Merits and Demerits of Hospice Care Review Essay

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Introduction

Man is said to have three important stages in life. These are birth, marriage, and death. Though it is a part of life, the prospect of death evokes terror in the hearts of many people. Worse still is the thought of dying of a terminal disease. When one is sick, there is always the prospect of going to a good doctor and the assurance of our health is restored. But when one goes to a doctor and they are told that they have an untreatable ailment then the reality of death settles in. Example of terminal illnesses includes cancer, HIV, kidney problems among others. It’s normal for people who have come to the end of their life to feel dejected by society. Most family members find the duty of caring for these family members to be a big burden. It’s at this point that hospice care comes in. (Miller, et al 801)

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Main Discussion

Hospice represents the sympathetic care given to people who have come to the end of their life. Initially, hospice was the care given to travelers who were either tired or sick and needed a place to rest and refresh before going on with their journey. In the mid 20th century, Dame Cicely Saunders of St. Christopher Hospice center in London used the term hospice to refer to the professional care given to those patients who were suffering from an ailment they were not likely to recover from. This move saw the mushrooming of hospice programs all over the world. Today, it is estimated that there are over 3000 hospice programs in the U.S. alone. (Kaplan)

The term hospice is a term based more on the care given to patients than on the place where the care is administered. People who have come to the end of their life are given the option of choosing to spend the remaining part of their life in such kinds of homes. Once they are put in such kinds of homes, they are enrolled in programs geared toward preparing them for the inevitable death ahead. In most cases, there is no treatment given to these patients. What happens is that they are taken through programs to lessen their pain. This happens so that when death finally comes, it happens with grace and dignity. (Parker-Oliver & Bickel 50)

The best thing about hospice care in a facility is that it concentrates on all areas of one’s life. This involves the bodily, emotional, and religious front. The fact that this care does not restrict people based on their age makes it more appealing to many people. Though most hospitals and nursing homes have hospice care programs, some people prefer to take care of their terminally sick people in a home setting. (Miller, et al 801)

There are numerous benefits of hospice care in a facility setting. However, the benefits of taking care of terminally ill patients at home far outweigh those of a nursing home. One of these reasons is that the nursing homes are run by professional nurses who provide specialized care to the patient. The nurses also act as a link between the patient, their doctor, and the family. Since the nurses are trained, they can also watch out for any symptoms or complications that the patient may develop and which may be treatable. (Oliver, et al 150)

Another advantage of nursing homes is that there are always social workers at hand to counsel the patients and prepare them psychologically. These social workers also act as a link between the family and the society at large. The director of the nursing home is always at the beck and call of the concerned physician and he can always report on things that need to be given priority concerning the patients’ health. This becomes important when there are things that need to be taken care of by the physician. (Miller, et al 801)

When one is in great pain, some simple chores in life may become such great problems. Examples of this include walking, eating, or even putting on one’s clothes. In a hospice care facility, some workers are ready to help the patient with such kinds of duties. These might not be possible in a home setting where people have many duties to attend to. (Oliver, et al 150)

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Another area of importance in a nursing home is the spiritual support given to the patient. When we are alive, every one of us has our way of living. This is because each one of us can choose the kind of life we would like to live. Some people acknowledge the presence of God while others do not. However, at the prospect of death, almost everyone tends to reconcile with their spiritual part. It is at this point when spiritual leaders are needed more than ever in one’s life. Nursing homes provide this kind of care by helping the patient reconcile with their God. This leaves the patients in great peace and makes the dying process less painful because they now have new hope. (Parker-Oliver & Bickel 50)

Everyone knows how cumbersome it is caring for a terminally ill patient. Since the patient is usually very weak at this point and can not do anything for themselves without help, caring for them becomes a problem for many people who have other chores to attend to. Nursing homes with hospice care programs present a much-needed respite for these people. This is because these facilities have professional caregivers and volunteers who are ready to take on the extra burden. This may not be possible in a home setting where people have to attend to other duties. (Oliver, et al. 150)

Even though people in hospice care do not need medication, there are times when the intervention of a doctor is needed urgently. These are cases like when the patient is in a lot of pain and they have to be given medication to ease the pain. This is a service that can not be gotten in a home setting but would readily be available in a hospice facility. The hospice team not only arranges for such kind of care but also remains involved the whole period the patient is at the hospital. (Parker-Oliver & Bickel 50)

The last major reason why people choose hospice facilities over home care is that when death finally comes, the hospice staff provides support to the family throughout the mourning period. They also visit the family for a period of up to one year following the death of a loved one. This is important since lack of a proper follow-up may lead to stress on the concerned family members. Also, not all people in a hospice care facility die within the six months that one is given to live upon being placed in such kind of a facility. If one does not die, the staff refers such kinds of people to a place where they can get the needed care. (Parker-Oliver & Bickel 50)

