PDF Palliative Care and Hospice A Sensitive Guide to Making The Right Decision for Your Loved Ones

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The Difference Between Hospice and Palliative Care
Contents:
  1. Key Concepts and Definitions
  2. Introductory Guide to Hospice and Palliative Care Social Work
  3. Oops, something is wrong
  4. Palliative Care vs. Hospice Care
  5. Why don’t we want to talk about it?

Hospice and palliative care regards dying as a natural process. The goal of hospice and palliative care is to achieve the best possible quality of life through relief of suffering, control of symptoms, and restoration of functional capacity while remaining sensitive to personal, cultural and religious values, beliefs and practices.

The intensity and range of hospice and palliative interventions may increase as illness progresses and the complexity of care and needs of the patients and their families increase. Care priorities shift to focus on end-of-life decision making and to support physical comfort and a death, consistent with the values and expressed desires of the patient.

Key Concepts and Definitions

Hospice and palliative care guides patients and families as they address issues of life completion and closure. When things need to be said, issues resolved and dreams fulfilled, hospice will be there for you.


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Have more questions regarding Hospice and Palliative Care? Visit our FAQ page. Member Login. Find-A-Provider Near You. For example, the American Academy of Hospice and Palliative Medicine offers training in end-of-life care, and the Accreditation Council for Graduate Medical Education offers competencies for hospice and palliative medicine. Many medical schools offer palliative care training as well. The End-of-Life Nursing Education Consortium of the American Association of Colleges of Nursing offers palliative care training worldwide for nurses and their physician or social work colleagues.

The College believes that the principles articulated in this document should be honored regardless of whether or not a woman is pregnant. Some state laws, however, are not congruent with this position and, in some cases, specify that with or without clearly stated end-of-life wishes from a pregnant woman, additional consideration should be given to the fact that she is known to be pregnant. If the woman has not previously voiced or documented any wishes or values and is unconscious or lacks capacity, her surrogate decision maker will be her voice.

The health care facility should not attempt to contravene her wishes and values, whether she voices them or they are relayed by a surrogate decision maker. Every attempt should be made to respect the wishes and values of a woman who is conscious and who has the capacity to make health care decisions. Recently, some pregnant women who are dead according to brain death criteria have been technologically supported in an attempt to allow further maturation and delivery of the fetus. Such technological support may be ethically permissible if the surrogate decision maker for such a pregnant woman requests an attempt at additional fetal development on her behalf 28 , In the case of In re A.

The obstetrician—gynecologist who provides end-of-life care may need to consider the ethics of the posthumous use of gametes and embryos for reproduction. In the course of fertility treatment and assisted reproduction, reproductive tissue, including oocytes, sperm, and embryos, may be cryopreserved. Patients are strongly encouraged to state in writing their decisions regarding the disposition of their stored gametes and embryos in the case that one or both intended parents die before the gametes or embryos are used.

Such decisions should be made at the time of the initial treatment. Options include transferring dispositional control of the gametes or embryos to a surviving partner or to a third party, donating them to research, or discarding them. Such requests are normally honored.

Occasionally, family members or surrogate decision makers may ask physicians to invasively procure posthumous gametes for reproductive purposes. Good end-of-life care is an intradisciplinary and interdisciplinary effort. Specially trained palliative care physicians, nurses, social workers, counselors, and religious or spiritual advisers are integral partners in end-of-life transitions, and partnering with these professionals is encouraged when they are available. Obstetrician—gynecologists are in a unique position to encourage women to formulate advance directives.

All patients appreciate the support of their physicians when difficult situations arise, and families remember how their loved one was treated by the health care team. Communicating honestly and openly, being receptive to differing views, and appreciating cultural differences that may determine how death is understood will help physicians to make end-of-life care a valued part of their work. Physicians should be true to their own values as well, never ceasing to acknowledge the dignity of the dying patient and provide support to her and her loved ones, but asking other colleagues to step in when the situation warrants.

