Hospice Care and Palliative Care: Similarities and Differences

By Katrina Millar

For most people there is no difference between palliative care and hospice care, especially to those who are not in the healthcare field. They may seem similar in terms of their philosophy, but these two are quite different in many ways. This article will bring clarity to such confusion. If you know of anyone, may it be your family or friend who is confused between the two, this article will help you get a better idea of what the two types of care are all about. This is also helpful to nurses who are either working for or wanting to work in these types of fields.

What is Hospice Care?

It is described as support and care for patients who are terminally ill. It is the facility's goal to give them the best comfort and satisfaction with their remaining life. Rather than focusing on the finding a cure for their illnesses or trying to extend their lives, the facility does its best in making them happy during their living days. They want the patients to experience a good quality of life.

Their philosophy is that which accepts the reality of death. That death is part of life and one must accept it.

What is Palliative Care?

Palliative care is used inside and outside hospice locations. In general terms, palliation is described as that which focused on relieving and preventing suffering in patients who have diseases or conditions that are not responsive to curative treatment. Palliative care's goal is to give patients relief from their illnesses.

While they both have similarities, they are still essentially unique on their own. Palliative care is usually being offered and used in hospitals, whereas hospice care is usually used in a patient's home. Palliative care areas offer therapies that aim to give patients a longer life, as this kind of care does not stop them from finding a cure for their illness of condition. On the other hand, hospice care facilities only treat patients who are willing to give up any treatments that can cure them of their conditions. If they are still in search of curative treatments, they may not get coverage for their care. When it comes to costs and reimbursement, hospice care is fully paid by Medicare benefit or Medicaid. It is also important to note that those who want hospice care through Medicaid or Medicare must be found to be within the last six months of their life.

Working in hospice care and palliative care are both rewarding for registered nurses. Which RN specialization would you prefer?

Article Source: http://EzineArticles.com/?expert=Katrina_Millar
Article Source: http://EzineArticles.com/7192906

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For more information, you might enjoy reading my book, More Than Meets the Eye True Stories about Death, Dying, and Afterlife. Purchase paperback on Amazon.com. It's also on Amazon as an e-book for those who have Kindle or Sony Readers. The audio book is now available!
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In Home Hospice Care: How It Helps

By Sarah E Reilly

Hospice services may offer help in the form of medical care, assistance and safety, and often spiritual and emotional support for both the patient and the caregiver. This may also include the participation of other members of the family. Hospice care is offered by a lot of organizations, including hospitals and private practices. It provides the necessary help to manage the details and challenges of caring for a sick friend or member of the family.  Some of the most common hospice services may include:  - Medical care focusing on managing pain - Bringing medicines and equipment when needed - Counselling and Guidance on difficult issues like closure - Voluntary assistance for making meals or running errands - Counselling and support prior to death; and after death (for the family)  One reason to choose in home hospice care is that many patients would like to spend their final days at home. With this service, family members can stay close and take care of their loved one. A hospice team member will come by several times a week and see what is needed. These teams usually consist of a physician, nurses, a social worker, specialists in palliative medicine, a priest or spiritual advisor, nurse assistants and volunteers. The extended group would also include the pharmacist, psychiatric specialists and other therapists. They are available on call 24/7.  Hospice Services are available to almost anyone in need. To become eligible, however, a patient may fall under a certain medical condition category, such as an incurable or terminal illness, and diagnosed by a medical professional to have six months or less to live. A signed form from the primary physician and doctor on the hospice team is needed to start care. Of course, it is difficult to estimate life span - some people live longer than expected and continue receiving care. If people get better, they can stop getting this assistance. Hospice care is available to everyone regardless of religion, gender, diagnosis, sexual orientation, or even the ability to pay. These services are covered by Medicare and Medicaid programs. Quite a few private insurance companies also pay for these services - make sure to check if it will be covered and what services are included. Hospice programs will also be able to provide information on coverage.  The aim of in home hospice care is to bring palliative care to terminally ill people. It is a way to help those approaching death have confidence, dignity, and peace. Hospice care brings humane charity and compassion to those in need. Proper care usually helps people live longer and experience fewer side effects from chemotherapy and other medications. Other helpful activities like physiotherapy, art, music, and massage therapy, are offered to patients to keep them engaged. The attending physician or nurse will be able to help with finding in home care or a facility close by. You may also search online to find a reputable provider of hospice care.  Sarah Reilly provides in Home Hospice care and Hospice Services. Article Source: http://EzineArticles.com/?expert=Sarah_E_Reilly Article Source: http://EzineArticles.com/7234832
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For more information, you might enjoy reading my book, More Than Meets the Eye True Stories about Death, Dying, and Afterlife. Purchase paperback on Amazon.com. It's also on Amazon as an e-book for those who have Kindle or Sony Readers. The audio book is now available!
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Hospice Services: Providing Comfort During Trying Times

By Gwendlyn Price

What are hospice services?

