Hospice and Palliative Care Nursing
In the past few years, the demand for nursing professionals has grown several folds across the world. There are actually several factors behind this soaring demand. Earlier, people used to think illnesses are similar to death sentences. Now, thanks to the advancements in medical science, those illnesses, even the long-term ones, are treatable. This explains why the demand for hospice and palliative care nursing is so strong in countries like the US, the UK and Australia.
What is Hospice and Palliative Care Nursing?
Hospice care and palliative care are two different forms of nursing reserved for people who are fighting critical illnesses. Both of them offer medicine and care that can ease the pain. However, nursing approaches used in these two are different.
Hospice care focuses on improving the overall quality of life and wellbeing of an individual (child or adult) with a life-limiting or terminal illness. Palliative care, however, is about tending to people with the symptoms of long-running illnesses that are not life-threatening for now.
What Does Hospice Care Mean?
Hospice care aims to help people with terminal illnesses to live as fully as they can for the precious time they have left. Hospice care involves looking after the patient’s physical needs while also fulfilling the emotional, spiritual and social needs. This is provided in a wide range of settings, including day services, care homes, and people’s own homes.
Hospice care offers a variety of services which include the following:
- Counselling
- Rehabilitation
- Pain and symptom control
- Complementary therapies (such as aromatherapy and message0
- Psychological and social support
- Spiritual care
- Support in bereavement
- Practical and financial advice
Hospice care is generally preferred when it’s no longer possible to cure a serious illness, or the patient chooses not to undergo certain treatments. Medical practitioners usually recommend this form of care when the patient has 6 months or less to live.
For nursing professionals, hospice care is one of the most challenging things to perform. Giving constant medical and emotional support is a taxing job. A professional nurse needs to be both sensitive and strict to treat a patient who has a few days to live.
What Does Palliative Care Mean?
Quite similar to hospice care, palliative care also aims to ease pain and provides support to those suffering from serious illnesses. However, in this case, the illnesses aren’t considered to be life-threatening for now. Generally, palliative care helps people who live with the symptoms of long-running diseases like AIDS, Cancer, kidney disease, etc.
There are special medicines for palliative care. However, they don’t replace the on-going treatment. It works more like an additional treatment that helps the patients and his/her family deal with the problems related to the illness. Since the illness can make working or even moving around difficult for the patient, palliative care addresses that as well.
Even when the illness is considered to be fatal, this form of care can help a person lead an active life. Again, for a nursing professional, treating a patient with a critical illness can be challenging. However, the experience of helping someone to find a reason to live when all hope is lost is often unparalleled.
Classification of Palliative Care
Based on the settings, there are four options available to people looking for palliative care. All these types of palliative care offer pain and symptom management, emotional support and more. It is only the environment that differs significantly in these types of care.
- Palliative care in Hospitals:
This form of palliative care is mostly delivered over a short-term period in the hospital. It is handled by a team of specialist caregivers or a single nurse, based on the case. The palliative care department in hospitals also monitors the discharge plans. Moreover, the team arranges the transfer of the patient to another place (care homes, patient's home, or hospices).
- Palliative care in a care home:
People, who already live in care homes, this is the best palliative care option for them. It saves them from the stress of moving to a hospital ward. And because of the calmer environment, it is considered an ideal place to receive the required medical support. However, every care home does not have the infrastructure to facilitate palliative care, so that's a downside.
- Palliative care at home:
Palliative care is often more effective in a homely atmosphere. This is the reason why most people prefer palliative care at home over the other options. The palliative care nurses come to the patient's home and offer round-the-clock support as a part of the treatment. A palliative nurse can also arrange times and pay home visits if the family members are willing to share the load.
- Hospice daycare:
Hospices are quite similar to care homes in some aspects when it comes to palliative care. In this setting, professional nurses offer palliative nursing and rehabilitation. Interestingly, people do not need to reside in the hospice permanently. They can attend a palliative care session and then return home.
It is always better for the patient or his/her family to communicate with the doctor who is looking after the case. The doctor can suggest which option will be more suitable for palliative care.
What is the difference between Hospice Care and Palliative Care?
Hospice care and palliative care have quite a few similarities. However, the differences are also quite evident. Here is a comprehensive comparison of these two forms of medical care.
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Palliative Care
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Hospice Care
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Who receives it?
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Any person with a serious illness.
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Any person with a terminal or life-limited illness where he/she has less than 6 months to live.
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Will it relieve the patient from the symptoms?
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Yes, as much as possible.
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Yes, as much as possible
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Can the patient continue to receive other treatments to cure the illness?
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Yes, if only the patient wishes.
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No. The patient will receive symptom relief only.
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Will Medicare cover it?
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It depends on your benefits and treatment plan.
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Yes, it pays all hospice charges.
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Does private insurance cover the expenses?
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Again, it depends on the plan
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It depends on the plan.
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How long will this treatment continue?
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This depends on what kind of care the patient needs and his/her insurance plan.
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As long as the patient meets the hospice's criteria of an illness with a life expectancy of months, not years.
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Where can the patient receive this care?
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· Home
· Assisted living facility
· Nursing home
· Hospital
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· Home
· Assisted living facility
· Nursing home
· Hospice facility
· Hospital
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Scope and standards of palliative care practice
A lot of things have changed in the area of palliative care over the past decade. Some of the noticeable changes include:
- The expansion of the evidence base for clinical care
- Re-design of service delivery models of care to comply with the changing needs and expectations of the community.
- Changes to the language used for describing the treatment to the ones this is meant for.
Moreover, people have started to recognise the potentials of palliative care for those, who are suffering from chronic illnesses. Palliative Care Australia acknowledges that these following elements are essential to understanding the definition of palliative care.
- Palliative care needs to be strongly responsive to the preferences, needs and values of people, their families and caregivers. Effective communication, shared decision-making and personal autonomy is the key in palliative care.
- Palliative care should also be available to people living with an active, progressive, or advanced disease, irrespective of the diagnosis.
- Palliative care affirms life while acknowledging the fact that death is inevitable. The treatment is provided during a time that the person is living with a serious illness, but it is not driven by the thought of either bringing forward or delaying death.
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