{"title":"A milestone for hospices in the United States.","authors":"T S West","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"7 1","pages":"19-21"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13509689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-01-01DOI: 10.1177/104990919000700106
D Lescohier, S Silver
{"title":"A rationale for improving hospice reimbursement.","authors":"D Lescohier, S Silver","doi":"10.1177/104990919000700106","DOIUrl":"https://doi.org/10.1177/104990919000700106","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"7 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990919000700106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13509694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-01-01DOI: 10.1177/104990919000700116
B Thompson
Hospice day care is a cost-effective way to expand the range of services available to hospice patients and families. Additionally, day care can increase continuity of care between inpatient and homecare settings, and ease the burden of responsibility on the homecare component of hospice.
{"title":"Hospice day care.","authors":"B Thompson","doi":"10.1177/104990919000700116","DOIUrl":"https://doi.org/10.1177/104990919000700116","url":null,"abstract":"<p><p>Hospice day care is a cost-effective way to expand the range of services available to hospice patients and families. Additionally, day care can increase continuity of care between inpatient and homecare settings, and ease the burden of responsibility on the homecare component of hospice.</p>","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"7 1","pages":"28-30"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990919000700116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13509690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-01-01DOI: 10.1177/104990919000700107
W C Farr
Introduction The adrenocorticosteroids, (steroids), are importantchemicalcompoundsthat appearto have several beneficialeffectson symptomsof patientswith tenninaldisease.Although steroids have beenused widely for symptommanagement, theyare used very little outsidethe hospicesetting! There is an abundant,although anecdotal,literaturethatdescribesthe virtues of steroidsfor symptommanagement.The limited useof these agentsby non-hospicephysiciansis probablypartially dueto a paucityof well controlled clinical trials, plus muchoftheexistingliteratureis outof the main-streamof physicianreadership. Steroids,in addition to having specifictherapeuticanti-inflammatory effects,bothin cancerandnon-cancer situations,havea number of rather nonspecificeffectsfor whichtheyare usedin the treatmentof thetenninally ill. Theanti-inflammatoryeffectseems usefultoreducetheedemazonearound malignant accumulation.There are alsononspecificeffectsthatarehelpful for a wholehostof disturbingsymptoms causedby the primarydisease. (SeeTableI.) The purposeof this paper is to reviewourexperiencewith theuseof corticosteroidsin patientswith terminal disease, duringafive yearperiod at St. Mary’s Hospice in Tucson. In addition, this paperwill discussthe shortcomingsof theliteratureandsuggesta rationalapproachto the useof theseimportantagentsas we wait for moreandbetterresearchdata.
{"title":"The use of corticosteroids for symptom management in terminally ill patients.","authors":"W C Farr","doi":"10.1177/104990919000700107","DOIUrl":"https://doi.org/10.1177/104990919000700107","url":null,"abstract":"Introduction The adrenocorticosteroids, (steroids), are importantchemicalcompoundsthat appearto have several beneficialeffectson symptomsof patientswith tenninaldisease.Although steroids have beenused widely for symptommanagement, theyare used very little outsidethe hospicesetting! There is an abundant,although anecdotal,literaturethatdescribesthe virtues of steroidsfor symptommanagement.The limited useof these agentsby non-hospicephysiciansis probablypartially dueto a paucityof well controlled clinical trials, plus muchoftheexistingliteratureis outof the main-streamof physicianreadership. Steroids,in