Hospice is the concept of catering to the needs of those whose life expectancy has been predicted to be 6 months or less. It is a concept that dates back to the time of the Crusades in the 14th century. Religious orders during that time, however, prevented its growth. Modern hospices came to be during the 1960s, starting in Great Britain. From there, the practice grew and spread to the United States, and parts of Europe and Asia.

Once all efforts to cure the patient of his/her disease have been exhausted, hospice care is recommended. The practice is palliative in nature. Palliative is the field of healthcare that focuses not on curing, but in preventing and reducing the suffering of a patient. This type of care allows the patient to live his or her last days with dignity.

Why and when should we consider hospice?

The idea of being diagnosed with an incurable disease is a tough pill to swallow. For the patient, it's an overwhelming experience that is difficult to deal with. There is so much uncertainty that comes with knowing you only have a limited amount of time left. While some are intent on treatment in the hopes of curing their disease, most cases don't end so well. In some cases, continued curative treatment only makes the body weaker.

Hospice services should be considered once a doctor diagnoses inevitability. This means that the doctor has predicted a certain timeframe left for the patient. Hearing news like this will, without a doubt, stir up emotions of fear and sometimes even anger. Once you start entertaining the idea of hospice care, remember that it is not proof of hopelessness. Believe that by making the decision, patients aren't giving up. Rather, they are taking control by deciding what to do with the remainder of their lives.

Where is hospice care provided?

In most cases, patients choose in home hospice care. Most services provide this option with the understanding that patients would rather be in the privacy of their own homes. If in home hospice care proves to be too strenuous, options such as inns and other facilities may be available as well.

What can I expect from this service?

First of all, you can expect counseling and guidance through you and your loved ones' trying times. Professionals will help the patient and his/her family members understand and cope with the issues at hand. No one knows the pain endured by someone who knows his or her end is coming. Patients often find themselves dealing with so many previously unrealized frustrations, and that's something that the treatment method caters to.

Apart from helping relieve all mental and emotional anguish, the practice also highlights the spiritual needs of a person. Patients can expect that through this palliative treatment method, whatever spiritual concerns they have will be attended to. Dealing with grief and bereavement also come later.

While hospice services might sound like a good option from the get go, remember to discuss the topic with care. Make sure that the patient is emotionally prepared to avoid misunderstandings during an already difficult time.

Gwen Price is a nurse who has worked with several in home hospice care. For additional information on how this can help your terminally-ill loved one, please read up about hospice services.

Article Source: http://EzineArticles.com/?expert=Gwendlyn_Price

~~~~~~~~~~~~~~~~~~~For more information, you might enjoy reading my book, More Than Meets the Eye True Stories about Death, Dying, and Afterlife. Purchase paperback on Amazon.com. It's also on Amazon as an e-book for those who have Kindle or Sony Readers. The audio book is now available!
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How to Give Terminal Care to a Dying Parent

By Kum Martin

Usually, as children we reconcile to the fact that sooner or later we will have to care for our parents because of deteriorating health and age. However, when your parent is diagnosed with a terminal illness, it can be devastating for you. Giving terminal care to a dying parent is not easy. Usually, this type of care is given when the life expectancy is less than 6 months.

Talk to your parent about terminal care and other treatment options. Find out what your parent wants. At times, your parent may not be ready to give up treatment options to prolong life. Hence, their wishes should be fulfilled. However, warn your parent about the possible side effects after discussing the same with the doctor. If your parent does not want to suffer from the side effects, then terminal care would be the only option available. This concentrates on making the person feel more comfortable during the last stages of the disease.

Speak to your parent about making end of life care decisions. If your parent is lucid and able to make decisions, then find out whether they want to spend the last days of their life at home or in a hospital. This is important from your parent's point of view, as it will reduce emotional stress and also let them choose where they die. Generally, people with terminal disease want to spend their last days surrounded by their loved ones and in familiar surroundings.

Make sure that your parent gets palliative care during the last stages of their disease. This will keep your parent comfortable and reduce symptoms associated with the disease. The doctors may medicate your loved one for pain and other uncomfortable symptoms that they may experience, such as nausea, shortness of breath or constipation. It will also provide you with some relief, as palliative care tries to ease the burden of the primary caregiver. It gives emotional, spiritual and physical support to both the patient and family members. Speak to your parent about hospice care, as it will allow your parent to die with dignity and grace.

When your parent is lucid, find out about what plans they have in place for their funeral. It sounds morbid to be discussing such a topic even before the person passes away, but it will allow you to fulfill your parent's last wishes. This may not be necessary if your parent has made a living will.

An important part of terminal care is providing emotional support to the dying person. This is extremely challenging, as everyone involved will be emotionally fraught. Hence, you would have to get your emotions under control and be there for your parent. Speak to your loved one and find out what they want. At times, they would just want you to listen. Address any spiritual need by calling on a religious leader. If they want to reminisce about the good old days, make sure you listen actively and also speak about those days. Try to spend as much time as possible with your parent, while ensuring that they are comfortable and pain-free.

Kum Martin is an online leading expert in elderly care. He also offers top quality articles like: Terminal Illness

Article Source: http://EzineArticles.com/?expert=Kum_Martin

