Talk:Hospice

What is hospice?

The article tells me hospice is widely geographically dispersed but not what it is.

I have no clue how a person in hospital would benefit from hospice care. Apparently much of hospice care is in the home--what does that mean? What do hospice workers do? —Preceding unsigned comment added by 76.94.82.148 (talk) 05:46, 5 February 2010 (UTC)

What Hospice IS:

(I am a Hospice nurse, ftr)

Hospice provides physical, spiritual and emotional support to not only the patient but the family/caregivers too. In a hospital setting, you are provided with a Registered Nurse, Hospice Aide, Chaplain, Social Worker and volunteers ON TOP OF the hospital staff. Hospice acts as an added layer of care. Hospice focuses on pain/comfort control and symptom management. In hospital settings, to aid in the already over-worked hospital staff (or ANY facility, for that matter), we provide the assurance your loved one will be cared for and comfortable. Hospice is available 24/7 in a hospital setting and a private area for family and loved ones is provided in the patient room and usually in a waiting room area or chapel.

Services provided in a hospital setting are very similar to the home setting services. How the process works is this: A Registered Nurse receives an order to assess a patient. She/He contacts the patient and/or family/caregiver to set up an appointment to assess the patient to see if they meed Medicare's extremely strict criteria. ALL Hospice patients are admitted under Medicare guidelines, which are VERY difficult to use. (That's a soapbox for another day.)

Once the patient is admitted to services, they are assigned an RN Case Manager (unless the RN doing the assessment is the case manager also), a Hospice aid, chaplain and social worker.

The RN overseas the entire care of the patient. The Aid sees to everything from assisting/doing Activities of Daily Life (ADL's), housework and general errands along with companionship. The Chaplain sees to the Spiritual needs along with providing counseling, support and bereavement needs after the patient passes away. The Social Worker assists in anything from financial needs to funeral arrangements, living arrangements, safety needs, support services, living wills, powers of attorney and any legal needs the patient and/or family may have. Volunteers, if chosen to use by patient/family do anything from companionship, errand running and just about anything that doesn't require hands-on care.

All Hospices are overseen by a Local Certifying Doctor. The referring physician may or may not be the attending physician for the patient. ALL patients MUST have an MD or Nurse Practitioner for follow-up orders after admission. Most states require an MD to give admission orders. After the initial admission process is complete, many states allow Nurse Practitioners to follow the patient, in conjunction with the Local Certifying Doctor. A physician is always available to hospice. 24/7.

Medicare requires an anticipated life expectancy of six months or less. However, since none of us can predict the future, patients are reviewed for re-certification to hospice services periodically. Many times, a patient will improve in their condition once hospice comes in and may be discharged from services after a time. These patients are eligible for services again once their condition declines.

The sooner a patient is referred to hospice the better. Many times, patients can still receive palliative treatments while on hospice. Encourage your doctor to refer sooner than later to hospice. There is so much we can do to provide a good quality of life for a longer amount of time.

I hope this helps you.

Emansgirl60 (talk) 13:23, 6 February 2010 (UTC)

A very thorough response, Emansgirl60. :) 76.94.82.148, as it seems you may be in the United States, the article Hospice care in the United States also provides more information as to what hospice provides in that country. I'll see if I can find more information for this article, which needs to be a bit more global. --Moonriddengirl ^(talk) 13:28, 6 February 2010 (UTC)

EL section

The EL section was removed in toto on 1 June with a note that "only contained promo / irrelevant links". I disagree with this assessment and have restored them for individual review (following which I've removed a couple for reasons set out in edit summary). At this point, the article contains the following links:

