Pub Date : 1989-09-01DOI: 10.1177/104990918900600519
M A Smith
As hospicebecomesa part of the mainstreamhealth care system,patientsandfamilies facing terminalillnesswho are choosinga healthcare provider needinformation about the specificservicesandtheuniqueaspects of hospice.Butdo potentialclientsand theirfamilieshaveaccesstocritical informationregardinghospiceservices? A surveyof patientorientedliterature providedby hospiceagencieswas undertakento determineto what extent essentialelementsof hospicephilosophywereincludedin consumeroriented publicationsdistributed by hospicesin aMidwesternstate. As a result of current healthcare economicsandchangingconsumer attitudes, the Americanpublic is demandingmore informationregarding health care servicesand resources. Shorterhospitalstayshaveresultedin increasednumbersof personsdischargedneedingsome form of posthospitalcare. Since Medicareand manyprivate insurersnow reimbursefor hospicetype care, rapid growth in agencies providing this service can be anticipated. The needfor carefulclient selectionand costcontainmentcould becomean all too important factor.1 There is a concernamonghospice professionalsthat this might result in lower standardsof careandlossof individual services.z3~4 Somefear thatjf third-party reimbursement results in care given by for-profit groups,the holisticphilosophyessential to hospice mightbelost. Assuming,then, that the spirit of hospicemight be jeopardizedas the movementis absorbedinto the more traditional healthcaresystem,it is important that hospicesbecomeproficient in communicatingconcepts centralto thehospicephilosophytothe public andpotentialclients.
{"title":"What patients are told about hospice: a survey of hospice information pamphlets.","authors":"M A Smith","doi":"10.1177/104990918900600519","DOIUrl":"https://doi.org/10.1177/104990918900600519","url":null,"abstract":"As hospicebecomesa part of the mainstreamhealth care system,patientsandfamilies facing terminalillnesswho are choosinga healthcare provider needinformation about the specificservicesandtheuniqueaspects of hospice.Butdo potentialclientsand theirfamilieshaveaccesstocritical informationregardinghospiceservices? A surveyof patientorientedliterature providedby hospiceagencieswas undertakento determineto what extent essentialelementsof hospicephilosophywereincludedin consumeroriented publicationsdistributed by hospicesin aMidwesternstate. As a result of current healthcare economicsandchangingconsumer attitudes, the Americanpublic is demandingmore informationregarding health care servicesand resources. Shorterhospitalstayshaveresultedin increasednumbersof personsdischargedneedingsome form of posthospitalcare. Since Medicareand manyprivate insurersnow reimbursefor hospicetype care, rapid growth in agencies providing this service can be anticipated. The needfor carefulclient selectionand costcontainmentcould becomean all too important factor.1 There is a concernamonghospice professionalsthat this might result in lower standardsof careandlossof individual services.z3~4 Somefear thatjf third-party reimbursement results in care given by for-profit groups,the holisticphilosophyessential to hospice mightbelost. Assuming,then, that the spirit of hospicemight be jeopardizedas the movementis absorbedinto the more traditional healthcaresystem,it is important that hospicesbecomeproficient in communicatingconcepts centralto thehospicephilosophytothe public andpotentialclients.","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"34-7"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600519","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748543","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: 10.1177/104990918900600504
S H Critz
The purpose of this study is to describe the attitudes and experiences of family members with respect to death determination practices for the terminally ill clients of home care agencies. A sample of family 53 members in Southeast Michigan returned survey questionnaires. The findings indicate that police and emergency medical technicians most frequently respond to the call when a person with a terminal illness has died. Fifty percent of the family members reported feeling sad, 35 percent reported feeling relieved and 18 percent of the respondents felt angry about the arrival of municipal personnel. Feelings of anger were significantly associated with the absence of a nurse at the time of death, the use of lights and sirens, disrespectful personnel and the arrival of multiple personnel. Feelings of anger were also significantly associated with continuing thoughts of the day of death by family members. Results suggest the need to rethink state and local laws in regard to death determination and to educate those most likely to respond to families sensitively. Home care agencies and hospices should also encourage attendance by nurses at the time of death.