~~~~~~~~~~~~~~~~~~~For more information, you might enjoy reading my book, More Than Meets the Eye True Stories about Death, Dying, and Afterlife. Purchase paperback on Amazon.com. It's also on Amazon as an e-book for those who have Kindle or Sony Readers. The audio book is now available!
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Top Five Regrets of the Dying

By Bronnie Ware

For many years I worked in palliative care. My patients were those who had gone home to die. Some incredibly special times were shared. I was with them for the last three to twelve weeks of their lives.

People grow a lot when they are faced with their own mortality. I learned never to underestimate someone's capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.

When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five:

1. I wish I'd had the courage to live a life true to myself, not the life others expected of me.

This was the most common regret of all. When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people have had not honoured even a half of their dreams and had to die knowing that it was due to choices they had made, or not made.

It is very important to try and honour at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realise, until they no longer have it.

2. I wish I didn't work so hard.

This came from every male patient that I nursed. They missed their children's youth and their partner's companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.

By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle.

3. I wish I'd had the courage to express my feelings.

Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.

We cannot control the reactions of others. However, although people may initially react when you change the way you are by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way, you win.

4. I wish I had stayed in touch with my friends.

Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.

It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks, love and relationships.

5. I wish that I had let myself be happier.

This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called 'comfort' of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again.

When you are on your deathbed, what others think of you is a long way from your mind. How wonderful to be able to let go and smile again, long before you are dying.

Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.

Bronnie Ware is a writer and songwriter from Australia. Her blog has a loyal and ever-increasing following and has been quoted in several respectable international publications. Based on this article, Bronnie has now released a full-length book, also titled 'The Top Five Regrets of the Dying'. For more information about this or to read more of Bronnie's work, please visit her blog at http://inspirationandchai.com.

