When people approach the end of their lives, probably because of sickness or age, they develop a need for respect, compassion, and dignity. In a long-term care unit, people who are terminally ill and mostly in their last six months of life are provided with a 24-hour medical care, psychological support, and emotional support.
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Long-term care unit enables terminally ill patients to make the most out of their final days with their lives and loved ones. This research focuses on long-term care unit services as a remedy for the final days of the human life. Specifically, the paper focuses on the National Guard Hospital that is located in Riyadh, Saudi Arabia. It provides residents with such services to relieve any kind of pain and symptoms from their illnesses.
Today, terminal diseases such as cancer, heart failure, emphysema, liver cirrhosis, advanced dementia, massive stroke, Alzheimer’s disease, and kidney failure have become rampant in the world. Every human being is bound to contract a terminal disease or reach a terminal point of life. During this period, one is likely to spend a lot of money in home-based care.
He or she is also likely to experience grief, pain, sorrow, diminishing respect, and compassion from family members and friends due to the extended period of illness. Out of these experiences, there has been a wide acceptance of long-term care unit services across the world.
National Guard Hospital provides such care to terminally ill patients. Long-term care unit provides patients in their last several months of their terminal illnesses with counseling and medical care in order to make them enjoy their last days. Long-term care unit services do not aim at curing diseases. Rather, they aim at relieving pain, eliminating symptoms, and offering emotional and psychological support to the patient.
Dietitians in long-term care units provide nutritional counseling while psychological counselors enable patients to maintain emotional stability. Family members and friends are also allowed to visit the patients to relieve their stress and pain. Long-term care unit services are crucial in helping patients and family to prepare for the time-consuming recovery process in a rewarding way.
Therefore, there is the need to uphold the services in the world today. As such, family and the patient find it easy copying with the situation despite its persistence. The services are so engaging such that the patient does not even realize that he or she is sick and that the sickness is taking long to end.
Such an engagement is vital as it lengthens the life of the patient as he or she experiences no stress about the sickness since many death cases result from the pressure associated with disease in question-leave alone the disease itself.
Statement of the Problem
The study focuses on the preference of long-term care unit services to home-based care for the terminally ill patients in the National Guard Hospital.
- How many people in the community have access to long-term care unit services in the National Guard Hospital?
- What are the reasons behind the wide preference of long-term care unit services to home-based care in the National Guard Hospital?
Objective and Significance of the study
The study finds out the rate of preference of long-term care unit services in the in the National Guard Hospital in Riyadh, Saudi Arabia. The findings of the study will be of great importance in the implementation of long-term care unit programs in the hospital and in the country at large.
Long-term care unit services began to be offered in the 1800s. In fact, they were first adopted from the ‘rest homes’ that were used as the stopping points used by pilgrims and travelers during the middle ages. From these religious pilgrims’ stopping points, a nun from Dublin, Ireland donated a house for rest for dying patients. To her, dying was a stage in life where people in such a stage needed special care.
In 1967, the modern long-term care unit got a foundation as one British physician, social worker, and the nurse called Cicely Saunders began long-term care services in London. Long-term care unit services have since gained acceptance across the world (Cannor 4). Today, in the United States, there are about 3150 long-term care units in operation.
It is also estimated that more than 700,000 patients are taken care of in the units in the United States. The units harbor health care professionals and trained service attendants. Volunteers are trained to work in the units. Such services are also offered in nursing homes and nursing hospitals. In the 19th century, there was a wide acceptance of campaigns for the need to take care of the terminally ill in the United Kingdom (Lewis 21).
The Lacent Journal and the British Medical Journal also agitated for proper medical care for the terminally ill. The latter advocated for care and proper sanitation for the fatally ill (Lewis 22). Other long-term care units developed in the world in different times.
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For example, according to Lewis, such units include homes for incurables established in Australia in 1879, the Anglican House of Peace for the dying established in Sydney in 1907, and St Joseph’s Long-term Care Unit established in London in 1905 (21). Cicely Saunders established many other units after 1950s (Connor 4).
Long-term care unit services have currently grown from the initial volunteer and religious-led affairs to national affairs in some nations. For example, in the United States, the government organized for long-term unit care for all the isolated terminally ill persons.
It is estimated that about 1.581 million were cared for in long-term units in 2010. In the United States, long-term care unit services are covered by health insurance such as Medicaid. For example, according to Plochar and Metzger, in 1995, long-term care unit industry in the United States was worth $ 2.8 billion (222).
However, the establishment of long-term care has faced opposition across the world. Such resistance has majorly emanated from cultural foundations, taboos, and medical professionals. The point of debate is about open communication on psychological matters concerning the persisting illness. Some physicians believe that there should not be such open communication among doctors or patients.
During long-term care, medical professionals discontinue the treatment of diseases. They majorly administer the medicine that is aimed at relieving pain and eliminating symptoms of a certain terminal disease (Ratcliff and Craig 365). The patient in a long-term care unit may therefore become uncomfortable with the change in medical technique.
Others argue that long-term unit care services are a manifestation of medical callousness towards terminally ill patients. Nevertheless, long-term care units have received acceptance across the world.
Plochar and Metzger are for the opinion that much of acceptance is developed from its relieving nature to the patient and to the family of the terminally ill (222). Long-term unit care services have also enabled the patient and their families to save money and or experience a longer life with the terminally ill patients.
This chapter expounds on the research method adopted in this study. It will therefore include research design, data sources, and data analysis tools. The study will adopt quantitative and descriptive survey designs in investigating the acceptance of long-term care unit services by both health professionals and patients in the National Guard Hospital in Riyadh, Saudi Arabia.