Though hospice care given in a facility has its benefits, care given in a home has more advantages. One of the major advantages of home care over hospice care in a facility is the economic aspect of the whole setting. Recent studies have shown that the cost of the care given in a hospice facility has been on the rise in the last few years. This has called for a change in lifestyle and home care has instead taken over. With the high cost of living today and the current economic recession, there is a need for people to look for less cost-effective services and on this front home care comes in handy. It is also important to note that by the time one is pronounced to be eligible for hospice care, they are bound to have cost the family much money, and therefore looking for low-priced care would be prudent. (Oliver, et al. 150)

Another major benefit of home care over hospice care in a facility is pain management. Contrary to the common belief, studies have shown that staff in hospice facilities does not bother with managing the pain those patients go through. This leads to much suffering on the part of the patients leading to despair and frustration. This may be because the patients do not have blood ties with the involved staff thus leading to negligence. This is something that could never happen in a home setting care. (Miller, et al 801)

Studies also show that upon admission to a hospice facility, death is quicker than that of people in a non-hospice setting. This is due to the lack of personalized care that patients need. Most of the staff in hospice care centers are volunteers who have little or no experience in caring for people with terminal diseases. This makes home-based care to be the best since there is the possibility of personalized care. (Oliver, etal150)

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Another most important thing that makes home care superior to hospice care in a facility is the bond that grows between the patient and their people. When people are in their last days, there are lots of things that they would want to put right in their own lives. Staying close to family members plays this one important role. Since every concerned party knows that this particular time is the last that they will ever live together, then everyone becomes eager to please the other. Many people choose this time to show the love that they had failed to show earlier. (Zerzan, et al 2494)

The prospect of death is not an easy one to endure. That’s why people need to be shown much love and compassion during this important period. This makes the terminally ill patient more positive toward life. It’s well known that most people die out of depression than from the ailment that they initially had. The love that one’s family gives can not be found at any other place. This makes care at home to be more effective than care gotten from any other quarter. This bond between the patient and the family makes death less painful to the patient. To the family, it is also beneficial in that it prepares them psychologically so that when the person finally dies they do not take the loss negatively. (Parker-Oliver & Bickel 50)

Hospice care has been wrongly associated with old people. It is however important to learn that terminal diseases affect even young children. Though hospice care facilities are open to any age; it would be obnoxious putting a child in hospice care. Children always need a mature family member beside them at any time. This becomes more important especially when the child is sick. Putting the child in a hospice facility is not only wrong under the constitution, it causes the child great suffering hastening their death. There are also patients whose wish would be to die at home. Putting them under hospice care at a facility would therefore go against their wishes causing them great depression. Above this, it is known that the wishes of a dying man should always be honored. (Zerzan, et al 2494)

Initially, a physician prescribes to a family the best place that they can take their terminally ill patient. Most doctors today do not however refer patients to hospice centers. This has been caused by the negative publicity that is associated with these centers. Some physicians also fail to refer patients to hospice centers for economic gain. Instead of telling the concerned family that their member is suffering from an incurable disease and they are on their last days, they hide the fact for purely selfish reasons. These doctors know that the longer the period that one stays in their care, then the more they will gain financially. A family may also choose to retain their patient in the hospital than take him to a hospice facility. (Parker-Oliver & Bickel 50)

Conclusion

Death is an inevitable part of life for everyone. For those who are about to die and for those who are affected by the person’s death, this can be a depressing time. It is therefore important for people to be psychologically prepared for any such eventuality. Some illnesses present a patient with certain death. This can be a cause for both fear and anxiety to both the family and the patient. To the patient, they are afraid of leaving behind their loved ones and facing the unknown while the family is afraid of facing an uncertain future. If not handled correctly, this can be a hard time for everyone concerned. It is at this point that hospice care comes in handy. A hospice care facility transforms the painful process of dying and makes it pleasant for everyone concerned. Though the benefits of a hospice care facility are numerous, they are outweighed by the demerits. One of the demerits of hospice care is the high cost involved. Most institutions charge large amounts of money. This puts more strain on a family that has already suffered from the high costs of medical fees charged in our country today. This makes home care to be more effective than hospice care. Besides saving the family a considerable amount of money, the patient gets personalized attention from the family. When a patient is cared for at home, there is always the chance that they will make up with family members whom they might have crossed paths with during their lifetime. This lives everyone at peace when the concerned patient is gone.

Works Cited

Kaplan, Nicole. Hospice Care: Full Service Support at Home or in a Facility, 2005. Web.

Miller, S. C., Mor, V., & Teno, J. “Hospice enrollment and pain assessment and management in nursing homes”. Journal of Pain Symptom Management, 26.1 (2003):791-799

Oliver, D. P., Porock, D., & Zweig, S. “End-of-life care in U.S. nursing homes: A review of the evidence”. Journal of the American Medical Directors Association 5.1(2004): 147-155.

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Parker-Oliver, D., & Bickel, D. “Nursing home experience with hospice”. Journal of the American Medical Directors Association 3.1 (2002): 46-50.

Zerzan, J., Stearns, S., & Hanson, L. “Access to palliative care and hospice in nursing homes”. Journal of the American Medical Association 284.2 (2000): 2489-2494.

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