{"title":"The attitudes and experiences of families with death determination in the home.","authors":"S H Critz","doi":"10.1177/104990918900600504","DOIUrl":"https://doi.org/10.1177/104990918900600504","url":null,"abstract":"<p><p>The purpose of this study is to describe the attitudes and experiences of family members with respect to death determination practices for the terminally ill clients of home care agencies. A sample of family 53 members in Southeast Michigan returned survey questionnaires. The findings indicate that police and emergency medical technicians most frequently respond to the call when a person with a terminal illness has died. Fifty percent of the family members reported feeling sad, 35 percent reported feeling relieved and 18 percent of the respondents felt angry about the arrival of municipal personnel. Feelings of anger were significantly associated with the absence of a nurse at the time of death, the use of lights and sirens, disrespectful personnel and the arrival of multiple personnel. Feelings of anger were also significantly associated with continuing thoughts of the day of death by family members. Results suggest the need to rethink state and local laws in regard to death determination and to educate those most likely to respond to families sensitively. Home care agencies and hospices should also encourage attendance by nurses at the time of death.</p>","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"38-43"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600504","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748544","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: 10.1177/104990918900600520
D Wesley
It’s eight o’clock Thursdaynight whenregisterednurse,Stella Dodge’s telephonerings announcinganother probablecrisis for oneof herterminally ill, homecarepatients. And in fact it’s a patient’sson, who havingnoted his father’sseverediscomfort,placed thecall tothehospiceon-callnursefor help. Quickly referencinga detailed patientstatusreport shekeepsby her phone,Stella reviews the patient’s standingandPRN medicationorders andsuggests everalalternativesto alleviate the patients discomfort, and continuestoreassuretheyoungmanas he executesher suggestions.After severalminutesthe problem subsides to the youngman’s relief. But before hangingup, he expresseshis appreciation at the promptassistancethat she has provided to his father. Stella, pleasedwith the outcomeof the call hangsup her cellulartelephone,turns hercartdowntheproduceisleandcontinuesherweeklygroceryshopping. No, it’s not sciencefiction, it’s reality and it’s a part of how the Hospice of SouthwestMissouri in Springfield,Missouri is respondingto its patient’s critical needsutilizing state-of-the-art cellulartelephonetechnology to improveresponsetimeduring afterhoursoperation.Theon-call, or after hoursnurse,carriesa battery powered,cellulartelephoneaboutthe sizeof alunchboxandcanbereached immediatelybypatients,caregiversor physicians.Of coursethis means hospicecallersareno longerforcedto be processedthrough the frustrating mazeof telephonerecorders,answering services or pagercodestypical when calling home care or clinical agenciesafterhours. Stella Dodge hasbeenone of the principalsinvolved in this innovative new cellular responseserviceandhas seenfirsthandthedramaticdifference thisrecentchangeinservicehashadon her patientsin comparisonto the previoustraditional method. “They (the callers) seemvery surprisedwhen I answerthe phoneand identify myselfas the hospicenurse,” saidStellarelatingsomeof hercaller’s reactionsto the innovativeprogram. ‘It’s like they really can’t believe it’s not ananswering service or machine or something.And whentheyfindout it really isalive nurse, rightthereandready to help, they’re appreciativeandseem very relieved.” When asked abouttheinconvenienceof carryingthe cellular telephone aroundor aboutgetting calls in public placeslike the grocery store, Stella’s face getsalittle red as sheanswers. ‘Well, at first I wasalittle selfconscious about carrysystem. ing it or talkingon it out in public. But then,aftera couple of peopleaskedme aboutit andI told themwhoI wasandwhatI wasdoing, theyseemedimpressedthat I andmy organizationwere that concerned aboutourpatients’care, which made mefeelprettygood.Besides,”shecontinuedwitha veryseriouslook, “when a nursehasto go out in the middleof the night to take careof a patient,it’s GREAT having a telephonewith you just incasethereareanyproblems.” When questionedabout the introduction of the high-techconceptMr. RickWilliams,theChiefExecutiveOfficer of HospiceSouthwestand a former hospital administratorand entrepreneurtold me, “The financia
