Suchergebnisse

This case study traces the creation and evolution of Medicare hospice policy. The Medicare hospice benefit, created in 1982, emphasizes palliative rather than curative care. It focuses on quality of life for the dying patient and family and encompasses medical, psychological, and spiritual care. Because no standard hospice care practices existed before this benefit was implemented, Medicare rules almost exclusively dictated the structure and delivery of services. Despite initial concerns about low use, spending averaged 17 percent per year between 1991 and 2001, largely driven by increased enrollment, covered days, services provided, and inflation. A rich accumulation of research studies and analyses of specific aspects of the hospice program provides an opportunity for a retrospective analysis of the program's genesis, impact on health care delivery, and implications for future policy decisions.

The term "palliative care" has a negative connotation and may act as a barrier to early patient referrals. Rebranding has thus been proposed as a strategy to reduce the negative perceptions associated with palliative care. For example, using the term "supportive care" instead of "palliative care" in naming palliative care units has been proposed in several studies. In Taiwan, terms other than "palliative" and "hospice" are already widely used in the names of palliative care units. With this in mind, this study investigated the characteristics of palliative care unit names in order to better understand the role of naming in palliative care. Relevant data were collected from the Taiwan Academy of Hospice Palliative Medicine, the National Health Insurance Administration of the Ministry of Health and Welfare, and the open database maintained by the government of Taiwan. We found a clear phenomenon of avoiding use of the terms "palliative" and "hospice" in the naming of palliative care units, a phenomenon that reflects the stigma attached to the terms "palliative" and "hospice" in Taiwan. At the time of the study (September, 2016), there were 55 palliative care units in Taiwan. Only 20.0% (n = 11) of the palliative care unit names included the term "palliative," while 25.2% (n = 14) included the term "hospice." Religiously affiliated hospitals were less likely to use the terms "palliative" and "hospice" (χ2 = 11.461, P = .001). There was also a lower prevalence of use of the terms "palliative" and "hospice" for naming palliative care units in private hospitals than in public hospitals (χ2 = 4.61, P = .032). This finding highlights the strong stigma attached to the terms "palliative" and "hospice" in Taiwan. It is hypothesized that sociocultural and religious factors may partially account for this phenomenon.

This practicum report is a summary and reflection upon a Master of Social Work practicum completed at Victoria Hospice, supporting my desire to understand the role of a social worker within an interdisciplinary hospice palliative healthcare team. Several aspects of my practicum experience are explored through a literature review, embracing a biopsychosocial-spiritual model of practice. Included is a brief examination of Medical Assistance in Dying (MAiD) and its legislation in Canada. The knowledge gained from this practicum will guide my hospice palliative social work practice in northern BC, which in turn will provide a learning environment for future social work students wanting to specialize in this area of practice. ; Palliative Care

This practicum report is a summary and reflection upon a Master of Social Work practicum completed at Victoria Hospice, supporting my desire to understand the role of a social worker within an interdisciplinary hospice palliative healthcare team. Several aspects of my practicum experience are explored through a literature review, embracing a biopsychosocial-spiritual model of practice. Included is a brief examination of Medical Assistance in Dying (MAiD) and its legislation in Canada. The knowledge gained from this practicum will guide my hospice palliative social work practice in northern BC, which in turn will provide a learning environment for future social work students wanting to specialize in this area of practice. ; Palliative Care

This article examines the intersection between masculinity, military culture, and hospice and palliative care (HPC). The authors conducted a narrative literature review, supplemented with clinical annotations, to identify the impact of masculinity and military culture on the following topics salient to end-of-life care with older male veterans: pain management, mental health, coping, communication, autonomy and respect, and family roles. Findings suggest that traits associated with masculinity and military culture have an influence on the end-of-life process and HPC for older male veterans. Specifically, results suggest that older male veterans may deny or minimize physical pain, decline mental health treatment, utilize maladaptive coping strategies, avoid emotional conversations, struggle to manage perceived shifts in autonomy, and experience challenges negotiating changing family roles. The authors provide clinical recommendations for providers across various disciplines to address the aforementioned concerns with older male veterans in HPC. Overall, information presented in this article may be an important contribution to the literature for building cultural competencies with older male veterans and has the potential to improve the delivery of HPC for veterans and their families.

