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What Are the Requirements for and Barriers to Hospice Care?

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What are the requirements for and barriers to hospice care?

In order for hospice care to run efficiently, an International Work Group on Death and Dying developed guidelines that established standards of care. These guidelines were proposed for not only the patients, but also the families of the ill, the terminally ill patients, and the staff to ensure their passing goes as smoothly as possible, eliminating any extra stress. Implicit standards of care would ensure a successful death being quiet and uneventful. The transition would be so smooth from life to death that nobody would be affected. There would be a routine established that would create a calm, quiet environment. The physician would not be required to attend the patient's passing- as long as the staff could guarantee minimal errors. The patient's body and comfort is the main priority. The patient would pass at the right time, and the family will be grateful for the help they received- as the staff did everything that they could for the patient. The International Task Force also proposed standards, which are quite different than those of IWG (International Work Group). Patient-Oriented Standards keep the patients comfort in mind, even if it creates more work for the staff. Remission of symptoms is a treatment goal, for instance, if a dying person is thirsty, they will be given a drink, or if they are having trouble breathing, the patient will be moved to a more comfortable position to ensure better airflow. The patient will feel safe, given a routine for care, and not be surprised by different treatments or medications. Also, there will be leave taking opportunities for people who are close with the patient to say their proper goodbyes, without interruption. Family oriented standards were proposed as well, to give the family a sense of peace that their loved on is being care for and that they are going to be heard as well. They are given the opportunity to discuss the patient's needs, and requests for information. They will also be given time and privacy with their dying loved one while alive, as well as after their passing. At last, staff oriented standards are proposed as well. The caregivers will develop a personal relationship with the dying patient, and not passed off like they are in the hospital with staff schedule changes. A mutual support team will exist throughout the staff. As caring for the terminally ill will be somewhat draining, they will be there for each other to lean on when they are having a rough day.

Explain how hospice/palliative care is able to serve any two of the following groups of people with health problems: children, people with aids, and people outside mainstream society.

As sad as the situation may be, hospice care for children is devastating. It is still devastating when someone lived a long life, and fulfilled most of their dreams and accomplishments, but dealing with a terminally ill child has to take its toll on staff as well as family. Like adults, their family abandons some children as they are too stressed to tolerate the visits with their terminally ill child. Unfortunately, children are not usually given pain medication, as they do not want to the child to become addicted to pain medication. It is not very common for children to be placed with hospice care because committing to that care implies that their child will die. Most parents choose every fighting cause they can to save their child's life. Fortunately, more and more general hospice services are beginning to accept children, but as technology and medicine advances, their chances of survival increase each year fortunately.

Not only does hospice treat cancer patients, but they also treat people who are actively infected with AIDS. A person infected with AIDS may experience all of the same symptoms as someone who is dying of natural causes or cancer, such as loss of functions, pain, fatigue, and limited plans for the future that have been replaced by the thought of death. In the 1980's certain barriers were given as HIV and AIDS was a major public health threat. There was a fear that if AIDS patients were accepted to hospice care, the quality of care and of hospice services would decrease through the public's eyes. But with persistence, the correlation between



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