{"title":"High-tech hospice.","authors":"D Wesley","doi":"10.1177/104990918900600520","DOIUrl":"https://doi.org/10.1177/104990918900600520","url":null,"abstract":"It’s eight o’clock Thursdaynight whenregisterednurse,Stella Dodge’s telephonerings announcinganother probablecrisis for oneof herterminally ill, homecarepatients. And in fact it’s a patient’sson, who havingnoted his father’sseverediscomfort,placed thecall tothehospiceon-callnursefor help. Quickly referencinga detailed patientstatusreport shekeepsby her phone,Stella reviews the patient’s standingandPRN medicationorders andsuggests everalalternativesto alleviate the patients discomfort, and continuestoreassuretheyoungmanas he executesher suggestions.After severalminutesthe problem subsides to the youngman’s relief. But before hangingup, he expresseshis appreciation at the promptassistancethat she has provided to his father. Stella, pleasedwith the outcomeof the call hangsup her cellulartelephone,turns hercartdowntheproduceisleandcontinuesherweeklygroceryshopping. No, it’s not sciencefiction, it’s reality and it’s a part of how the Hospice of SouthwestMissouri in Springfield,Missouri is respondingto its patient’s critical needsutilizing state-of-the-art cellulartelephonetechnology to improveresponsetimeduring afterhoursoperation.Theon-call, or after hoursnurse,carriesa battery powered,cellulartelephoneaboutthe sizeof alunchboxandcanbereached immediatelybypatients,caregiversor physicians.Of coursethis means hospicecallersareno longerforcedto be processedthrough the frustrating mazeof telephonerecorders,answering services or pagercodestypical when calling home care or clinical agenciesafterhours. Stella Dodge hasbeenone of the principalsinvolved in this innovative new cellular responseserviceandhas seenfirsthandthedramaticdifference thisrecentchangeinservicehashadon her patientsin comparisonto the previoustraditional method. “They (the callers) seemvery surprisedwhen I answerthe phoneand identify myselfas the hospicenurse,” saidStellarelatingsomeof hercaller’s reactionsto the innovativeprogram. ‘It’s like they really can’t believe it’s not ananswering service or machine or something.And whentheyfindout it really isalive nurse, rightthereandready to help, they’re appreciativeandseem very relieved.” When asked abouttheinconvenienceof carryingthe cellular telephone aroundor aboutgetting calls in public placeslike the grocery store, Stella’s face getsalittle red as sheanswers. ‘Well, at first I wasalittle selfconscious about carrysystem. ing it or talkingon it out in public. But then,aftera couple of peopleaskedme aboutit andI told themwhoI wasandwhatI wasdoing, theyseemedimpressedthat I andmy organizationwere that concerned aboutourpatients’care, which made mefeelprettygood.Besides,”shecontinuedwitha veryseriouslook, “when a nursehasto go out in the middleof the night to take careof a patient,it’s GREAT having a telephonewith you just incasethereareanyproblems.” When questionedabout the introduction of the high-techconceptMr. RickWilliams,theChiefExecutiveOfficer of HospiceSouthwestand a former hospital administratorand entrepreneurtold me, “The financia","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"17-8"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600520","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748550","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: 10.1177/104990918900600512
N Clark
{"title":"Illinois State Hospice Organization goal.","authors":"N Clark","doi":"10.1177/104990918900600512","DOIUrl":"https://doi.org/10.1177/104990918900600512","url":null,"abstract":"","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/10.1177/104990918900600512","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748553","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: 10.1177/104990918900600509
W E Flannery
{"title":"Hospice education for the attending physician.","authors":"W E Flannery","doi":"10.1177/104990918900600509","DOIUrl":"https://doi.org/10.1177/104990918900600509","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 5","pages":"8, 47-8"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13625889","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 : 1989-07-01DOI: 10.1177/104990918900600403
R E Enck
{"title":"The management of dyspnea.","authors":"R E Enck","doi":"10.1177/104990918900600403","DOIUrl":"https://doi.org/10.1177/104990918900600403","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 4","pages":"11-2"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748534","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 : 1989-07-01DOI: 10.1177/104990918900600418
