Southern Luzon State University

College of Allied Medicine

Lucban, Quezon

Honeylee B. Pumarada HCN00 Hospice Care Nursing

BSN - 4A Prelim - Activity 1

HOSPICE CARE

Definition

Hospice care is for people who are nearing the end of life. The services are provided by a team of health
care professionals who maximize comfort for a person who is terminally ill by reducing pain and
addressing physical, psychological, social and spiritual needs.

Terminologies

 Advance care planning—making plans about the care you would want if you could no longer
speak for yourself while you are healthy enough to consider options, make choices and discuss
with your family; making a living will and naming a healthcare surrogate are part of advance
care planning
 Advance directive—a document that describes the healthcare you would and would not want if
you were seriously ill and unable to speak for yourself
 Anticipatory grief—mourning the death of a loved one before that person has died, common
when the patient is terminally ill
 Bereavement—grief following the death of a loved one
 Care transition—a change in a patient’s care, from hospital to home, for example, or from one
team of doctors to another, or from curative care to hospice care. Transitions are difficult for the
patient and require planning, communication and careful monitoring
 Chaplain—a clergy or lay person employed by a secular organization: a college, military branch,
prison, hospice or hospital, police or fire department, etc. A chaplain ministers to those of any
religious belief, and of no religious belief
 DNR—a do not resuscitate (DNR) order is written by a physician at the request of a terminally ill
patient and placed in the patient’s records. It instructs medical staff not to revive the patient if
their breathing or heartbeat stops

Hospice vs. Palliative

While the objective of both hospice and palliative care is pain and symptom relief, the prognosis and
goals of care tend to be different. Hospice is comfort care without curative intent; the patient no longer
has curative options or has chosen not to pursue treatment because the side effects outweigh the
benefits. Palliative care is comfort care with or without curative intent.
Hospice care is compassionate comfort care (as opposed to curative care) for people facing a terminal
illness with a prognosis of six months or less, based on their physician’s estimate if the disease runs its
course as expected.

While palliative care is compassionate comfort care that provides relief from the symptoms and physical
and mental stress of a serious or life-limiting illness. Palliative care can be pursued at diagnosis, during
curative treatment and follow-up, and at the end of life.

Trends

In present time many studies saw a significant uptick in technology adoption such as hospice software,
instant video chat technology and hospice management suites - designed to streamline operations and
ensure compliance. As Hospice News points out, effective technology deployment can help optimize IDG
teams across disparate locations, improve communication between families and caregivers and reduce
hospice staff burnout by centralizing and digitizing document input and management responsibilities.

MODULE 1 EVALUATION

1. Role of a Nurse in Hospice Care

• Collaborate with physicians and other professionals to plan care

• Make frequent visits to the patient to evaluate their condition
• Provide support and comfort according to individual patient’s needs
• Work with caregivers to plan and execute excellent patient care
• Help in administering medication
• Alleviate sudden symptoms of the disease’s end phase
• Notify a doctor for a patient’s condition when deemed necessary
• Assist patients and their families with paperwork
• Maintain accurate records
• Help relatives cope with the upcoming loss and provide post-mortem support
• Be an advocate for the patient.
• Provide good and peaceful death.

2. Identify the areas that require competencies

1. Patient care: life-limiting conditions in adult patients

2. Pain management
3. Symptom management
4. Patient and Family Care, Education and Advocacy
5. Practice issues

3. How is the communication during patient transition. Tools used.

A common communication tool should be utilized to help patients transition smoothly, such as when
moving from a home setting to an inpatient one or when they pass away. The military created SBAR as a
mechanism to standardize reports and break down communication obstacles. It is currently commonly
utilized in healthcare settings to convey all of the patient's significant data.

SBAR PROCEDURE

SBAR can be written or provided verbally, but the purpose is to provide essential, concise information,
usually during crucial situations.

Situation

In this initial section, the exact circumstances of the situation get explained. Non-essential information is
excluded. The focus should be on the seriousness of the situation.

Background

The background section presents essential information related to the situation. This information should
pertain only to the current situation.

Assessment

The assessment is a precise statement based on the situation and background information. The
assessment must be made by a qualified staff person.

Recommendation

The qualified staff person makes a recommendation for resolving the issue based on the situation,
background, and assessment.

4. Discuss the conflict management.

When a team approaches clinical problems with divergent aims, values, duties, or needs, conflict is likely
to result. Team members may believe their opinions are irrelevant when the aims are different. Conflict
can be exacerbated by cultural variations, conflict expression methods, reactions to actual or perceived
conflict, and conflict resolution strategies. Conflicts can be managed and resolved if team members are
able to: 1. Communicate openly and honestly 2. Use direct rather than indirect communication 3.
Maintain focus on the issue at hand 4. Control their emotions 5. Engage in problem solving rather than
arguing 6. Listen to each other and 7. Convey sincere understanding of the other person’s position.

Good conflict management promotes innovation and growth, enhanced group performance and
decision-making, and teamwork among all members. Burnout, job discontent, strained interpersonal
and group relationships, a lack of constant communication, distrust and suspicion, decreased job
performance, and resistance can all result from a failure to manage conflict properly.

All team members should make an effort to have productive conversations while also being mindful of
conflict triggers. Positive conflict resolution techniques should be applied to resolve conflicts and refocus
attention on patient care. To promote high-quality end-of-life care within the team, the nurse manages
the plan of care and aids in good communication.

References:

https://www.vitas.com/hospice-and-palliative-care-basics/about-hospice-care

https://www.nethealth.com/year-in-review-exploring-top-hospice-trends-in-2021/