addition to having specifictherapeuticanti-inflammatory effects,bothin cancerandnon-cancer situations,havea number of rather nonspecificeffectsfor whichtheyare usedin the treatmentof thetenninally ill. Theanti-inflammatoryeffectseems usefultoreducetheedemazonearound malignant accumulation.There are alsononspecificeffectsthatarehelpful for a wholehostof disturbingsymptoms causedby the primarydisease. (SeeTableI.) The purposeof this paper is to reviewourexperiencewith theuseof corticosteroidsin patientswith terminal disease, duringafive yearperiod at St. Mary’s Hospice in Tucson. In addition, this paperwill discussthe shortcomingsof theliteratureandsuggesta rationalapproachto the useof theseimportantagentsas we wait for moreandbetterresearchdata.","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"7 1","pages":"41-6"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990919000700107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13509692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-01-01DOI: 10.1177/104990919000700108
K Herth
Humorasatherapeuticintervention has receivedincreasingattentionin recentyears.Folk wisdomhasforages heldthathumorhelpsus to bearlife’s burdens.1But, whenlife is nearingits end, doeshumorhavea role?Do the terminally ill perceivehumorasanappropriateandeffectivestrategyin light of the magnitudeof emotional and physical pain and loss? Doeshumor belonginhospicecare?Tobegintofind answersto thosequestionsthe author conducteda smallpilot studythatinvolved interviewing 14 tenninally ill adults regardingtheir perceptionsof andexperienceswith humor.Thepurposewas to clarify the conceptof humorandits contributionsduringterminal illness from the perspectiveof thosewho areterminally ill, sothatthe potentialroleof humorinhospicecare canbedelineated. Thefindingsareimportanttonursingbecausenursesarein a strategicposition to assistthe terminally ill and presentlyassumea majorrole inprovidinghospicecare.
{"title":"Contributions of humor as perceived by the terminally ill.","authors":"K Herth","doi":"10.1177/104990919000700108","DOIUrl":"https://doi.org/10.1177/104990919000700108","url":null,"abstract":"Humorasatherapeuticintervention has receivedincreasingattentionin recentyears.Folk wisdomhasforages heldthathumorhelpsus to bearlife’s burdens.1But, whenlife is nearingits end, doeshumorhavea role?Do the terminally ill perceivehumorasanappropriateandeffectivestrategyin light of the magnitudeof emotional and physical pain and loss? Doeshumor belonginhospicecare?Tobegintofind answersto thosequestionsthe author conducteda smallpilot studythatinvolved interviewing 14 tenninally ill adults regardingtheir perceptionsof andexperienceswith humor.Thepurposewas to clarify the conceptof humorandits contributionsduringterminal illness from the perspectiveof thosewho areterminally ill, sothatthe potentialroleof humorinhospicecare canbedelineated. Thefindingsareimportanttonursingbecausenursesarein a strategicposition to assistthe terminally ill and presentlyassumea majorrole inprovidinghospicecare.","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"7 1","pages":"36-40"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990919000700108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13509693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In summary, it would seem that the term terminally ill is used to convey an impression that has been formed by the carers, based on actuarial data for the particular disease from which the patient is suffering, their clinical experience dealing with others similarly affected, and a set of traditionally held beliefs. The consequences of describing someone as terminally ill are legion, affecting all aspects of care and involving the belief systems both rational and primitive of carers and patient alike. As long as we understand that it is an opinion, rather than a statement of fact, then the term terminally ill can serve an important function in communicating information in a readily understood form.