National/International Associations

• Foundation for Hospices in Sub-Saharan Africa homepage; a 10-year-old international non-profit organization covering 13 African nations.
• Palliative Care Australia; formerly the Australian Association for Hospice and Palliative Care Inc., a 20-year-old umbrella association that gathers palliative care associations from the eight states and territories of Australia and New Zealand.
• Canadian Hospice Palliative Care Association; a 19-year-old Canadian non-profit association, covering all ten provinces & three territories.
• Federazione Cure Palliative, an association of 55 non-profit Italian palliative care associations.
• Norsk forening for palliativ medisin; a 10-year-old interdisciplinary organization of palliative care professionals in Norway.
• Fundacja Warszawskie Hospicjum, a hospice association in Warsaw. Must admit I know little about this one, since I can't follow the language well even via google translate, but I have a fear of systemic bias in excluding it.
• The Scottish Partnership for Palliative Care, a 19 year-old Scottish charity comprising 54 member organizations.

Additional resources

• Canadian Virtual Hospice; an online resource with information about hospice. Established in 2001 and supported by such organizations as Winnipeg Regional Health Authority, the Government of Manitoba and Health Canada.
• The national standards for hospice care in Romania
• The national standards for hospice care in Scotland
• The national standards for hospice care in Spain
• The national standards for hospice care in Switzerland

Considering that the article is on hospice care with a focus on international hospice care, I'm inclined to believe that these links all contain "neutral and accurate material that is relevant to an encyclopedic understanding of the subject and cannot be integrated into the Wikipedia article due to...amount of detail." Alternatively, these would each be useful in a further reading section. Eventually, we may be able to develop individual articles on hospice care in different countries/continents, akin to the one we have on Hospice care in the United States, but at the moment this at least helps to counter the natural systemic bias resultant from our contributor demographic. --Moonriddengirl ^(talk) 11:01, 1 June 2010 (UTC)

I was the one who removed the section per "promo/irrelevant". My reasoning was as follows: these links were all to local association/foundations (currently, after your cleanup, only 'Canadian Virtual Hospice' does not fall under any of these categories). If we are linking 'Palliative Care Australia' we need to link Italian counterpart 'Federazione Cure Palliative (Italy)', given that we'll need to link Norwegian 'Norsk forening for palliativ medisin' and so on ad infinitum. The same applies to local standards. This will inevitable lead to a massive amount of external links, to which the only answer is: Wikipedia is not a link farm, and subsequently remove all — that's what I did.

Analogously hospital should not link local hospital association/foundations; Trade union should not link local trade union association/foundations; And to take it to the extreme, Google should not link all local-language websites of theirs.

While I still agree with myself, I've nothing against leaving this decision to you and the other contributors of this article, I just wanted to give my reasoning. For a lengthier response I'll point you to my first essay I finished just a minute ago, User:Jonkerz/One fish in the ocean, ironically linking it is a little bit of shameless self-promotion ;). By the way, {{dmoz|Health/Medicine/Facilities/Hospice/}} may not be exactly what you're looking for, since the links are to individual hospices and not association/foundations, but it's worth mentioning. jonkerz♠ 19:54, 1 June 2010 (UTC)

When locality is talking about whole countries, or in the case of the first link 13 countries, I'm inclined to think that they are probably relevant for inclusion, again pending counterparts to Hospice care in the United States. For instance, the article discusses some continents and countries, but not all (because I couldn't find information on all), but I wouldn't want to exclude any of what I did find on the basis that other countries do not have equal coverage. But we'll see what others might have to say. --Moonriddengirl ^(talk) 20:10, 1 June 2010 (UTC)

UK hospice

I just updated this section - the data was from 2009, I've added 2011 data but kept the 2009 figures as it seems interesting to me to track the changes. But I'm not an experienced editor and this may be more me-shaped than Wikipedia-shaped. All feedback gratefully received. Doctor Girl (talk) 20:51, 2 October 2012 (UTC)

I've deleted a single line which refers to providing 'free' hospice care for newborn babies. No reference is provided and the only mention I can find on the internet is to an OpEd piece in the daily Mail which uses the term Hospice in a negative and emotive way. I don't understand what was intended by the line, also the term 'free' in the context of care provided by the NHS is redundant. — Preceding unsigned comment added by Shrubage78 (talk • contribs) 21:43, 30 March 2013 (UTC)

