What is Hospice Care? Hospice Care Definition
Hospice care is provided to terminally ill patients who have a life expectancy of less than six months. Every patient has right to die without bodily and emotional pain. The primary focus behind hospice care is making patients feel comfortable, stable, and dignified during their final months of living. In addition, hospice care improves the quality of life for the patients but it does not help prolong life. Aside from the focus on the patients and their experience, hospice care ensures that they families are able to handle the emotional stress and trauma that is related to death. Curative treatment is an approach in which the goal is to cure the disease and to prolong life at all costs. Palliative care is not curative in nature but is designed to relieve pain and distress and to control the symptoms of the disease. Symptoms that palliative care focuses on relieving include: pain, nausea, vomiting, constipation, anorexia, malnutrition, dyspnea or air hunger, psycho social and spiritual issues, weight loss, dehydration, weakness, risk for skin impairment, depression, Sleeplessness and insomnia.
Patient and Caregiver Education
The way hospice care is planned should affect the patient and caregiver in an honest and straightforward method. It is thought that the fear of the unknown is always greater than the fear of the known. Educating the caregiver in symptom management, hands-on care of the patient, caring for body functions, and teaching regarding the signs and symptoms of approaching hospice patient are important to relieve fears.
How to Initiate Hospice Care
To initiate hospice care, the attending physician must certify that the patient’s illness is terminal and that the patient has a prognosis of 6 months or less to live. The patient must be willing to forego any further curative treatment and be willing to seek only palliative care. The patient and caregiver must understand and agree that the care will be planned based on the comfort of the patient, and that life-support measures may not necessarily be performed. The patient and caregiver must also understand the prognosis and be willing to participate in the planning of the care. Admission to a hospice program is the decision of the patient and their family, because not all people need or desire hospice care. Autonomy is one of the attributes of quality of health care. The patient or family should be the center of all-important decisions taken in regard’s to the patient’s care, and there shouldn’t be any decisions made without consulting the patient or their family first.
Objectives of Hospice Care
Managing symptoms and improving the quality of life without life prolonging measures is the main objective of hospice care. Allowing the patient and caregiver to be involved in the decisions regarding the plan of care is a primary aspect of hospice care, as well as encouraging the patient and caregiver to live life to the fullest. Other objectives include: providing continuous support to maintain patient/family confidences and reassurances to achieve these goals, educating and supporting the primary caregiver in the home setting that the patient chooses, and providing a clear understanding of death related issues as it affects much on the performance of caregivers and the quality of hospice care.
81 million children in the United States require pediatric hospice care. In the United States alone, there are 2.5 million deaths annually. About 50,000 deaths are pediatric 0-19 (2.2%). Children represent 25% of the US population. Half of childhood deaths are in the first year of life, while half of infant deaths are in the first month of life.
Pediatric Palliative Care Diagnosis
There are conditions for which curative treatment is possible but may fail. The following are common diagnosis in children, which make them eligible to receive hospice care.
- Genetic/Congenital (40%)
- Neuromuscular (40%)
- Respiratory (12%)
- Gastrointestinal (10%)
- Cardiovascular (8%)
- Advanced or progressive cancer or cancer with a poor prognosis
- Complex and severe congenital or acquired heart disease
Models of Care
Hospice care can be provided in the following settings and situations:
- Inpatient consultation palliative care teams
- Inpatient palliative care
- Home hospice
- Perinatal and neonatal hospice
- Concurrent care