It will involve collection of data from the population in question and using the sample as a representative of the whole. It is the best design for research dealing with character, behavior, value, and attitude. Descriptive survey is therefore the best for this study. The data to be used in this study will be collected from the community around the National Guard Hospital as the primary source of data for the study.
The research setting for this study is the National Guard Hospital. The research finds this community the most appropriate since it has the capacity to provide good long-term care unit services at will. The research will adopt the use of both closed-ended and open-ended questionnaires. The sample will be limited to 90 members of the National Guard Hospital’s community.
The sample will comprise 50 terminally ill patients, 10 doctors, 10 administrators, and 20 family members of the terminally ill patients. The research will collect and code data for analysis. Data analysis will be done through statistical and descriptive analysis procedures. The statistical procedures will include percentages and averages. The results will be reported in summary form using frequency tables and pie charts.
Table 1.0 Preference of long-term care unit services to home based care for terminally ill patients
|Title of Hospital Community member||Terminally ill patients (out of 50)||Doctors (out of 10)||Administrators (out of 10)||Family members of the patient (out of 20)|
Pie chart 1.0 Preference of long-term care unit services to home based care for terminally ill patients
Table 2.0 Reasons for adopting long-term care unit services over home-based care
|Reasons for preferring long-term care unitservices||Number (out of 90)||Percentage|
|Emotional stability of patient||70||77.8%|
|Improved quality of Medicare||67||74.4%|
|Emotional stability of family and friends||75||83.3%|
|Better health services||80||88.9%|
|Better engagement of the patient’s mind||65||72.2%|
From table 1.0, it is clear that the National Guard Hospital’s community prefers long-term unit care services to home-based care. The table indicates that an average of 75% of the hospital’s community prefers long-term unit care services. Such a percentage indicates acceptance. The research found that 84% of the terminally ill patients under treatment in the hospital would prefer long-term unit care services to home-based care.
It is even clearer on the segment based on the percentage represented on the pie chart 1.0. Therefore, it is inferable that patients would enjoy nutritional care, psychological care, and emotional care offered in the long-term unit care. The research also discovered that 80% of the administrators in the National Guard Hospital preferred long-term unit care services. A large segment of the pie chart 1.0 represents the percentage.
One can deduce that the administrators would have preferred long-term unit care services since they understand that it is of high quality and that it provides better Medicare services for patients. The percentage of family members who would prefer long-term unit care services to home-based care was 75%, which was in line with the average preference of the hospital’s community. The figure was also above average.
The findings were attributed to the understanding of the families that having their relatives in the units would eliminate stigma and would provide them with a better environment at home. Long-term unit care eliminates stigma besides offering counseling to both the patient and the family. 60% of the doctors preferred long-term unit care services for terminally ill patients.
Although this finding was the least figure in percentage and in the pie chart 1.0 segment, it was also above average. It is therefore deducible that doctors preferred long-term unit care services the least due to controversies and oppositions posed by their profession concerning open communication about psychological issues.
Doctors should not communicate openly about issues that may interrupt the patient’s peace of mind as he or she recovers. Putting a patient under long-term unit care is like condemning him or her.
The research also found that most of people from the National Guard Hospital’s community would prefer long-term unit care services due to better health care. In fact, 88.9% of the people cited better health care as their major reason for long-term unit care services. One can attribute this case to the 24-hour care offered in long-term unit care by medical professionals.
The percentage was followed by 83.3% of people that preferred long-term unit care services for emotional stability of the family members and friends. Long-term unit care services eliminate the stigma that family members go through as they watch a close relative in pain or waiting to die in their presence. When patients are in long-term unit care, family members are allowed to visit them at any time as doctors take care of them.
The third largest percentage was 77.8% scored under emotional stability of the patient, which was attributed to the sociological and emotional therapy offered by healthcare specialist and counselors in long-term unit care. Medicine to relieve pain and symptoms of diseases is also administered in long-term unit care.
The research also realized that 75% of the community believed that the care was more patient-friendly relative to home-based care. Donors, volunteers, and insurance services support long-term unit care services thus making them preferred in relation to home-based care.
Finally, the research realized that 75% of people would take terminally ill patients to long-term unit care in order to prepare them and family for the length of time they take before recovering (Bakitas et al. 488). Long-term unit care services offer psychological counseling for the family and friends of the terminally ill. Such counseling is relieving to the family, which later finds the particular illness as more of a natural process.
Conclusion and Recommendations
The research concludes that long-term unit care services are a preference for most people in the National Guard Hospital, Riyadh. An average of 75% of people would prefer long-term unit care to home-based care. Long-term unit care services were also preferred for offering emotional stability for the family through counseling and preparing them psychologically as the wait for the time-taking recovery process of the patient.
The sample collected was also small and may not be a clear reflection of the large number of people in the community. The research recommends that the hospital should put in place a better long-term unit care services to meet the increasing demand.
There is also a need for the hospital to offer better quality of health services since it is the quality that attracts the highest percentage of long-term unit care patients. The research also recommends that there is the need for more health education since some people disregarded long-term unit care services due to the many evident controversies it.
Bakitas, Marie et al. “A Palliative Care Demonstration Project for Advanced Cancer Patients in Three Settings.” Journal of Palliative Medicine 7.3(2004): 486-93. Print.
Connor, Stephen. Hospice: Practice, Pitfalls, and Promise. London: Taylor & Francis Press, 1998. Print.
Lewis, James. Medicine and Care of the Dying: A Modern History. Oxford: Oxford University Press, 2007. Print.
Plochar, David, and Patricia Metzger. The Case Manager’s Training Manual. New York: Jones & Bartlett Publishers, 2001. Print.
Ratcliff, Margaret, and Elizabeth Craig. “The GRACE Project: Guiding End-of-Life Care in Corrections 1998-2001.” Journal of Palliative Medicine 7. 3(2004): 363-72. Print.