Overview of Hospice Care
Hospice is an organization that provides multi-disciplinary support and care for terminally ill patients. Nowadays, hospices exist in almost all countries of the world. Even though care peculiarities may be different, the goals are the same. The paramount task of hospice is to provide care for people with a life-limiting illness or injury to living the rest of their life as fully and comfortably as possible. The philosophy of hospice care is built on the belief that patients and their families can live more fully thanks to the personal care and care of others. It should be stressed that such care cannot accelerate or delay death, but it helps to meet it adequately (Kirk & Jennings, 2014).
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Most of the care is delivered at patients’ homes, yet there are plenty of nursing homes, hospice centers, and other similar facilities. Hospice care is covered by Medicaid, Medicare, and so on and provided to everyone regardless of race, sex, age, and illness. Palliative care focuses on caring rather than on curing. In particular, the following care options can be received at hospice:
- provision of health and social services at a medical facility;
- improvement of medical care at home;
- symptomatic care for patients in the terminal stages;
- organization of qualified care with the use of psychotherapeutic techniques;
- necessary pain therapy;
- social and psychological assistance to patients and their families and the explanation to the latter of how to care for their relative.
Ancillary services refer to supplemental health care services that are essential to support a primary physician’s performance. In particular, these services help to support a diagnosis, improve treatment, or promote rehabilitation. There are three types of ancillary services, including diagnostic, therapeutic, and custodial (Bodenheimer & Grumbach, 2016). The diagnostic category focuses on laboratory tests, diagnostic imaging, etc. The therapeutic category involves a wide range of services, from physical and occupational therapy to massage and speech therapy. The third category of custodial services is directed to facilitate acute pain, urgent care, and hospice care. Thus, it becomes evident that custodial services are the most important for hospice. Among the additional services that are to be provided in the context of ancillary care, one may note monitoring of weight, dental and podiatry services, and nutrition control (Bodenheimer & Grumbach, 2016). An essential aspect of this work is also to meet the needs of patients associated with a religion that can relieve the suffering of patients.
The main objective of ancillary services in hospice care is to support the state of well-being and enhance terminally ill patients’ general health. Therefore, the elements of ancillary care are to be implemented from the first days of care delivery. This is likely to improve the quality of life at all stages of the disease and allow patients to enjoy their lives. Having sufficient information about the course of the disease, a doctor, a nurse, and a patient in collaboration can choose a rational way to cope with its symptoms. Selecting one or the other ancillary care tactics, it is also critical to take into account the biological and emotional conditions of a patient, along with his or her social and psychological statuses (Kelley & Morrison, 2015). A patient’s quality of life can be enhanced only in terms of appropriate ancillary care that is the ultimate goal of hospice.
The idea of creating hospice was born in close connection with human needs. It implies creating such conditions under which there would be no humiliation of a person with pain, fear, or hopelessness. On the contrary, it is of great importance to save a patient’s world, values, and interests and let him or her go quietly and with dignity (Wordingham & Swetz, 2015). Hospice work involves studying issues related to the content of the central theoretical positions of a functioning approach. It consists of the study of a range of topics that are directly related to ancillary care:
- nature of the disease;
- forms of necessary ancillary assistance;
- characterization of the primary care facility;
- communication with a patient;
- adequate treatment of pain;
- forms of collateral psychological comfort.
Another critical position of the hospice concept is the need to provide the psychological comfort of a patient. This is achieved, first of all, by the establishment of an atmosphere of respect for his or her personality, the satisfaction of expectations, and the maintenance of relationships with the outside world and interest in life (Thompson et al., 2014). Psychotherapists’ collaboration with clinical psychologists, social workers, and other interested parties allows providing appropriate palliative care to a patient.
The psychological aspect of ancillary services composes one of the essential parts of hospice care. It evaluates a patient’s psychological condition, offers individual consultation, and psychotropic medication monitoring. Many patients tend to fall into depression once they knew about their life-limiting disease. Among the reasons, there may be the progression of the disease, pathological symptoms, or social, cultural, and spiritual problems. In this regard, mental ancillary service’s role is to ensure that the attitude to a patient in need of palliative care contains a responsible manner, respecting individuality, cultural sensitivity, and the right to choose their place of stay (Wordingham & Swetz, 2015). In other words, the ancillary health care service providers are expected to express sympathy and compassion, attention to all the needs of a patient, and assistance in resolving any problems faced by him or her. Every patient should be treated individually, and his or her ethnic, racial, religious, and other cultural priorities should be respected.
A patient’s family is also the sphere of responsibility of the ancillary health care service providers. It is necessary to talk to them and know all about relationships within the family, identify the signs of the imminent decease of a patient, and have time to warn the family. The ideal outcome is to do everything to ensure comfortable and proper relationships between the family and a patient, explaining death’s inevitability in an accepting manner. Ultimately, it should be emphasized that the most important condition for the effective operation of ancillary hospice care is the careful selection of qualified personnel and the continuous learning process. It should be kept in mind that palliative care is time-consuming; therefore, it is crucial to have sufficient personnel in every hospice (Wordingham & Swetz, 2015). The ancillary health care service providers are expected to accept the principles of palliative care, be qualified to provide it, and respect patients.
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Education.
Kelley, A., & Morrison, S. (2015). Palliative care for the seriously ill. The New England Journal of Medicine, 373(8), 747-755.
Kirk, T. W., & Jennings, B. (2014). Hospice ethics policy and practice in palliative care. New York, NY: Oxford University Press.
Thompson, S., Varvel, S., Voros, S., Thiselton, D., Grami, S., Turner, R. M.,…Barron, J. (2014). The changing role of ancillary health care service providers: An evaluation of Health Diagnostic Laboratory, Inc. Population Health Management, 17(2), 121-126.
Wordingham, S., & Swetz, K. (2015). Overview of palliative care and hospice services. Clinical Liver Disease, 6(2), 30-32.