"Data in this report from health and demographic surveys present statistics by age and other variables on alcohol- and drug-related visits to hospital emergency departments; hospitalizations for injury and poisoning; health insurance and cancer screening among women; energy and macronutrient intakes; overviews of home health and hospice patients and agencies; dietary intake of vitamins, minerals, and fiber; and contraceptive use. Estimates are based on the civilian noninstitutionalized population of the United States, These reports were originally published in 1994." ; Alcohol- and drug-related visits to hospital emergency departments: 1992 National Hospital Ambulatory Medical Care Survey (no. 251) -- Hospitalizations for injury and poisoning in the United States 1991 (no. 252) -- National Ambulatory Medical Care Survey: 1992 summary (no. 253) -- Health insurance and cancer screening among women (no. 254) -- Energy and macronutrient intakes of persons ages 2 months and older in the United States third National Health and Nutrition Examination Survey (no. 255) -- An Overview of home health and hospice care patients: preliminary data from the 1993 National Home and Hospice Care Survey (no. 256) -- Hospices and home health agencies: data from the 1991 National Health Provider Inventory (no. 257) -- Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the united states third National Health and Nutrition Examination Survey, Phase 1,1988-91 (no. 258) -- Characteristics of elderly men and women discharged from home health care services: United States, 1991–92 (no. 259) -- Contraceptive use in the United States: 1982-90 (no. 260) ; "July 1995." ; U.S. Government Printing Office : 1995 -- 386-952/20020. ; Also available via the World Wide Web. ; Includes bibliographical references. ; National Center for Health statistics. Advanoe data trom vital and health statistioq numks 251-260. National Center for Health statistics. Vi Health Stat 16(2S). 1995.

As part of an on-going review of service provision for Hospice adult patients, six chaplains were interviewed to elicit their views and experiences of meeting spiritual needs within a multidisciplinary palliative care team. Interviews were taped: transcribed and common themes were identified. The chaplains highlighted many positive aspects of their work, recognising their role as one of service to the patients. They emphasised the importance of teamwork, both within the chaplaincy service and throughout the wider palliative care team. Negative aspects of working in palliative care were also identified, such as compassion fatigue. Chaplains need special coping skills and ongoing support in their work. They must recognise and obtain resources for patients from other world faith communities.

• Summary: This article reports an audit of people considered for transfer from a hospice to a nursing home for end-of-life care and discusses implications for patients, families and staff. • Findings: Moving patients to nursing homes at the end of their lives is often distressing for both patients and families and in many cases patients die within a short time of transfer. Few patients are actually transferred although many more are asked to face this possibility often creating unnecessary anxiety. This may have adverse consequences for family members' bereavement. • Applications : There is a weak evidence base for transferring patients from hospices to nursing homes. Palliative care services assume a short in-patient stay to ration an expensive scarce resource. Assessment with social work contributions identifying complex emotional, family and bereavement consequences may allow multidisciplinary teams to justify longer hospice stays by identifying more complex needs to justify better substantive equality between patients.

Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform provides an introduction to the principles of palliative care; describes current models of delivering palliative care across care settings, and examines opportunities in the setting of healthcare policy reform for palliative care to improve outcomes for patients, families and healthcare institutions. The United States is currently facing a crisis in health care marked by unsustainable spending and quality that is poor relative to international benchmarks. Yet this is al

