The Hospice Movement

The hospice movement has been developed to serve older persons and others in need of a particular level of medical and nursing care. In ancient times, hospices were a sanctuary for the poor wayfarer, and medieval hospices were operated by religious orders. Hospices have been revived today as care facilities for the dying and their families. Patients are admitted to the facility at the request of their doctor. They generally have one of several diseases with a terminal prognosis, some to stay, some to return home again, and some who improve to be returned to a treatment hospital. All patients receive personal care. Bereaved families are supported by visits from the staff and volunteers.

The hospice is actually a flexible concept which can fit into many settings. Some hospices today function in an established hospital setting, while others have independent inpatient facilities or are affiliated with some other community service. Many offer home care and bereavement services. Two divergent types of hospice seem to be developing: 1) independent and heavily volunteer hospices with unstable funding; and 2) institutionally based hospices providing both inpatient and home care. Hospices have encountered some funding difficulty, but Congress recently voted to extend Medicare coverage to hospice care, primarily because it is less expensive than hospitals or nursing homes. This coverage remains limited, but it does indicate national recognition of the value of the hospice

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e is the comfort of the patient, and this is also one of the major reasons for its popularity. In addition, many people prefer to die at home rather than in an institution. The comfort of the patient is not found exclusively in medications for pain or on corrective measures for distressing symptoms. Comfort is also taken from the environment, from comfortable, familiar surroundings, loving care, and visitors such as young children and pets, both rarely seen in an acute-care setting. Comfort may also come from the right to live and die in the style of life the patient has created. The family is benefited by these surroundings as well. The family suffers as does the patient, and one of the basic tenets of hospice care is that the patient and family are to be treated together: Approaching death can be spiritual or growth-filled, an experience families can share. Hospice staff are trained to facilitate communication between family members so that the remaining time can be as complete as possible. Family problems cannot be ignored, for if they remain unresolved they affect the peace of the dying patient. Anne Munley emphasizes the importance of spiritual support for the patient and reports on the results of her interviews

Category: Medical - T