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Hospice care is designed to help individuals with pain, physical and psychological, that arises during the advanced stage of a disease so that the patient can face their impending death with dignity. Through the hospice lens, the patient is viewed as an entity that needs both medical and non-medical care, which differentiates hospices from other forms of care available. However, despite hospice care having been integrated into the medical sphere and its widespread availability to patients, it has begun to be met with social reluctance and fear. This article is a review of theories, concepts, and research in the context of the social construct of cancer, palliative treatment, and hospice care. The texts analyzed in this article have been selected to show both the time-changing approach to the issues discussed, as well as the indication of threads that are characteristic of the USA and Europe, including Poland. The aim of the article is to reflect on the social stigmatization of hospice care, changes in the identity of patients, especially the transition from oncological treatment to palliative and hospice care, and thus draw attention to the patient experience before the impending death.

As the Korean government's recognition of the importance of hospice service grows, the government has initiated a variety of hospice services in Korea. Each hospice organization has shown a significant difference in its health care delivery methods, constitution and care content. Developing a clinical protocol is essential for establishing standardized hospice services. A preliminary protocol was drawn up by examining the records of terminal patients (n=541) in a home hospice organization while elucidating the health problems as well as classifying them through the Home Health Care Classification (HHCC), and by reviewing the relevant nursing interventions and medical treatments in the literature concerning the clinical protocols. Korea's leading hospice specialty groups participated in four rounds of content validity verification processes in order to establish a protocol. A guideline was developed through a team approach, integrating the opinions of doctors, nurses, ministers, volunteers, patients' families, nutritionists and pharmacists. Eighteen health problems and a total of 223 interventions (173 major treatments and nursing interventions, and 50 optional interventions) were included in the final clinical protocol. This study is expected to contribute to the overall qualitative improvement of home hospice care and the subsequent shortening of documentation time. Evaluation tools and a regulatory feedback system need to be developed in order to maintain consistent evaluation procedures based on the continuous promotion and use of the protocol. ; open

Medicare guidelines are used to determine eligibility for hospice care (strength of recommendation [SOR]: C, based on expert opinion), but they correlate with 6-month mortality no better than an experienced clinician's judgment (SOR: B, based on 1 cohort study). Recent studies, however, have identified additional criteria that may better predict survival in select populations.

Workplace violence in the home health industry is a growing concern, but little is known about the content of existing workplace violence prevention programs. The authors present the methods for this study that examined workplace violence prevention programs in a sample of 40 California home health and hospice agencies. Data was collected through surveys that were completed by the branch managers of participating facilities. Programs were scored in six different areas, including general workplace violence prevention components; management commitment and employee involvement; worksite analysis; hazard prevention and control; safety and health training; and recordkeeping and program evaluation. The results and discussion sections consider these six areas and the important gaps that were found in existing programs. For example, although most agencies offered workplace violence training, not every worker performing patient care was required to receive the training. Similarly, not all programs were written or reviewed and updated regularly. Few program differences were observed between agency characteristics, but nonetheless several striking gaps were found.

Purpose The life expectancy in the United States is longer than ever before. However, as the Baby Boom generation ages and people die increasingly slow deaths from chronic conditions, there will be a growing need for partnerships and programs to ensure end of life patients get the care they need in the setting that they want. One partnership in particular that has a growing following is that between hospice agencies and the Emergency Medical Services. This paper will examine potential policies at the Federal, State, and systemic levels that hinder or prevent EMS agencies from participating in hospice services. Methods A review of literature was conducted. Academic literature from after 1974 – the date of the first American hospice agency – and grey literature from after 2007 were considered. SCOPUS, CINAHL, and the Himmelfarb Library database were queried with various combinations of MeSH terms. Those results were then screened by date and content for relevance. A variety of government agencies and relevant NGOs were also searched for applicable content. Results Significant barriers to EMS involvement in hospice services exist at the Federal and State levels. At the Federal level, there is a major problem with reimbursement for both EMS and Hospice services with regards to this type of care. The Drug Enforcement Administration also has policy barriers written into the Controlled Substances Act, but there is legislation waiting for the President's signature that may reverse these barriers. Additional barriers exist on a state by state basis, but these were more difficult to determine, and searching for each independently proved challenging. Conclusion Significant barriers to EMS involvement in Hospice care exist at Federal and State levels. Because some states allow for EMS agencies to provide home health services without transport, and because the major barriers to the federal controlled substance issue is expected to resolve soon, there is an opportunity for further research into EMS / hospice collaboration ...

AbstractSince the hospice benefit was introduced into the Medicare program, utilization has increased steeply. Previous research suggested that the use of hospice care is growing most rapidly in nursing facilities; however, little was known about the characteristics of the Medicare beneficiaries who receive hospice care in nursing facilities or the hospices that provide care in this setting. A synthesis of research from the U.S. Department of Health and Human Services, Office of Inspector General (OIG) examined Medicare hospice care provided in nursing facilities. Findings are based on analysis of Medicare hospice claims data and medical record reviews. OIG findings suggest that some hospices may be seeking out beneficiaries with particular characteristics, including those with conditions associated with longer but less complex care. Such beneficiaries are often found in nursing facilities. By serving these beneficiaries for longer periods, the hospices receive more Medicare payments per beneficiary, which can contribute to higher profits. The OIG's recommendations for reform include modifying the payment system for hospice care in nursing facilities and targeting monitoring efforts on certain hospices.