F S Wald
All aroundtheworldtodayweface, for better and worse, disruption and changein both religious and secular values.Andthiswastruein1963,when we,beginnersof hospices, reachedout to one anotherto find new ways of caringfor theterminally ill. For me it beganwith DameCicely Saunders’ first visit to Yale University in New Haven,Connecticutin 1963. Her lecture on palliative care with photographsof tenninally ill cancer patientsbroughtthe audienceof many disciplinesat Yale’s medicalcenterto its feet. Seeingher patientsandtheir familiesbeforeandaftersymptomcontrol openeda doorfor uswherethere hadbeenawall. Theastonishment and relief I felt was alsoon the facesof medicalstudents,nurses,doctors,social workersandchaplains. For too long all of us had been numbedand hopelessby the sightof patientsdying,not onlylosingstrength butsufferingunbearably.Weeitherdid nothing or continuedwith intensive treatmentto the end. She gaveus a senseof possibilityandaway togo. I havehadanunshakableurgein the pastsix yearsto encouragehealthcare professionalsand clergy of various sects and denominationsinvolved in careof thosefacing deathto developa dialoguewith one another,and hear eachother’s views on spiritual support.1The ideacameto me from conferencesheld at NaropaInstitute by TibetanBuddhists,in whichexchange betweenEastern and Western theologiansled to appreciationof one another’sphilosophiesandrecognition of commonthemes. As the interdisciplinary natureof hospicecare madeit imperative for doctors,nurses,clergy, psychiatrists, social workers, administrators,dieticiansandartdirectorstoworktogether as a team,differencesin ideasand/or actioncalledfor awillingnesstostruggle togetherand so resolvethesedifferenceswithin an institution and in colleagialforumsonthe outside. In the United States the spiritual facetof the individual is complexand has many sides. Our religions are diverse,ourlife stylesareincreasingly materialistic.ThesolidChristianfoundation St. Christopher’sHospicehas was a model that manythoughtinappropriatefor ourculture.We knewour spiritualbasewasshakybutit tooktime to appreciatehowmuch. The Christianreligiousfoundation was essentialto Dame Cicely Saunders. However, she encouragedthe groupatYale to geton with its hospice dreamsevenwithoutareligiousfoundation.Shesaid, “Don’t startahospice unlessyou haveto, “but shealsosaid, “I couldn’t havedone it without my spiritual foundation.”Shesawthepossibility of St. Christopherwithin the Christianfaith but saidto mein 1986, she wasn’t sure it could spanother religionsor secularspiritualsources. Howandwhydid thehospicemovementarisein thefirstplace?Clearly, I can speakwith more authorityon the hospicemovementin theUnitedState, butI haveonly impressionsof ourmentor institution, St. Christopher’sHospice; its impetus,its religiousfoundation, its philosophy. BeforeDameCicelySaundersconceivedSt. Christopher’sHospice,her life wastouchedby World WarII. She wasnotin themilitary, butsheleftacademiafor thepracticeprofessionmost concerne
{"title":"The widening scope of spiritual care.","authors":"F S Wald","doi":"10.1177/104990918900600418","DOIUrl":"https://doi.org/10.1177/104990918900600418","url":null,"abstract":"All aroundtheworldtodayweface, for better and worse, disruption and changein both religious and secular values.Andthiswastruein1963,when we,beginnersof hospices, reachedout to one anotherto find new ways of caringfor theterminally ill. For me it beganwith DameCicely Saunders’ first visit to Yale University in New Haven,Connecticutin 1963. Her lecture on palliative care with photographsof tenninally ill cancer patientsbroughtthe audienceof many disciplinesat Yale’s medicalcenterto its feet. Seeingher patientsandtheir familiesbeforeandaftersymptomcontrol openeda doorfor uswherethere hadbeenawall. Theastonishment and relief I felt was alsoon the facesof medicalstudents,nurses,doctors,social workersandchaplains. For too long all of us had been numbedand hopelessby the sightof patientsdying,not onlylosingstrength butsufferingunbearably.Weeitherdid nothing or continuedwith intensive treatmentto the end. She gaveus a senseof possibilityandaway togo. I havehadanunshakableurgein the pastsix yearsto encouragehealthcare professionalsand clergy of various sects and denominationsinvolved in careof thosefacing deathto developa dialoguewith one another,and hear eachother’s views on spiritual support.1The ideacameto me from conferencesheld at NaropaInstitute by TibetanBuddhists,in whichexchange betweenEastern and Western theologiansled to appreciationof one another’sphilosophiesandrecognition of commonthemes. As the interdisciplinary natureof