{"title":"On being terminally ill.","authors":"J Pardoe, R Pugsley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In summary, it would seem that the term terminally ill is used to convey an impression that has been formed by the carers, based on actuarial data for the particular disease from which the patient is suffering, their clinical experience dealing with others similarly affected, and a set of traditionally held beliefs. The consequences of describing someone as terminally ill are legion, affecting all aspects of care and involving the belief systems both rational and primitive of carers and patient alike. As long as we understand that it is an opinion, rather than a statement of fact, then the term terminally ill can serve an important function in communicating information in a readily understood form.</p>","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"7 1","pages":"14-5"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13509686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-01-01DOI: 10.1177/104990919000700109
C F Knight
Volunteershavebeen an essential component of U.S. hospicessince the foundingof the first hospicein this countryin 1974.The rapid growthof hospiceshas led to an increasein the numberof hospicevolunteersserving terminally ill patientsand their families.In aneffortto meetthe emotional, spiritual,andphysicalneedsof patientswith an increasinglybroad spectrumof terminalillnesses, hospice programshavebegunrecruitingvolunteersfrom non-traditionalgroups. Volunteershavetypicallybeenmarried women who werenot employed outsidethehome,butthishaschanged. Currently, two thirds of the nation’s volunteersare women betweenthe agesof 25-44yearswhoareemployed outsidethe home, with working men andwomenbecomingthemostrapidly growing portionof thosewho volunteer.1 The rapidgrowth in thenumberof personswith AIDS (PWAs) who are terminally ill has led to increased demandson both formal andinformal supportsystemsto provideemotional, spiritual, and physicalassistance.2 With the helpof organizationswithin thegay community,hospiceprograms havebegunrecruitingandtraininggay volunteerstocareforPWAs.3Although little isknownaboutthe relativecosts and benefitsof matching volunteers with terminallyill patientsaccordingto commoncharacteristics,4thegaycommunityhasproventobegenerousin its caringfor PWAs.5 This article will describespecial aspectsof avolunteertrainingprogram developedjointly by St. Anthony’s HospiceandLife EnrichmentProgram and the Metropolitan Community Church. Membersof this church, whose ministry is to the gay/lesbian community,were trainedto work as hospicevolunteerswith PWAs. Networking
{"title":"Networking with the gay community to meet the needs of AIDS patients: special considerations for volunteer training.","authors":"C F Knight","doi":"10.1177/104990919000700109","DOIUrl":"https://doi.org/10.1177/104990919000700109","url":null,"abstract":"Volunteershavebeen an essential component of U.S. hospicessince the foundingof the first hospicein this countryin 1974.The rapid growthof hospiceshas led to an increasein the numberof hospicevolunteersserving terminally ill patientsand their families.In aneffortto meetthe emotional, spiritual,andphysicalneedsof patientswith an increasinglybroad spectrumof terminalillnesses, hospice programshavebegunrecruitingvolunteersfrom non-traditionalgroups. Volunteershavetypicallybeenmarried women who werenot employed outsidethehome,butthishaschanged. Currently, two thirds of the nation’s volunteersare women betweenthe agesof 25-44yearswhoareemployed outsidethe home, with working men andwomenbecomingthemostrapidly growing portionof thosewho volunteer.1 The rapidgrowth in thenumberof personswith AIDS (PWAs) who are terminally ill has led to increased demandson both formal andinformal supportsystemsto provideemotional, spiritual, and physicalassistance.2 With the helpof organizationswithin thegay community,hospiceprograms havebegunrecruitingandtraininggay volunteerstocareforPWAs.3Although little isknownaboutthe relativecosts and benefitsof matching volunteers with terminallyill patientsaccordingto commoncharacteristics,4thegaycommunityhasproventobegenerousin its caringfor PWAs.5 This article will describespecial aspectsof avolunteertrainingprogram developedjointly by St. Anthony’s HospiceandLife EnrichmentProgram and the Metropolitan Community Church. Membersof this church, whose ministry is to the gay/lesbian community,were trainedto work as hospicevolunteerswith PWAs. Networking","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"7 1","pages":"31-5"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990919000700109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13509691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-01-01DOI: 10.1177/104990919000700105
R E Enck
