All About Nursing · Blog Reading & Sharing · Hospice & Palliative Care

Hospice – Eligibility (Reading & Sharing)

Hospice is an all-encompassing service available for patients with a prognosis under 6 months. Under the Medicare hospice benefit, patients eligible for hospice are greater than 65 years or receiving Medicare disability payments. At the start of care, two physicians must sign a statement certifying that the patient’s life expectancy is six months or less based on their best estimate of the patient’s medical prognosis. While hospice benefit was originally designed for Medicare recipients, most insurance providers cover hospice care for patients not eligible for Medicare. But hospice eligibility depends on more than only a physician determining a prognosis of six months or less until death.

Continue reading “Hospice – Eligibility (Reading & Sharing)”
All About Nursing · Hospice & Palliative Care · Nursing Continue Education

Palliative Care (宁养服务)

Palliative care is available to acutely ill patients, may be provided along with disease-specific, life-prolonging treatment. Meticulous attention to be prevention and relief of pain and other burdensome symptoms is a basic part of quality palliative care. Yet, comprehensive palliative care includes much more. Psychosocial and spiritual care, counseling, and guidance in choosing among treatment options, and assisting with practical support for patients and caregivers are all equally fundamental components of comprehensive palliative care. It is critical to stress that palliative care should be provided from the time of diagnosis of a serious, debilitating, or life-limiting illness. Palliative care should be an integral part of healthcare aimed to achieve best possible outcomes including optimal quality of life, function, and opportunities for personal growth across the life span. Palliative care can and should be provided along with any disease-modifying treatments. And, yes, for some people with advanced illness, palliative care may be the main focus of care.

寧養服務適用於任何人——無論什麼年齡, 種族, 文化, 背景或宗教, 而且大多數服務是免費的。您可以在病情的任何階段使用寧養服務,這並不僅僅是為生命即將到達終點的人而設。使用寧養服務並不意味著生命沒有希望,您已經“放棄”或您的家庭不在乎您。您可以在接受寧養服務的同時繼續治療。

Continue reading “Palliative Care (宁养服务)”
All About Nursing · Hospice & Palliative Care

Determining Prognosis: Patients with End-Stage Cardiac Disease (Reading & Sharing)

The principles for determining when patients with end-stage cardiac disease require end-of-life care, are actually similar to those for determining prognosis of patients with advanced pulmonary disease.

Disabling Dyspnea or Chest Pain

  • Dyspnea or chest pain with rest or minimal exertion and can therefore classified as New York Heart Association class IV (NYHA class IV)
  • Ejection fraction less or equal 20%, if available
  • Persistent symptoms despite optimal medical management with vasodilators and dialectics, or
  • Inability to tolerate optimal medical management due to hypotension and/or renal failure
Continue reading “Determining Prognosis: Patients with End-Stage Cardiac Disease (Reading & Sharing)”
All About Nursing · Hospice & Palliative Care · Nursing Continue Education

Euthanasia- Good Death vs Killing on Request (Reading & Sharing)

The word euthanasia is combination of the Greek eu= good, and thanatos = death. Literally and etymologically it therefore means “good death”. Historically and scholarly, euthanasia in the strict- and in the Dutch context the only proper- sense refers to the situation in which a doctor kills a person who is suffering “unbearably” and “hopelessly” at the latter’s explicit request (usually by administering a lethal injection)… and euthanasia is in the Netherlands reserved for killing on request. In concrete terms, euthanasia invovles injecting the patient with two types of eubstances: barbiturates to induce coma, followed by neuromuscular blockers which cause respiratory muscle paralysis. The consequent anoxia and cardiac arrest bring on immediate death.

Continue reading “Euthanasia- Good Death vs Killing on Request (Reading & Sharing)”
Hospice & Palliative Care

End Stage Disease Progression and Complications – Oncologic Disorders (Learning Hospice)

  • Breast cancer is the most frequently diagnosed and is the leading cause of death from cancer in women worldwide.
  • Lung cancer is the most frequently diagnosed and the leading cause of death from cancer in men worldwide.
  • Cancer is the second most common cause of death in the United States following heart disease.

Cancer is characterized by uncontrolled growth and spread of abnormal of mutated cells that can be caused by external and internal factors. Mutated cells have certain characteristics as follows:

  • can avoid apoptosis (cell death)
  • resist normal aging process
  • can replicate outside normal controlling mechanisms
  • produce chemicals that dissolve surrounding tissue
  • invade other parts of the body
  • overcome the immune system
Continue reading “End Stage Disease Progression and Complications – Oncologic Disorders (Learning Hospice)”