Hospice Care in the 21st Century

Hospice comes from the Latin word “hospis,” meaning both host and guest. Over time, it has come to stand for a place of rest and modern hospice programs try to maintain that ideal. Hospice care aims to improve the quality of life for patients who are in the final stages of terminal illness in addition to providing support and care for their families.

Hospice Care

Hospice care lends itself to such debilitating conditions as ALS (Lou Gehrig’s disease), Alzheimer’s, lung disease, cancer, stroke, congestive heart failure and liver or kidney disease.

The Purpose of Hospice Care for the Patient

Hospice care serves as a support system for individuals who are reaching the end of their lives. In hope of providing comfort and peace in the final stages of their journey, hospice care workers require compassion, a nurturing personality, and a thick skin. Hospice care serves to:

• Offer relief from pain and suffering.
• Confirm the process of life and the normality of death.
• Improve the quality of life as long as possible, possibly positively influencing the progression of the sickness.
• Neither quicken nor prolong death, but instead attempt to prolong life in conjunction with therapies such as chemotherapy.

The Purpose of Hospice Care for the Family

When an individual is diagnosed with a terminal illness and requires the special care of hospice, the emotional and physical toll affects the family of the individual as well. Hospice provides a safe haven for families, during times of treatment and following the death of their loved one. Hospice provides for the family in the following ways:

• A support system for the family of the sick individual.
• Spiritual guidance in dealing with death and dying.
• Assistance and care with financial issues and legal concerns.
• Education in medicine management and health care training for those caring for the sick individual.
• Bereavement counseling and learning, including anticipatory grieving.
• Support and education with the letting-go process.

Hospice Care in the Past

Societies throughout history have developed unique methods of caring for the terminally ill and the bereaved. Up until the 19th century in America, death and dying were viewed as matters of the family and church, and only in the past 100 years has dying been increasingly viewed as a medical event rather than a part of life and a family’s history.

The Middle Ages: A form of ‘hospices’ were established at important crossroads on the ways to religious shrines. Many who visited were looking for miracle cures for fatal illnesses and many used the shelters as a place to die while on their pilgrimages.

16th-18th Centuries: Churches were charged with caring for the sick and dying in community institutions, but most individuals passed away in their homes.

1800s: Mother Mary Aikenhead of the Irish Sisters of Charity opened Our Lady’s Hospice in Dublin, Ireland, an organization that cared specifically for the dying. A “calvaire” was also opened in France with a similar mission.

Early 1900s: St. Luke’s Hospice and the Hospice of God opened in London to offer end-of-life care.

1905: St. Joseph’s Hospice opened in East London to care for the sick and the dying.

1957-67: Cicely Saunders, a young physician with a background in nursing and social work, studied pain control in advanced cancer at St. Joseph’s Hospice. Her work led the way for the regular use of opioid analgesics given around-the-clock for pain management, a standard practice utilized in modern hospice care.

1967: Dr. Saunders opened St. Christopher’s Hospice in London, introducing a multi-disciplinary method of caring for the dying including regular use medicine-controlled physical pain management and necessary consideration for the spiritual and psychological suffering of patients and families.

1974: The first American hospice opens in New Haven, Connecticut, providing care for individuals sick with ALS, cancer, and other terminal illnesses.

1974-78: America begins to experience a growing availability of hospices and palliative care units, including the Support Team at St. Luke’s Hospital in New York City, Hospice of Marin in California and the Church Hospital Hospice in Baltimore.

1980s: In 1984, Medicare adds a hospice benefit and hospices begin to care for patients in the advanced stages of AIDS.

1990-2000: Hospice care programs grow to over 3,000 locations in the United States, and the World Health Organization sets guidelines for hospice care and pain control.

Working in Hospice Care in the 21st Century

Modern hospice care recognizes the principles of excellent palliative care. Terminally ill patients and their families have the option of knowledgeable and compassionate end-of-life care in hospice facilities, hospitals, nursing homes or their own homes. The best hospices are rooted in the communities they serve, and to the individuals who live and die there. In a study conducted by the National Hospice and Palliative Care Organization, it was found that the lives of individuals in hospice care was extended by an average of 29 days in comparison with similar individuals who received care in a hospital, promoting the positive effects of hospice care. Hospice care workers are presented with diverse options for employment, including:

• Hospice Nurse: Registered nurses care for patients, monitoring symptoms and administering medication, as well as teach the families about what to expect and how to assist. Hospice Nurses (whether working in a hospice facility or not) also serve as a link in communication between the individual, the family and the doctor.
• Social Worker: Social workers provide care and counseling to the individual and family, acting as a resource for any information or services needed.
• Hospice Physician: The patient’s doctor provides a care plan and works closely with the hospice team to assure the best treatments are available.
• Spiritual Counselor: Religious and spiritual guidance is provided by qualified individuals, assisting in the acceptance and understanding of death and dying.
• Home Health Aides: Personal care (such as bathing or shaving) is offered by home health aides, who may also be responsible for meal preparation and light housework, such as pet care or laundry.
• Trained Volunteer: Volunteers serve a valuable place in hospice, offering companionship for the sick, support for the families and assistance with everyday chores, such as shopping or babysitting.
• Inpatient Caregiver: If at-home hospice is not an option, or if more thorough treatments require a hospital stay, hospice workers in inpatient care work with pain management and round-the-clock nursing care.
• Grief and Loss Support: Losing a loved one is difficult, and qualified bereavement counselors help the family in the time of mourning that follows the loss. Hospice care workers often care for the families for months after the death of a patient, assuring availability for answered questions and emotional support for times of sadness and loss.

Work in hospice requires the dedication of a compassionate individual, one who is not only proficient in administering excellent health care but who is also capable of caring for the emotional needs of a patient and family. While enrolled in a nursing education program, hospice care is a wonderful avenue for volunteering, helping others while gaining a first-hand education.

Sacred Heart University’s online RN to BSN degree provides the first steps in reaching your nursing career goals. The program provides valuable health care training in health and wellness, clinical leadership and critical decision making. With the flexibility of an online nursing education, your path to a thriving health care career is possible, regardless of a busy work or home schedule.