSPICE PRINCIPLES AND PRACTICES
Patient, family, and caregivers
The care of people living with serious illness is a process that involves the patient, family, and hospice caregivers. Hospice patients need to be surrounded by caring people in a caring community. As a result, the patient, family, and hospice caregivers constantly interact in order to provide the best possible care.
One myth that has been adopted y the American population is that when cure is no longer possible, nothing more can be done. The hospice philosophy proposes that there is still a great deal that can be done through palliative care. Through constant interaction, the hospice team, including the patient’s physician, provides quality palliative care to patients and their families in a caring community.
Coordination of Care
Coordination of care is essential in assuring that the palliative care goals established by the patient, family, and hospice care team are carried out among team members and across care settings. From the home, to the nursing home, to the hospital, and to any other care setting, hospice philosophy emphasizes the need for one well-communicated and coordinated palliative plan of care.
The Hospice Advantage team coordinates care within their own organization and provides a link with health care and human service professionals in the community. Hospice coordinates care between nurses, psychosocial professionals, spiritual care providers, physicians, volunteers, hospitals, and other community resource organizations as needed to care for patients and families.
Supportive Physical Environment
When patients are asked about their ideal environment in the final stages of their lives, their responses include items that signify life, nature, and provide life-review, such as pictures of their family and friends. A supportive physical environment contributes to the well-being of patients, families, and hospice caregivers. The environment should reflect the patient’s lifestyle in that they are surrounded by not only their loved ones but also their physical belongings and symbols of their life.
While most patients prefer to die at home, some reside in other care settings. Nursing homes and residential care settings can incorporate a feeling of well-being while creating a home like appearance, in extending visiting hours and by encouraging family participation in patient activities. A supportive physical environment also allows for flexibility in schedules. Scheduling of baths, meals, and outings should be in accordance with the patient’s and family’s preferences and lifestyle. Allowing choices in a patient’s environment gives that patient control and supports quality of remaining life.
Palliative Versus Curative Care
When a patient’s disease process is no longer curable or reversible, aggressive curative treatment becomes increasingly inappropriate. Hospice philosophy emphasizes palliative care, which can be as aggressive as curative care, but having a focus on comfort, quality of life, and patient choice. Palliative care is a lessening and relief of physical, psychosocial, and spiritual suffering so that the patient can accomplish foals in the time remaining.
Curative care focuses on quantity of life and prolonging of life. Death is often seen as a failure to cure. Palliative care focuses on quality of life, and death is viewed as a natural part of life.
Within this philosophy, hospice gives patients and families choices regarding resuscitative measures. Quality of life is often elusive if a patient is subjected to treatments and interventions that he/she did not choose, such as respirators, intravenous infusion, and tube feedings. Yet, if chosen, these measures are available to support patient choice.
Respect for Patients
Care and quality of life measures are most effective when the patient’s lifestyle is maintained and the personal philosophy of life is respected. The hospice approach allows for individual lifestyles to be supported and respected. This requires respect for ethnicity, cultural heritage, social practices, sexual orientation, and family structures. The needs of patients and families vary depending on values, culture, personal characteristics, and the environment.
Each patient and each family has their own coping skills, varied dynamics, and differing strengths and weaknesses. It is our responsibility to "accept patients and families where they are," approaching living and dying in their own way. Patients are allowed to express any emotion, including anger, denial, or depression, without fear of what the hospice staff or volunteers might think. By listening without being argumentative, rationalizing, or becoming defensive with the patient, the hospice team accepts the patient’s and family’s coping mechanisms as effective.
Hospice philosophy promotes patient autonomy, the right of the patient to make decisions regarding care. A hospice death is one in which dying is in accordance with one’s desires and in congruence with one’s life. Hospice philosophy strongly believes in patient choice regarding where one dies, how one dies, and with whom one dies. Patient wishes, which may include practicing rituals or forms of behavior, which support the patient’s culture, religion, or lifestyle, should be respected.
- Zelline LaFleur
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