hospicecare madeit imperative for doctors,nurses,clergy, psychiatrists, social workers, administrators,dieticiansandartdirectorstoworktogether as a team,differencesin ideasand/or actioncalledfor awillingnesstostruggle togetherand so resolvethesedifferenceswithin an institution and in colleagialforumsonthe outside. In the United States the spiritual facetof the individual is complexand has many sides. Our religions are diverse,ourlife stylesareincreasingly materialistic.ThesolidChristianfoundation St. Christopher’sHospicehas was a model that manythoughtinappropriatefor ourculture.We knewour spiritualbasewasshakybutit tooktime to appreciatehowmuch. The Christianreligiousfoundation was essentialto Dame Cicely Saunders. However, she encouragedthe groupatYale to geton with its hospice dreamsevenwithoutareligiousfoundation.Shesaid, “Don’t startahospice unlessyou haveto, “but shealsosaid, “I couldn’t havedone it without my spiritual foundation.”Shesawthepossibility of St. Christopherwithin the Christianfaith but saidto mein 1986, she wasn’t sure it could spanother religionsor secularspiritualsources. Howandwhydid thehospicemovementarisein thefirstplace?Clearly, I can speakwith more authorityon the hospicemovementin theUnitedState, butI haveonly impressionsof ourmentor institution, St. Christopher’sHospice; its impetus,its religiousfoundation, its philosophy. BeforeDameCicelySaundersconceivedSt. Christopher’sHospice,her life wastouchedby World WarII. She wasnotin themilitary, butsheleftacademiafor thepracticeprofessionmost concerne","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 4","pages":"40-3"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748536","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 : 1989-07-01DOI: 10.1177/104990918900600408
M Pawling-Kaplan, P O'Connor
A lackof servicesfor tenninally ill patientspersists despitethe growing awareness of theiruniqueneeds.Moreover,while innovativemodelsof care havebeenshownto result in ahigher level of patientandfamily satisfaction whencomparedto conventionalcare, theseprogramstendto beunavailable tothemajorityof thepopulation.’3For mostdyingpatients,isolation,neglect, and inappropriatemedical treatment continuesto bethenonn.’ In a responseto theunmetneedsof terminal cancerpatients in Great Britain,Dr. CicelySaundersin thelate l960s foundeda model of care in which the focus of treatmentbecame the managementof chronic pain in orderto enablepatientsto live to their maximumpotential.4Sheadoptedthe term, “hospicecare,” to describeher protocolsdesignedto promote:physical and psychologicalcomfort using themostmodemtechniquesavailable. Impressedby hertreatmentoutcomes, Americanhealthplannersin the mid l970s beganto establishsimilar programs,andat aboutthe sametime her principleswere introduced into Canadaas“palliative care.” By 1983,whenthe federalgovernmentpublishedregulationsforhospice certification under Medicare, there were an estimated1500 programsin the United States.5Although the Medicarealternativewasoriginallyintendedtoextendutilizationof terminal careservices,criticsfearedthatexpensive eligibility requirementsandstrict reimbursement policies mandatedin the regulationswould havean adverse effecton access.68At present,increasinggovernmental restraintscontinueto severelychallengethe survival of manyof thepioneeringprograms.9 Nationwide,aminorityof programs havesoughtMedicarecertification,but in New York state the responsewas strong. Not only did many programs becomecertified, but Albany reinforcedthe federallegislationby limiting the designation“hospice” to Medicarecertifiedprograms.This unexpectedoutcomeof the certification processled to the creationof a second categoryof terminal care delivery. Sinceprogramsunable to operate under the Medicare reimbursement restrictionswereno longerallowedto usethename“hospice,” theyarenow generally referred to as “palliative care”programs,adoptingthepreferred Canadianterm. This articledefmesapalliativecare serviceand explainshow this kind of servicediffers from a Medicarecertified hospicemodel. The authors describethe goals,objectives,admissioncriteria,andoperatingpoliciesand proceduresof the St. Luke’s Hospital Palliative CareService.They present an analysisof recentoperatingexperienceat the St. Luke’s Palliative CareServicebasedon data gathered from the program’s recordsandmake comparisonswith parametersderived fromtheNationalHospiceStudyanda recentNew York State Hospice Associationstudy. They examine averagelength of stay, the inpatienthomecaredaysratio,locationof death, minority groupstatus,income status, availability of primarycarepersonin the home, and other important variables.