Article Source: http://EzineArticles.com/?expert=Bronnie_Ware

~~~~~~~~~~~~~~~~~~~For more information, you might enjoy reading my book, More Than Meets the Eye True Stories about Death, Dying, and Afterlife. Purchase paperback on Amazon.com. It's also on Amazon as an e-book for those who have Kindle or Sony Readers. The audio book is now available!
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Spirituality and Music In Palliative Care

Unlike hospice care which entails providing services to the terminally ill patients whose physicians have declared that they have only six months to live, palliative care does not postpone nor speed up death, it helps relieve pain and symptoms by offering support which the client needs to live actively and functionally.

Part 1 - Spirituality and Music in Palliative care.

Palliative care may also involve other professional disciplines to ensure that the patient receives all the necessary services. In this article, I will review and explore the perceptions of nurses and patients on spirituality and music in palliative care.

Spirituality and Palliative Care.

Spirituality in general has been shown to contribute to patients' comfort at the end of life and has been identified as one of the key concerns of dying patients who need support. Spirituality does not necessarily mean that one's beliefs are religious based, it is therefore unique in everyone and may be explored and assessed in one's own values, beliefs, relationships, attitudes, practices, their hopes, fears, meaning and purpose in life as reported by Kernoham, Waldron, McAfee, Cochrane, & Hasson (2007).

Read more here.. http://tinyurl.com/yeenfrg

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For more information, you might enjoy reading the complete book More Than Meets the Eye True Stories about Death, Dying, and Afterlife. Purchase on Amazon.com

Hospice & Palliative Care - Where's the Common Ground?

Receiving "The News"


A person faced with a new diagnosis that is life-limiting is generally overwhelmed. Everything has changed, and nothing will ever be the same. All of the grief stages can come into play: denial, anger, bargaining, depression and ultimately, acceptance. The person might wonder, Why me? Why now? Can I beat this? The situation can become overwhelming when coupled with confusing medical jargon about palliative care and hospice care. Let's start by clarifying the care options that are available.

Palliative care for life-limiting disease naturally follows curative treatments. Treatments can include chemotherapy, radiation, blood transfusions, dialysis, physical therapy and more. The goal is to achieve the highest quality of life for the patient while trying to control or eradiate the disease process. This is a time for hope and challenge for the patient and family. It is generally only when all treatment options fail or have been exhausted that the physician may suggest comfort care, which is also known as hospice care.

Similarities & Differences

Hospice care and palliative care both provide compassionate care for patients facing life-threatening illnesses. Both share a team-oriented approach to medical care: pain management, symptom management, and emotional and spiritual support that are patient-specific. Both share a common core belief as well: that every patient deserves the very best care possible, and that each of us has the right to die with dignity and respect, pain-free. In fact, the word palliate refers to giving comfort (but not cure). The differences between the two disciplines are subtle. While all hospice care is palliative or comfort care, not all palliative care is considered hospice care.

Confused?

Let's look at it another way. The focus of hospice is on caring, when curing is no longer an option. To be eligible for hospice care, two physicians (the primary physician and the hospice physician) must certify the patient's prognosis to be six months or less, should the disease run its natural course. The hospice philosophy embraces death as a natural part of life, and encourages a patient's desire for dignity, respect, and autonomy over his or her own care. Aggressive symptom management and pain control support this philosophy.

Most hospice care is provided in the patient's own home. Some care is also provided in nursing homes, residential care facilities and hospice facilities. Services are provided regardless of religion, race, age or illness. The patient care goals are centered on quality of life as opposed to quantity of life. Hospice care is covered under the Medicare Hospice Benefit, Medicaid, most private insurance plans, HMOs, and other managed care plans. All charges related to the terminal diagnosis, such as medications, durable medical equipment (e.g., a hospital bed), and nursing and supportive services, are paid by the benefit. Hospice care, therefore, is both a philosophy and a method of health care financing for terminally ill patients and families.

Palliative care is very similar to hospice care, but with a broader population. It is not time-restricted-indeed, it can last for years-and no specific therapy is excluded if it can improve the patient's quality of life. Palliative care helps meet the needs of patients and families who are not yet eligible for hospice services as well as those who still want to pursue more aggressive treatments not covered under the hospice reimbursement system. Payment for palliative services is generally paid by the patient's insurance, Medicare or Medicaid (but not under the hospice benefit). Goals of care focus on improving quality of life and helping support patients and families during and after these treatments. Whereas palliative care is appropriate from terminal diagnosis on, when prognosis is uncertain, hospice care focuses on supporting patients with a life expectancy of months, not years. From that standpoint, palliative care should naturally follow curative care, and then evolve into hospice care as the disease process progresses.

Looking to the Future

The hospice benefit is written for comfort care only, and is intended for patients with terminal illnesses who have exhausted all curative and therapeutic treatments. In that sense, it can be abrupt and frightening, and generally results in very late hospice referrals from physicians. The challenge for hospices is to find a way to transition from one discipline to another.

Patients should have a safe place to explore care options while still receiving palliative treatments-without pressure to enroll in the hospice program later on. This is an important step in patient continuity of care, and one that warrants further attention.

Currently, hospice and palliative care are separate disciplines. Helping patients and families deal with terminal diagnoses and navigating the various palliative therapies available is the goal of both. Finding a way to blend the two would help alleviate the confusion many patients and families experience and help motivate physicians to discuss end-of-life care options earlier in the disease trajectory.

Please visit the Gilbert Guide for the very best in Hospice and for more information about Palliative Care.

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For more information, you might enjoy reading the complete book More Than Meets the Eye True Stories about Death, Dying, and Afterlife. Purchase on Amazon.com