Title Using Participatory Action Research in the development of an innovative Cottage Hospice model of care in the United Kingdom Objectives a) To contribute to the development of the Cottage Hospice programme and its constituent components. b) To ascertain barriers to and facilitators of Cottage Hospice using action cycles to address identified challenges. Methods Our three-phase Participatory Action Research (PAR) study comprised: 1) A situational analysis using documents (n=150) and stakeholder qualitative interviews (n=28). 2) A Core Action Group oversaw action cycles designed to address challenges identified from the situational data. Local stakeholders participated in a deliberative workshop where study results were presented and refined. 3) An end of study conference is planned in order to disseminate learning to a wider stakeholder audience Results Results presented here align with the objectives in terms of identifying challenges and contributing to the development of the Cottage Hospice programme. Our situational analysis revealed growing support and enthusiasm for the model among hospice staff and volunteers, over time. However, anxieties regarding the viability, reach and conceptual clarity of Cottage Hospice were identified, as were concerns about communication systems and staff feedback to the planning team. Early results demonstrated a need to gather the views of a wider range of health and social care providers regarding the local impact of the initiative. Action cycles included a focus on determining who might use Cottage Hospice; what support family caregivers may need; and conceptual explorations of 'family'. The deliberative workshop enabled findings to be refined in discussion with those most invested in Cottage Hospice, feeding into the final report and dissemination plans. Conclusions Using PAR democratises the research process and provided an opportunity for all interested parties to contribute to the development of Cottage Hospice. It enabled 'ground up' development and ownership of the ...

Purpose: to analyze the organization of palliative and hospice care at different levels of medical care for the population of Ukraine at the current stage of healthcare reform in Ukraine and at the regional level. Materials and methods: the scientific work uses current regulations and guidelines of the Ministry of Health of Ukraine on the organization of palliative and hospice care in the healthcare system of Ukraine. Scientific methods were used for data processing: analytical, bibliosemantic and systematic approach. Results: Palliative care, as a separate type of medical care, has been legislated in Ukraine since 2011. But before the introduction of the program of medical guarantees and the signing of contracts with the National Health Service of Ukraine for packages of medical services in the direction of palliative and hospice care, such assistance in our country was provided only by a few dozen medical institutions. The introduction of a separate package in the program of medical guarantees became an incentive for the development of a network of institutions providing palliative care. Conclusions: Development and improvement of the quality of palliative care in accordance with world standards is one of the priority tasks of the health care system and public health of Ukraine, because palliative and hospice care is a complex of medical, social, psychological measures aimed at improving the quality of life of patients with incurable diseases and limited life prognosis. To create a highly effective palliative care system in Ukraine, it is also necessary to overcome the barriers identified by WHO experts. The reduction of pain, physical and mental suffering, elimination or reduction of disorders of life and other severe manifestations of diseases, professional care, psychological, social and spiritual support for patients and their families should be considered as the main objectives of palliative and hospice care. ; Мета: провести аналіз організації паліативної та хоспісної допомоги на різних рівнях надання медичної допомоги населенню України на сучасному етапі реформування галузі охорони здоров'я в Україні та на регіональних рівнях. Матеріали і методи. У науковій роботі використано чинні нормативно-правові акти та керівні документи МОЗУкраїни щодо організації паліативної та хоспісної допомоги в системі охорони здоров'я України. Для обробки даних застосовано наукові методи: аналітичний, бібліосемантичний та системного підходу. Результати. Паліативна медична допомога, як окремий вид медичної допомоги, в Україні закріплена законодавчо з 2011 р. Але до введення в дію програми медичних гарантій та підписання контрактів із Національною службою здоров'я України на пакети медичних послуг у напрямку паліативної та хоспісної допомоги – таку допомогу в нашій країні надавали лише кілька десятків медичних закладів. Запровадження окремого пакета у програмі медичних гарантій дало поштовх розвитку мережі закладів, які надають паліативну допомогу. Висновки. Розвиток та покращення якості надання паліативної допомоги відповідно до світових стандартів є одним із пріоритетних завдань системи охорони здоров'я та громадського здоров'я України, адже паліативна та хоспісна допомога є комплексом медичних, соціальних, психологічних заходів, спрямованих на покращення якості життя пацієнтів із невиліковними хворобами та обмеженим прогнозом життя. Для створення високоефективної системи паліативної допомоги в Україні також необхідно подолати бар'єри, які виділені експертами ВООЗ. Серед основних завдань паліативної та хоспісної допомоги потрібно розглядати максимально можливе зменшення болю, фізичних та психічних страждань, усунення або зменшення розладів життєдіяльності та інших тяжких проявів захворювань, професійний догляд, психологічну, соціальну та духовну підтримку пацієнтів та членів їхніх сімей.