Hospice day care would have to be flexible in order to meet individual needs. It would offer security, warmth and tender loving care, providing an opportunity for patients to socialize and maintain their quality of life. Hopefully day care would provide earlier hospice admissions--extending the continuity of care. Recently the hospice day care standards developed in Michigan were published in the American Journal of Hospice Care. They were developed to provide guidelines for policies and procedures which would assure a quality program. The future of hospice day care depends on further development and implementation of these beginning standards.
{"title":"Why hospice day care?","authors":"S Seely","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hospice day care would have to be flexible in order to meet individual needs. It would offer security, warmth and tender loving care, providing an opportunity for patients to socialize and maintain their quality of life. Hopefully day care would provide earlier hospice admissions--extending the continuity of care. Recently the hospice day care standards developed in Michigan were published in the American Journal of Hospice Care. They were developed to provide guidelines for policies and procedures which would assure a quality program. The future of hospice day care depends on further development and implementation of these beginning standards.</p>","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"7 1","pages":"16-7"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13509687","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":"Lesbian hospice nurse: the visible presence.","authors":"T M Stephany","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"13-4"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748545","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 : 1989-09-01DOI: 10.1177/104990918900600505
D Lescohier
{"title":"The spiritual care nemesis.","authors":"D Lescohier","doi":"10.1177/104990918900600505","DOIUrl":"https://doi.org/10.1177/104990918900600505","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600505","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748555","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 : 1989-09-01DOI: 10.1177/104990918900600510
R A Antonovich
not be given, and stray widely from the central theme of my paper which was the issue of the need for artificial hydration when a person is rendered incapable of swallowing by sedation. I am not talking about 'a certain amount of physiological dehydration' in the dying process, but of gross, iatrogenic dehydration. As I pointed out if sedation is continued without hydration, death from dehydration will be inevitable, whatever the underlying pathology, within about seven days. Of course death from natural
{"title":"Dehydration and the terminally ill.","authors":"R A Antonovich","doi":"10.1177/104990918900600510","DOIUrl":"https://doi.org/10.1177/104990918900600510","url":null,"abstract":"not be given, and stray widely from the central theme of my paper which was the issue of the need for artificial hydration when a person is rendered incapable of swallowing by sedation. I am not talking about 'a certain amount of physiological dehydration' in the dying process, but of gross, iatrogenic dehydration. As I pointed out if sedation is continued without hydration, death from dehydration will be inevitable, whatever the underlying pathology, within about seven days. Of course death from natural","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"48"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600510","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748547","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 : 1989-09-01DOI: 10.1177/104990918900600502
T Burzynski
{"title":"Marketing hospice to the health care community.","authors":"T Burzynski","doi":"10.1177/104990918900600502","DOIUrl":"https://doi.org/10.1177/104990918900600502","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"19-20"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748548","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 : 1989-09-01DOI: 10.1177/104990918900600503
R E Enck
{"title":"Pressure sores.","authors":"R E Enck","doi":"10.1177/104990918900600503","DOIUrl":"https://doi.org/10.1177/104990918900600503","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"9-10"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748559","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 : 1989-09-01DOI: 10.1177/104990918900600513
A K Gordon
