How can applying the motives of hospice care to other medical settings improve the quality of healthcare?

End of life care provides personalized care to dying patients. The main goal of hospice care is to give the patients a sense of dignity and respect their requests. Listening to the patient’s final wishes builds a supportive environment not only for the patient, but also for their family. After all, everyone deserves to be treated as a human being when dying. Continue reading “How can applying the motives of hospice care to other medical settings improve the quality of healthcare?”

Why was Hospice different?

In class on Tuesday we watched the documentary discussing the emergence of hospice care. One point that struck me was that it seemed like the people of London felt that hospice care was a worthy cause to give money and time to, and that is the reason it succeeded. Death seems to strike a chord with many people. I think it because it is a common link we all share and when confronted with the mortality of ourselves and our loved ones, priorities change. What if in the US we started tackling some of our healthcare problems using this fact? If there was a way to emotionally reach people on topics like preventative care and public health, then I don’t think there would be much of a problem trying to change the healthcare system.

Hospice Care

In the Documentary we watched today in class, it was mentioned that medical students should spend time on a hospice rotation before beginning their profession in medical practice. After everything we have learned throughout the semester about physician-patient relationships, and patient-centered care, and things of that nature, and now learning from the video the morals behind hospice care, it almost seems necessary to me for students to have a rotation at some point in a hospice facility. It teaches young doctors and soon to be doctors how to build relationships with the people they are treating, so that they do not lose their identity and become identified by their disease like patients so often do. Continue reading “Hospice Care”

Long term elderly care culture

Coming from a multicultural background, long term care for the elderly has always been viewed as unnecessary and careless on the part of the children of the elderly person. Many cultures outside of the USA view that it is the children’s first and utmost responsibility to care for their parents. With these cultural differences aside, since America is so diverse in elderly care culture, how can these differences be taken into account by the government should the government start trying to fix the inequality in care giving that is going on due to the differences in privately owned nursing homes and assisted living companies?

Changing End-of-Life Care

After reading “Fighting to Honor a Father’s Last Wish: To Die at Home,” I have to wonder what could possibly be done to change our current system of elder care and end-of-life care. If the system continues to be largely run for profit, then we are never going to get to a point where we stop spending so much money on unwanted medical care and start investing more in social services. My questions revolve around that idea. What can be done to incentivize home health care and social services? For those who are truly too sick to be cared for at home, what can be done to improve treatment in nursing homes and hospitals? If these institutions are turning such a profit, why is there such a staffing shortage? Surely, they can afford to hire more staff, which is frequently stated to be a way to improve conditions in these settings. Hopefully, changes can be made soon, so that less people have to endure what Joseph Andrey did in his last months of life and more elderly people can die at home, if they so wish.

Abuse and neglect in nursing homes

In reading the New York Times article “Fighting to Honor a Father’s Last Wish: To Die At Home”, I keep being appalled by the inhumanity of some of the stories of patients in these nursing homes. Beyond the fact that the system is becoming more and more profit-driven, the reports of abuse and neglect, in some cases, are major. From a basic human rights perspective, how can this be continuing with such frequency?

The wheel of life…

I have been lucky enough to get to know my great grand mother. As the wheel of life turns however, I also had to experience her end of life care and the approach that my family took. My parents involved me a lot into the situation even though my young age. I’m grateful since this experience opened my eyes in regard to death and the meaning that life has. At the age of 96 , after years at home, with my greatgrandmother being completely dependent onto my grandmother, my greatgrandmother, when understood that her time had come, actively decided to stop being under medications, eating and even drinking. What could my family do in front of such a strong decision? Was it right to attach her to machines and force her to a vegetative life that wouldn’t have honored the amazing woman she was and the harshness that she overcame in life. We all stayed next to her, gave all the love we could and accepted her decision if that was what she wanted to do. She looked happy serene. I remember my tears in front of her decision asking myself how a human being could be so strong to take such an approach towards death.

After reading Nina Berstein’s article I started questioning myself: “ How can the context surrounding us affect the individual’s approach to dying and the one of his family? “ In my country in fact, having a public health system, the approach to end of life care is much more different and in a way more free to follow the course of nature. Having a for-profit mechanism, as described in the article, determines how an individual has to die. What is therefore the sense of expressing your will on your death, if at the end, the envy of money of the society you live in, puts in second place the peaceful desire of his citizens, among which many of them have helped in the past make this country the place that it is now? Is an individual really free to express how he wants to die, in the for-profit system that the end of life care has become in the United States?

Where is all the money going?

Bernstein’s article suggests that despite elderly Americans’ desires to have end of life care at home, most do not. The primary reason for this seems to be the fact that it is far more profitable for elderly patients to live in nursing homes rather than at home. Where does all the money hospice/home care go? It it’s clearly not enough to sustain the patients. And even in nursing homes, proper care isn’t given to patients– the homes are often understaffed and inadequate care is given to patients. Despite this, nursing homes manage to make a profit. Where is the money going to allow this to happen? Is there a way to curb nursing home expenditures to ensure that elderly patients are given the care they need? And if not, is there a way to make it so that home care expenditures are sustainable, thus allowing elderly patients to die at home as many of them wish to?

The ethics of end of life care

In reading Bebinger’s article about of end of life care, I was besieged with a variety of conflicting emotions. I realize death is a part of life, and mandating doctors to give information to “appropriate patients” is a vital step to beginning necessary conversations. However, isn’t the duty of the doctor to save lives, as is specified by the Hippocratic Oath? When does saving lives merge into a hopeless preservation of life that leads the patient to have a lower quality of life and thus lead them to rather embrace death than continue living? Does the doctor’s ethics have nothing to do with this decision, but only the patient’s?  If it’s the patient’s decision, is that in itself an ethical decision?

Conversations About Death

The article “Tip-Toeing Toward Conversations About Death”, explains that a state law earlier this year was passed to encourage more people to make preparations about how they want to die. I had several questions regarding this article. First they mentioned that “Sixty-seven percent of people want to die at home and only 24 percent did”, is this because they simply never made arrangements for this death or did this data include sudden deaths such as heart attacks, car accidents, etc.

To add on, doo you think the Department of Public Health should broaden the qualifications of an “appropriate” patient like what Harvard Vanguard did in the attempt to promote end of life arrangements? Should these arrangements just be simple conversations with family members or are these patients suppose to set up meetings with lawyers and have written requests? Lastly, the article mentions that the law wants doctors to hand out pamphlets to patients. I believe that this is a very ineffective tool to encourage end of life talk. Many people do not read pamphlets and throw them away immediately. Obviously, face-to-face communication between the doctor and patient would be the easiest and an effective form of urging an end of life talk but what are other effective ways that can encourage these talks? Media usage? Ads? Should the doctor talk to family members before the patient about end of life talks?