The College recognizes and respects the depth of concern in the physician who must balance care for the dying woman, possibly a fetus, and the extended family, and. The College encourages those who provide care to dying patients to be aware of the burdens it may place on themselves and be sensitive to their need for self-care. All rights reserved. End-of-life decision making. Committee Opinion No. American College of Obstetricians and Gynecologists. Obstet Gynecol ;—7. Women's Health Care Physicians. Introduction Obstetrician—gynecologists care for women throughout their lifespans. On the basis of the principles outlined in this Committee Opinion, the American College of Obstetricians and Gynecologists the College offers the following conclusions and recommendations: Good end-of-life care is an intradisciplinary and interdisciplinary effort.

If decisions made by a woman or made on her behalf by her surrogate decision maker cause the physician to experience significant moral distress or ethical conflict, the physician has the right to transfer care to a physician who has more expertise and is more comfortable with these choices. The principles articulated in this document should be honored regardless of whether or not a woman is pregnant. Patient—Physician Relationships and End-of-Life Care Obstetrician—gynecologists encounter patients at the end of life in emergent and expectant situations.

Ethical Principles and Ethics Resources Adherence to basic ethical principles is critical in care for the dying. Advance Directives and End-of-Life Care Planning Since , Medicaid-participating and Medicare-participating health care institutions have been required to inform all adult patients of their rights to make decisions concerning medical care, including the right to formulate an advance directive.

Introductory Guide to Hospice and Palliative Care Social Work

Organ Donation Physicians who care for dying patients may wish to have further knowledge about organ donation. Care as the End of Life Approaches Determining treatment goals may become more difficult when the discussion occurs after an illness has been diagnosed or when the patient is ill and in the hospital. End of Life and Pregnancy The College believes that the principles articulated in this document should be honored regardless of whether or not a woman is pregnant.

Posthumous Reproduction The obstetrician—gynecologist who provides end-of-life care may need to consider the ethics of the posthumous use of gametes and embryos for reproduction. Conclusion Good end-of-life care is an intradisciplinary and interdisciplinary effort. Am J Crit Care ;—45; quiz Soc Sci Med ;— Concept analysis of good death in terminally ill patients.

Am J Hosp Palliat Care ;—9. Old ways, new ways, and patient safety. Health-leaders ;17 1 — End of life: the humanist view. Lancet ;—7. Cultural diversity at the end of life: issues and guidelines for family physicians. Am Fam Physician ;— Transcultural aspects of perinatal health care: a resource guide. Obstet Gynecol ;—9. Leadership in healthcare organizations: a guide to joint commission leadership standards.


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Retrieved July 7, Understanding and addressing moral distress. Moral distress, moral residue, and the crescendo effect. J Clin Ethics ;— How I wish to be remembered: the use of an advance care planning document in adolescent and young adult populations. J Palliat Med ;— Organ donation: practicalities and ethical conundrums.

Oops, something is wrong

Am J Crit Care ;—4. Improving donation outcomes: hospital development and the Rapid Assessment of Hospital Procurement Barriers in Donation. Prog Transplant ;—7. Nursing practice: the ethical issues. Obstet Gynecol ;— Obstet Gynecol ;—8. Time to revise the approach to determining cardiopulmonary resuscitation status.

Palliative Care vs. Hospice Care

JAMA ;—8. A tale of two conversations. Hastings Cent Rep ; Aid in dying: guidance for an emerging end-of-life practice. Chest ;— Am J Bioeth ;— Foregoing nutrition and hydration in the terminally ill obstetric patient. J Perinat Neonatal Nurs ;6 4 — Stopping eating and drinking. Am J Nurs ;—61; quiz Compassion fatigue and burnout: the role of Balint groups.

Palliative care: living with the dying

Aust Fam Physician ;—8. When the fetus is alive but the mother is not: critical care somatic support as an accepted model of care in the twenty-first century? Death in pregnancy—an American tragedy. N Engl J Med ;— Informed consent - the Angela Carder case.

Why don’t we want to talk about it?

Int J Childbirth Educ ;6 2 — The rights of pregnant patients: Carder case brings bold policy initiatives. Healthspan ;—6.

Why talk about end of life care?

Fertil Steril ;—5.