First hospice in India

I've reverted this change, which replaced sourced information with unsourced. Since the original link is dead, however, I have added three more. Perhaps the difference is in the kind of care provided at the older establishment. Looking at a quote from one of the sources used in that article, "Along with the neglect of diagnosis, the lack of good analgesia marks Mother Teresa's approach as clearly separate from the hospice movement", perhaps it isn't regarded as the first modern hospice in India because it does not focus on palliative care, which is the very definition of modern hospice. --Moonriddengirl ^(talk) 19:26, 30 June 2013 (UTC)

Representing opposition to hospice care?

I came to this article because I was interested in seeing information on conflicting views between hospice and right-to-die. This seems relevant in part because many prominent voices in hospice have been opponents of the right-to-die movement due to their spiritual beliefs (specifically, the Catholic belief that the god Jehovah eternally tortures the souls of people who use physician-assisted suicide).

I know of some coverage on this issue, but nothing recent. About ten years ago the New York Times did a piece on a hospice in Oregon, where physician-assisted suicide is legal. The hospice in question had conducted a survey which suggested that about 50% of people who resisted hospice did so because they found the hospice "condescending or arrogant", and this led them to change their practices significantly to better accommodate people who have different beliefs than those reinforced by the organizational culture.

I live in the Midwestern US and have personally heard people who are not religious speak negatively of hospice care because of the strong push against physician-assisted suicide (which can lead to extended suffering, or in some cases prolonged extension of the life of the body after brain death), and due to the involvement of "spiritual healing" in a non-scientific and one-size-fits-all manner. This article currently suggests that the only oppositions to hospice are "fear of [broaching] social taboo" and "professional callousness toward the terminally ill" (which sounds monstrous: it's hard to believe that exists, but perhaps in some parts of the world it does).

Are there still issues today with the religious orientation of hospice for people who don't share the hospice's belief system? I know there are still voices in hospice who campaign against physician-assisted suicide, so either way it seems like something that should be discussed here. However, I don't know any good places to find current information on this topic other than searching news articles to see if stories have been done (again, my ignorance is why I ended up on this article in the first place).TricksterWolf (talk) 18:31, 20 February 2015 (UTC)

Undue weight in opening paragraphs

The second paragraph deals exclusively with the position in the USA with a single sentence at the end referring to other countries. As the article makes clear, the Hospice movement has been in existence and active in many parts of the world and the US has come quite lately to the party. I made a (rather clumsy) move of the second paragraph to the USA section which has now been moved back. This seems to be giving undue weight to Hospice provision in the USA which is not merited by the history. Views would be welcomed  Velella  ^{Velella Talk}   22:09, 31 August 2015 (UTC)

The second paragraph deals with USA hospice in the opening sentence: "Within the United States". The second sentence explicitly does not, in fact contrasting with the words "Outside the United States". The third sentence also explicitly does not, beginning with the words " Outside the United State". Of the first three sentences, one third deal with the United States. What makes you think the fourth sentence is true only of the United States? (The fifth sentence, we agree, is multinational.) --Moonriddengirl ^(talk) 23:22, 31 August 2015 (UTC)

Locations

I learned that a hospice is actually a vocational center that specializes in health remedy for people feeling deathly ill. — Preceding unsigned comment added by 23.117.16.22 (talk) 14:34, 29 October 2016 (UTC)

Focus on hospice history?

It seems this article primarily covers the history of hospice in various countries but includes very little information on what hospice actually is. The "Hospice care in the United States" article is much more thorough, but it appears that article gets many fewer views. I am wondering if we could merge some of the information to make this article more complete. I have started the process by adding a "Philosophy" heading. Any thoughts/suggestions appreciated! Pattkait (talk) 16:15, 5 March 2020 (UTC)