Tag: doctors

Hospice Care Evolution

November is National Hospice and Palliative Care Month, a time to draw and raise attention of this special kind of care. Hospice care is a viewpoint of end-of-life care that concentrates on the comforting and care of a critically ill patient’s symptoms. These symptoms can be actual, psychological, spiritual or social in nature.  The idea of hospice as a place to cure the incurably ill has been changing since the 1200’s and first came into the United States in the nineteen seventies in reaction to the work of Cicely Saunders in the United Kingdom. Since its appearance, hospice care has evolved rapidly.

hospice_careHospice care is available to sufferers of any age with any terminal diagnosis. Although most hospice sufferers are in treatment for less than 30 days, care may increase beyond six months if an individual’s condition is constantly on the merit for such healthcare. Medical and social services are provided to sufferers and their loved ones by an interdisciplinary group of professional suppliers and volunteers who take a patient-directed strategy to handling sickness. Generally, therapy is not analytic or healing, but is based on what the individual and family members’ goals are. In many situations, hospice services are covered by medical health insurance and other suppliers.

Care may be provided in an individual’s home, experienced nursing service, or assisted living service. The objective of hospice care is to offer comfort to the individual and family members. This can mean independence from actual, psychological, spiritual and/or social pain. Hospices do not seek to speed up loss of life, or extend life. Hospices offer care with an interdisciplinary group. This interdisciplinary group strategy includes all members of the medical care group working together towards the same objective, which in this case is identified by discussions with the individual and family members. Members include the hospice medical director, doctors, pharmacy technician, RNs, certified nurse’s aide, social workers, spiritual consultants and volunteers. The hospice health director is a physician who provides support and guidance to the clinical staff providing care to the patient and family.

Humanities and Medical Professionals

The actual dogma is that learning the humanities makes physicians human. It appears to be good. It might even sound naturally right. But the “common” in common sense is often the unprocessed variety. Hiding within the medical humanities’ manifesto is a way of associative thinking, a kind of causal fallacy: it is the idea that fictional or philosophical consumption and sympathy for a one’s fellow beings, adhere to a simple straight line direction.

humanitiesAnd herein can be found the problem. There is no efficient proof that learning literary works enhances stages of sympathy among doctors. This is not to say the dogma won’t yet be vindicated. And it is not to say educating or enhancing stages of concern among medical care learners and physicians is an insignificant process. In fact, the very opposite is the case: sympathy and concern form an important part of the doctor-patient connection. Doctors need to be aware of the variety of experiences that diseases and personal conditions can bring. Empathy is also essential in developing the kind of environment where sufferers can connect successfully and when sufferers aren’t forth-coming about signs, physicians skip a significant item of the challenge.

The point is that nobody, least of all medical care educationalists, can manage to be glib about how this aspect of medical care professionalism and reliability can best be found or obtained. And what about other medical care professionals? Exponents of the fictional medical care humanities appear less desperate to ingratiate themselves among nurses, for example. Couldn’t our nurses, home health aides and other medical care employees use some of this (purported) fictional elixir? An educational Google search located one book suggesting the use of (specifically) “popular literature” among nurses. According to this thinking, we should recommend Danielle Steele to our medical staff, while providing Dostoyevsky to the medics.

Cause of Hospitalization from Nursing Homes

A primary cause of hospitalizations from nursing homes, discussed in industry literature for more than 20 years, is the inadequate health professional employment levels in nursing homes. Last fall, the Kaiser Family Foundation released two studies about the hospital stay of elderly care facility citizens. Their findings about why elderly care facility citizens are hospitalized confirm earlier research in this field and point to the need to increase health professional employment in nursing homes as a way to improve quality of care in assisted living features and reduce hospital stay and re-hospitalization of patients.

Nursing-HomesThe Kaiser study, “Financial Incentives in the Long-Term Care Context: A First Look at Relevant Information” determined the economical incentives that encourage hospital stay of elderly care facility citizens.[6]  These incentives include Medicare payment policies for doctors, skilled assisted living features, and hospice services as well as the dual roles of healthcare director and attending physician frequently being held by the same individual.

A companion study, based on interviews with doctors, nurses, social workers, and close relatives of residents, determined 10 factors that encourage hospital stay of elderly care facility residents: the limited capacity of assisted living features to address healthcare issues; physicians’ preference for inpatient settings; concerns with liability for not hospitalizing; economical incentives for doctors and facilities; inability of assisted living features to address residents’ healthcare needs; lack of relationship between facility staff, doctor, and family; lack of advance care planning; family preference; and behavioral health problems. Although several factors impact a decision to hospitalize an elderly care facility resident, a key factor determined in the Kaiser reviews and other studies mentioned is the lack of sufficient professional and paraprofessional medical staff in nursing homes.  The insufficient employment in assisted living features has been recognized for a long period.