The origins of U.S. hospicephilosophyin the early1970’sgrewfrom a holistic, self-help,anti-physician,antitechnologybias; a reputationthatstill lingers in medical circles. This nonmedical,volunteerbeginningof many hospicesplacedthehospicemovement outsidethemainstreamhealthcaresystem, atfirst by the choiceof hospices, andlater by physiciansand hospitals withholding referrals.Medical costcontainmentefforts embeddedin Federalhealthpolicylegislationled to theenactmentof theMedicarehospice benefitand the expansionof hospice services.For thosewho struggledfor somanyyearsto aiddyingpersonsand advancehospicecare, the Medicare hospicebenefitsymbolizesthesuccess of their efforts. Thoughaspectsof the benefitmay be imperfectlyconceivedand implemented,it is abeginningandis infinitely preferableto no beginning.Access issuesare important becausethe benefit mustbe used by the greatest possiblenumberofeligiblepersonsfor hospicestosurvivefinancially, andit is importantforpatientsto beableto access their Medicare hospiceentitlement at a fmancially and personally stressfultime.Whenthebenefitis fully utilized,thecreativemedicalskills and humane,holisticcaringthataretheessenceof hospicewill hopefully impact theoverallcareofseriouslyandchronically ill patients,no matterwhat roles hospitalsandphysiciansmayplay.This hasalreadybegun. In choosing to focus on the physicianas a gatekeeper controlling accesstotheMedicarehospicebenefit, I recognizethat thereareotherimportantaccessissuesaswell: • regulatory disincentivesfor hospicesto becomeMedicare certified; • patientandfamily reluctanceto acknowledgea terminalprognosisdue to personalandcultural variables; • financial incentivesfor hospitals andhomehealthagencies to keep eligible patients in MedicarePartA aslongaspossible;and • lackofknowledgeabouthowto accesshospiceservicesin low income and minority communities. Accessandphysician lossof control
{"title":"The physician gatekeeper: access to the Medicare hospice benefit.","authors":"A K Gordon","doi":"10.1177/104990918900600513","DOIUrl":"https://doi.org/10.1177/104990918900600513","url":null,"abstract":"The origins of U.S. hospicephilosophyin the early1970’sgrewfrom a holistic, self-help,anti-physician,antitechnologybias; a reputationthatstill lingers in medical circles. This nonmedical,volunteerbeginningof many hospicesplacedthehospicemovement outsidethemainstreamhealthcaresystem, atfirst by the choiceof hospices, andlater by physiciansand hospitals withholding referrals.Medical costcontainmentefforts embeddedin Federalhealthpolicylegislationled to theenactmentof theMedicarehospice benefitand the expansionof hospice services.For thosewho struggledfor somanyyearsto aiddyingpersonsand advancehospicecare, the Medicare hospicebenefitsymbolizesthesuccess of their efforts. Thoughaspectsof the benefitmay be imperfectlyconceivedand implemented,it is abeginningandis infinitely preferableto no beginning.Access issuesare important becausethe benefit mustbe used by the greatest possiblenumberofeligiblepersonsfor hospicestosurvivefinancially, andit is importantforpatientsto beableto access their Medicare hospiceentitlement at a fmancially and personally stressfultime.Whenthebenefitis fully utilized,thecreativemedicalskills and humane,holisticcaringthataretheessenceof hospicewill hopefully impact theoverallcareofseriouslyandchronically ill patients,no matterwhat roles hospitalsandphysiciansmayplay.This hasalreadybegun. In choosing to focus on the physicianas a gatekeeper controlling accesstotheMedicarehospicebenefit, I recognizethat thereareotherimportantaccessissuesaswell: • regulatory disincentivesfor hospicesto becomeMedicare certified; • patientandfamily reluctanceto acknowledgea terminalprognosisdue to personalandcultural variables; • financial incentivesfor hospitals andhomehealthagencies to keep eligible patients in MedicarePartA aslongaspossible;and • lackofknowledgeabouthowto accesshospiceservicesin low income and minority communities. Accessandphysician lossof control","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"44-7"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600513","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13831640","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 : 1989-09-01DOI: 10.1177/104990918900600506
T S West
Traditionalhealthcare,asnow practicedin non-Westernationsandinourownnationbeforethe adventof modem,scientific medicine,placesemphasison treatingthewholeperson.Thetraditionalhealeris amemberof the community.Heis both doctorandpastorto thesickperson.Religiousritualsareanintegralpartof hiscare.Theyareusedtocleanse,heal, andreconcile. Thehealeris skilled atfinding waysto integratethefamily, the community,andotherrelationsinto hishealingefforts as a supportsystemfor the sickperson.Thehealerseesaspartof hisjob creatingaloving, caringenvironmentwhich allowsthe communityto sharein andfacilitate theprocessof healingin aholistic way. Modernmedicinehastendedto introduceapproachesto carewhicharenot in keepingwith traditionalvalues.Theincreasing specializationof modemmedicinehas shiftedthe focusaway from the wholeperson,hisfamily, andcommunity.It has createdanassemblyline approachto healthcaredelivery,wherethepossibilitiesfor referralto evermorespecializedspecialists seemtohaveno limit. Whereastraditionalcaretreatsthe wholepersonwithin hissocialenvironment,modemmedicinetends to treat him asanindividual,asjustanothercase,orevenasmerelyadisease. Hospicesarethe only organizedeffort seekingto integratethe benefitsof modernmedicinewith traditionalvalues.As we enterthe lastdecadeof theTwentiethCentury,the successandacceptanceof ahospiceconceptwhichintegratesspiritual care with modem,scientificmedicineis vital to the well-being,not onlyof theterminally ill, but all ill persons.Hospiceclinicians canteachpractitionersof modernscientific medicinehowto combinephysiologicalandreligious-moraldiagnosisto achieve holistic care. Butbeforehospicecanteachthis, it mustfirst demonstratecompetencein thisregard.Thereis a awide gulfandmanypitfalls betweenclaimingto provideholistic care,andactuallydoing it. Unlessexplicit efforts aremadeandresourcesareallocatedtoholistic, spiritualcare,hospicepractitionersrisksufferingthesamenemesisthathasafflictedmodemscientificmedicine. In this issue,Milton Hay makesabeginningwhenhewritesthat,‘Becauseterminalillnessmayprecipitateaspiritual crisis, all hospiceteamprofessionalsbearsomeresponsibilityfor maldngaspiritual assessment anddirectinginterventions.”We feel thathisview shouldbe statedmorecategorically:
{"title":"The management of dyspnea.","authors":"T S West","doi":"10.1177/104990918900600506","DOIUrl":"https://doi.org/10.1177/104990918900600506","url":null,"abstract":"Traditionalhealthcare,asnow practicedin non-Westernationsandinourownnationbeforethe adventof modem,scientific medicine,placesemphasison treatingthewholeperson.Thetraditionalhealeris amemberof the community.Heis both doctorandpastorto thesickperson.Religiousritualsareanintegralpartof hiscare.Theyareusedtocleanse,heal, andreconcile. Thehealeris skilled atfinding waysto integratethefamily, the community,andotherrelationsinto hishealingefforts as a supportsystemfor the sickperson.Thehealerseesaspartof hisjob creatingaloving, caringenvironmentwhich allowsthe communityto sharein andfacilitate theprocessof healingin aholistic way. Modernmedicinehastendedto introduceapproachesto carewhicharenot in keepingwith traditionalvalues.Theincreasing specializationof modemmedicinehas shiftedthe focusaway from the wholeperson,hisfamily, andcommunity.It has createdanassemblyline approachto healthcaredelivery,wherethepossibilitiesfor referralto evermorespecializedspecialists seemtohaveno limit. Whereastraditionalcaretreatsthe wholepersonwithin hissocialenvironment,modemmedicinetends to treat him asanindividual,asjustanothercase,orevenasmerelyadisease. Hospicesarethe only organizedeffort seekingto integratethe benefitsof modernmedicinewith traditionalvalues.As we enterthe lastdecadeof theTwentiethCentury,the successandacceptanceof ahospiceconceptwhichintegratesspiritual care with modem,scientificmedicineis vital to the well-being,not onlyof theterminally ill, but all ill persons.Hospiceclinicians canteachpractitionersof modernscientific medicinehowto combinephysiologicalandreligious-moraldiagnosisto achieve holistic care. Butbeforehospicecanteachthis, it mustfirst demonstratecompetencein thisregard.Thereis a awide gulfandmanypitfalls betweenclaimingto provideholistic care,andactuallydoing it. Unlessexplicit efforts aremadeandresourcesareallocatedtoholistic, spiritualcare,hospicepractitionersrisksufferingthesamenemesisthathasafflictedmodemscientificmedicine. In this issue,Milton Hay makesabeginningwhenhewritesthat,‘Becauseterminalillnessmayprecipitateaspiritual crisis, all hospiceteamprofessionalsbearsomeresponsibilityfor maldngaspiritual assessment anddirectinginterventions.”We feel thathisview shouldbe statedmorecategorically:","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748552","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 : 1989-09-01DOI: 10.1177/104990918900600518
R W Williams
{"title":"Another look at hospice in America.","authors":"R W Williams","doi":"10.1177/104990918900600518","DOIUrl":"https://doi.org/10.1177/104990918900600518","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"15-6"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600518","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13831638","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 : 1989-09-01DOI: 10.1177/104990918900600514
M W Hay
Fivebasicprinciplesshouldbeconsideredwhen creatinga spiritual assessment tool to beusedby amultidisciplinaryhospiceteam.Beforediscussing them,however,it is importantto addressthe relationshipbetween spiritual issuesand religious/nonreligious beliefs. The assessment processgetsbadlymuddledwhenthis relationshipis not clear. Somehospiceteammembershave been known to function as though spiritualandreligiousrealitiesweresynonymous.Accordingly, somenonreligiousmembersincludethe concept of a spiritualdimensionto life in their rejectionof religion. Otherswho are religiousrejectthe possibilityof non-
{"title":"Principles in building spiritual assessment tools.","authors":"M W Hay","doi":"10.1177/104990918900600514","DOIUrl":"https://doi.org/10.1177/104990918900600514","url":null,"abstract":"Fivebasicprinciplesshouldbeconsideredwhen creatinga spiritual assessment tool to beusedby amultidisciplinaryhospiceteam.Beforediscussing them,however,it is importantto addressthe relationshipbetween spiritual issuesand religious/nonreligious beliefs. The assessment processgetsbadlymuddledwhenthis relationshipis not clear. Somehospiceteammembershave been known to function as though spiritualandreligiousrealitiesweresynonymous.Accordingly, somenonreligiousmembersincludethe concept of a spiritualdimensionto life in their rejectionof religion. Otherswho are religiousrejectthe possibilityof non-","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"25-31"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600514","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748542","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}
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