{"title":"Hospice care for minorities: an analysis of a hospital-based inner city palliative care service.","authors":"M Pawling-Kaplan, P O'Connor","doi":"10.1177/104990918900600408","DOIUrl":"https://doi.org/10.1177/104990918900600408","url":null,"abstract":"A lackof servicesfor tenninally ill patientspersists despitethe growing awareness of theiruniqueneeds.Moreover,while innovativemodelsof care havebeenshownto result in ahigher level of patientandfamily satisfaction whencomparedto conventionalcare, theseprogramstendto beunavailable tothemajorityof thepopulation.’3For mostdyingpatients,isolation,neglect, and inappropriatemedical treatment continuesto bethenonn.’ In a responseto theunmetneedsof terminal cancerpatients in Great Britain,Dr. CicelySaundersin thelate l960s foundeda model of care in which the focus of treatmentbecame the managementof chronic pain in orderto enablepatientsto live to their maximumpotential.4Sheadoptedthe term, “hospicecare,” to describeher protocolsdesignedto promote:physical and psychologicalcomfort using themostmodemtechniquesavailable. Impressedby hertreatmentoutcomes, Americanhealthplannersin the mid l970s beganto establishsimilar programs,andat aboutthe sametime her principleswere introduced into Canadaas“palliative care.” By 1983,whenthe federalgovernmentpublishedregulationsforhospice certification under Medicare, there were an estimated1500 programsin the United States.5Although the Medicarealternativewasoriginallyintendedtoextendutilizationof terminal careservices,criticsfearedthatexpensive eligibility requirementsandstrict reimbursement policies mandatedin the regulationswould havean adverse effecton access.68At present,increasinggovernmental restraintscontinueto severelychallengethe survival of manyof thepioneeringprograms.9 Nationwide,aminorityof programs havesoughtMedicarecertification,but in New York state the responsewas strong. Not only did many programs becomecertified, but Albany reinforcedthe federallegislationby limiting the designation“hospice” to Medicarecertifiedprograms.This unexpectedoutcomeof the certification processled to the creationof a second categoryof terminal care delivery. Sinceprogramsunable to operate under the Medicare reimbursement restrictionswereno longerallowedto usethename“hospice,” theyarenow generally referred to as “palliative care”programs,adoptingthepreferred Canadianterm. This articledefmesapalliativecare serviceand explainshow this kind of servicediffers from a Medicarecertified hospicemodel. The authors describethe goals,objectives,admissioncriteria,andoperatingpoliciesand proceduresof the St. Luke’s Hospital Palliative CareService.They present an analysisof recentoperatingexperienceat the St. Luke’s Palliative CareServicebasedon data gathered from the program’s recordsandmake comparisonswith parametersderived fromtheNationalHospiceStudyanda recentNew York State Hospice Associationstudy. They examine averagelength of stay, the inpatienthomecaredaysratio,locationof death, minority groupstatus,income status, availability of primarycarepersonin the home, and other important variables.","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 4","pages":"13-21"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748531","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 : 1989-07-01DOI: 10.1177/104990918900600416
L Quig
This paper describes the principal contributions of the hospice social worker. It enumerates professional duties of the social worker and the components of the family assessment. It describes the roles and responsibilities of the social worker as a member of the interdisciplinary hospice team.
{"title":"The role of the hospice social worker.","authors":"L Quig","doi":"10.1177/104990918900600416","DOIUrl":"https://doi.org/10.1177/104990918900600416","url":null,"abstract":"<p><p>This paper describes the principal contributions of the hospice social worker. It enumerates professional duties of the social worker and the components of the family assessment. It describes the roles and responsibilities of the social worker as a member of the interdisciplinary hospice team.</p>","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 4","pages":"22-3"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748532","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 : 1989-07-01DOI: 10.1177/104990918900600404
A A Dailey, S DiTullio
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