Although the vast majority of patientsadmittedtohospiceshavecancer, some4 to 5 percentsuffer from otherterminaldiseases, the mostnotable of which are neuromuscularin nature.Without a doubt,patientswith this groupof illnessescanbeverydifficult for thehospiceteamto carefor sincethey can havea wide constellation of terminal symptoms.Furthermore, thesepatientsoften live longer than cancerpatients,thus, further taxingnot only thefamily but alsothe hospiceteamaswell. This reviewwill focus on the most commonform of theseneuromusculardisordersencounteredin hospicepractice,namely amyotrophiclateralsclerosis(ALS) or Lou Gehrig’sdisease. Motor neurondisease(MND) is a heterogeneous groupof disorderswith varyingsignsandsymptoms, all affecting in somemannerthe anteriorhorn cells. The most common subsetof MND in adults is ALS which affects notonlytheanteriorhorncellsbutalso the corticospinaltracts.Theneteffect of theALS lesionis to causeprogressive wasting and weaknessof those muscleswhich havelost their nerve supplyinadditionto corticospinal tract signsof spasticityandpathologicreflexes in the absenceof sensoryfindings. In mostcasesof ALS, intellectual function remainsintact. Variants of classicalALS includespinalmuscular atrophy,progressivebulbarpalsy,primarylateralsclerosisandbenignfocal amyotrophy.Spinal muscularatrophy presentsa clinical picture of limb weaknessandwastingwithvaryingdegreesof cranialnerveinvolvement.Progressivebulbar palsy is dominatedby weaknessandatrophyof cranialnerves ofthelowermotorneurontype,whereas, primarylateralsclerosisismanifestedby uppermotorneuronsignsalone.Finally, benign focal amyotrophyis a clinical syndromein whichthe signsof muscle weaknessandatrophymaybeginin a singlelimb but notprogress. Theworldwideincidenceof ALS is 0.4to 1.8per100,000population.1The incidenceof familial ALS is approximately5 to 10percentof all ALS with the modeof inheritanceunclear. Of interest, thereis an unexpectedly high incidenceof ALS inGuamwhich hasbeenextensivelystudied.Themale to femaleratio is 1.0to 1.6with theage of onsetbetween50 and60 years.
{"title":"Amyotrophic lateral sclerosis and hospice care.","authors":"R E Enck","doi":"10.1177/104990919000700105","DOIUrl":"https://doi.org/10.1177/104990919000700105","url":null,"abstract":"Although the vast majority of patientsadmittedtohospiceshavecancer, some4 to 5 percentsuffer from otherterminaldiseases, the mostnotable of which are neuromuscularin nature.Without a doubt,patientswith this groupof illnessescanbeverydifficult for thehospiceteamto carefor sincethey can havea wide constellation of terminal symptoms.Furthermore, thesepatientsoften live longer than cancerpatients,thus, further taxingnot only thefamily but alsothe hospiceteamaswell. This reviewwill focus on the most commonform of theseneuromusculardisordersencounteredin hospicepractice,namely amyotrophiclateralsclerosis(ALS) or Lou Gehrig’sdisease. Motor neurondisease(MND) is a heterogeneous groupof disorderswith varyingsignsandsymptoms, all affecting in somemannerthe anteriorhorn cells. The most common subsetof MND in adults is ALS which affects notonlytheanteriorhorncellsbutalso the corticospinaltracts.Theneteffect of theALS lesionis to causeprogressive wasting and weaknessof those muscleswhich havelost their nerve supplyinadditionto corticospinal tract signsof spasticityandpathologicreflexes in the absenceof sensoryfindings. In mostcasesof ALS, intellectual function remainsintact. Variants of classicalALS includespinalmuscular atrophy,progressivebulbarpalsy,primarylateralsclerosisandbenignfocal amyotrophy.Spinal muscularatrophy presentsa clinical picture of limb weaknessandwastingwithvaryingdegreesof cranialnerveinvolvement.Progressivebulbar palsy is dominatedby weaknessandatrophyof cranialnerves ofthelowermotorneurontype,whereas, primarylateralsclerosisismanifestedby uppermotorneuronsignsalone.Finally, benign focal amyotrophyis a clinical syndromein whichthe signsof muscle weaknessandatrophymaybeginin a singlelimb but notprogress. Theworldwideincidenceof ALS is 0.4to 1.8per100,000population.1The incidenceof familial ALS is approximately5 to 10percentof all ALS with the modeof inheritanceunclear. Of interest, thereis an unexpectedly high incidenceof ALS inGuamwhich hasbeenextensivelystudied.Themale to femaleratio is 1.0to 1.6with theage of onsetbetween50 and60 years.","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"7 1","pages":"9-11"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990919000700105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13509695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The role of chemotherapy in the hospice patient.","authors":"B Kinzbrunner","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"7 1","pages":"8, 11"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13549690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：