Palliative Care Services

My grandmother is in palliative care and is doing quite well. A nurse comes to her house once per week, her doctor makes house calls and visits her once every six weeks. She also has a sitter who comes in and talks with her and keeps her company while my mom gets out for a few hours each week. Mom also has a social worker that she can talk to when she needs advice. Then, there’s the chaplain who comes to pray with Nanny, and the dear lady who comes by and gives her a bath three times per week. She even had three weeks of physical therapy that has helped her tremendously in becoming able to do some simple selfcare. We did not know this type of care was available, much less that insurance covers it. Here is an article that tells more about this service.

Palliative care is specialised health care of dying people which aims to maximise quality of life and assist families and carers during progressive illness and continues after death.

Palliative care, also called comfort care, focusses not on death, but on compassionate specialized care for the living. Complete palliative care programs also address mental health and spiritual needs. The focus is to make the person feel in control of their treatment and their quality of life. Palliative care involves family and friends, who also need to be prepared for the death of someone they love. When people enter a hospice or begin palliative care, their loved ones may begin to experience increased feelings of grief and bereavement. These feelings may intensify as people put final affairs in order, which may include funeral and memorial planning. Other issues that need to be considered are power of attorney arrangements, and the right to die, including voluntary euthanasia.

Read more here.. http://tinyurl.com/ybpxd8k

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For more information, you might enjoy reading the complete book More Than Meets the Eye True Stories about Death, Dying, and Afterlife. Purchase on Amazon.com

Palliative Care - Helping You Care For Your Terminally Ill Loved One

When my grandmother was placed in palliative care, I thought it meant that the doctors were giving up hope for her ever being able to recover. It’s not like that at all. In fact, she gets better care and more services now that she is in palliative care than she did when she was not. She no longer has to try to travel to the doctor—he comes to her. By the way, I think making the sick travel to the healer is quite backwards. The well/healers should come to the sick. No wonder everyone is sick. We gather them in a waiting room to share germs with one another while waiting for their turn to see the physician.
Back to the matter at hand. Nanny would have been bedridden if not for the hoist (like a car engine hoist) used to lift her lift her from her bed to her chair. Within the past month, she has begun to transfer from bed to wheelchair using a sliding board (see photo). When I visited her this past weekend, she stood on both feet for 42 seconds, and was able to stand from her bed using the walker and take three steps forward and then back to the side of the bed (see photo). She has set a goal for herself to be able to get from the bed to the wheel chair without the hoist or the sliding board by the end of this month. Physical therapy and palliative care have made all the difference for her, but without my mom’s consistent and firm urging Nanny to exercise her limbs for the past year while laying in bed, she might never have made this kind of progress. My mom is a saint. She is one of the strongest women I know of anywhere. And I see that same strength, willpower, and determination in my grandmother and my daughter.

I found the following article written by Lorraine Kember and hope it will be a blessing to you.

Ask most people what they know about palliative care and they will inevitably reply that it is intended for those who are dying. Undeniably, palliative care is available to support families at this sad time, however their services are equally intended to provide physical, emotional and spiritual support to the patient and their families as they journey through terminal illness.

It is important to bear in mind, that despite a terminal diagnosis, there is still life, and survival may range from months to several years. Quality of life, for the entirety of terminal illness is paramount. Palliative Care teams and the services they provide are there to help you care for your terminally ill loved one and to provide for them, the best quality of life attainable.

It is unfortunate that due to a misconception that Palliative Care is intended only for the very end of life, many do not embrace their services until the final stages of terminal disease and as a result, quality of life which could have been attained for the entirety of the illness is never realized.

Chronic untreated pain is debilitating, it dramatically affects a patient’s ability to participate in daily routines and in some cases takes away their will to live. Tragically, many people are suffering chronic pain unnecessarily. Pain management specialists attached to palliative care teams have vast knowledge regarding cancer pain and of medications available to control it. Once pain is brought under control, quality of life will be vastly improved.

Caring for a terminally ill loved one is a catastrophic experience; palliative care members understand this and there are counselors available to help you cope with your anticipatory grief. Likewise, chaplains are there to support you with prayer.

I cannot praise highly enough the services of palliative care, the team, who worked with me during my husband’s terminal illness, have my eternal gratitude. Through their dedication and the pain management specialist’s knowledge, my husband’s pain was controlled and the quality of his life improved dramatically. The silver chain nurses attached to the team visited us regularly and I looked forward to speaking with them and voicing any concerns I had in regard to my husband’s care. They never intruded on our privacy but were always just a phone call away if I needed them.

I urge you to embrace palliative care soon after diagnosis so that your terminally ill loved one and you may reap the benefits afforded by this wonderful group of caring individuals.

Article written by: Lorraine Kember – Author of “Lean on Me” Cancer through a Carer’s Eyes. Lorraine’s book is written from her experience of caring for her dying husband in the hope of helping others. It includes insight and discussion on: Anticipatory Grief, Understanding and identifying pain, Pain Management and Symptom Control, Chemotherapy, Palliative Care, Quality of Life and Dying at home. It also features excerpts and poems from her personal diary. Highly recommended by the Cancer Council. “Lean on Me” is not available in bookstores - For detailed information, Doctor’s recommendations, Reviews, Book Excerpts and Ordering Facility - visit her website http://www.cancerthroughacarerseyes.jkwh.com

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For more information, you might enjoy reading the complete book More Than Meets the Eye True Stories about Death, Dying, and Afterlife. Purchase on Amazon.com