د فيصل الناصر - The hospice and its role in the community

The Hospice Care

Faisal Abdul-Latif Al-Nasir FPC,MICGP,FRCGP,FFPC,PhD Professor of Family Medicine

Ex-Vice PredidentArabian Gulf University

Who is OldWho is Old: >60 Years???: >60 Years???

طفل األربعين سن في اإلنسان طفل إن األربعين سن في اإلنسان … … إنمراهق الخمسين سن مراهق وفي الخمسين سن وفي

شاب الستين سن شاب وفي الستين سن وفي …… وجنة مخضرم شيخ السبعين سن …… وفي وجنة مخضرم شيخ السبعين سن وفي

خضراءخضراء

للبحـــرين السـكاني للبحـــرين الهرم السـكاني الهرم20502050 - - 20002000 – – 19501950للسنوات للسنوات

Population Pyramids, 2000

1950 2000 2050

60+

0-59Male Female

Age

Percentage Percentage Percentage

• Poor raw material

• Prevailing poverty

• Fast ageing in parallel with rapid social changes

– urban vs. rural ageing

– changes in family structure

– Epidemic in Africa such as AIDS

The reality in the developing world

The developed world The developed world became became richrich before it before it

became became oldold..

Developing countries Developing countries are becoming are becoming old old

before they become before they become richrich..

End of Life

Ageing is good for you – remember: there is only one alternative to it!

End of Life

Ageing is good for you – remember: there is only one alternative to it! DEATH

End of Life

Ageing is good for you – remember: there is only one alternative to it! DEATH

Every person is different, and the paths to death will vary.

Definition

The word "hospice" stems from the Latin word "hospitium" meaning guesthouse.

It was originally used to describe a place of shelter for weary and sick travelers returning from religious pilgrimages.

HistoryIn UKDuring the 1960's, Dr. Cicely Saunders, established St. Christopher's Hospice near London. St. Christopher's organized a team approach to professional care-giving, and was the first program to use modern pain management techniques to compassionately care for the dying.

In USAThe first hospice established in New Haven, Connecticut in 1974.Today there are more than 3,200 hospice caring for nearly 885,000 people (in 2002).

What is Hospice care?

Is the choice made to enhance life for a dying person.

Traditional care emphasizes the use of medical interventions, hospitalization and drugs to cure or control disease. It may involve aggressive and expensive high-tech medicine.

Hospice is an appropriate choice, when cure is possible and when cure is not possible. However, it is not the only choice.

-A special concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments.

-Hospice care neither prolongs life nor

hastens death.

What is Hospice?

-Hospice staff and volunteers offer a specialized knowledge of medical care, including pain management.

-The goal of care is to improve the quality of a patient's last days by offering comfort and dignity.

What is Hospice?

What is Hospice?

-Hospice care is provided by a team-oriented group of specially trained professionals, volunteers and family members.

-Hospice addresses all symptoms of a disease, with a special emphasis on controlling a patient's pain and discomfort.

What is Hospice?

-Hospice deals with the emotional, social and spiritual impact of the disease on the patient and the patient's family and friends.

-Hospice offers a variety of bereavement and counseling services to families before and after a patient's death.

Why Hospice?

It is important to die with dignity and peace

Why Hospice?

Hospice provides relief from pain.The physical pain arising from a terminal illness may be debilitating, frightening and dehumanizing. Hospice providers have the skills and resources to permit persons to live as pain-free, as comfortable, and as full a life as possible.

Why Hospice?

Hospice care focuses on maintaining patients' quality of life, as opposed to aggressively treating their illnesses.

Hospice provides support.Provides physical comfort of the dying person, also social and spiritual support for the patient and his or her family.

Who are the Patients?

•The are typically in their last six months of life.•Approximately 2/3 of hospice patients are over the age of 65. •Not only patients with cancer, but patients with pulmonary disease, heart disease, neurological disorders, Alzheimer's Disease, and AIDS.

Hospice Staff

Multi-disciplinary team consisting of: physicians, nurses, aides, social

workers, spiritual care givers, counselors, therapists and volunteers.

Trained volunteers are an integral part of hospice service. In USA Over 95,000 people volunteer for hospice annually. Volunteers provide over 5 million hours of care and service annually.

Staff Training

They are specially trained to provide medical assistance and to deal with the loneliness and fears experienced by both the patient and his or her loved ones.

The experience of caring for people at the end of their lives Can be very difficult. Seeing the suffering of the dying may cause feelings of helplessness and anticipation of future losses. Working with the dying can be exhausting because of the various emotions that are shared. Those who do this work with the dying must understand themselves as important and valuable individuals.

Staff Training

There is a great need for psychosocial and psychological death education for nursing home staff.

Staff Training

They works with the patient and his or her family to develop a personalized care plan. They respect patient wishes and help foster communication amongst family members

Hospice Goals

•Stages of Dying

•Problems associated with a terminal illness

•How caregivers can help the dying

•Grief/Bereavement issues

•Care for the caregivers

•Exercises, handouts

What to Expect Before Death The Dying Process: Physical and Psychological Symptoms 

Signs of Approaching Death Sometimes caregivers do not know how to tell when their patient or loved one is dying. But patients often tend to show specific symptoms when they are nearing death.

Emergency ProfileWhat rational decisions will need to be made in times of crisis. 

What to Expect After Death

GriefGrieve after lose of beloved. Every person's journey through grief is different.

Correspondence details and logistics After the death, loved ones will be faced with overwhelming logistical details and paperwork. The person(s) responsible for taking care of these details will need to correspond with appropriate organizations, institutions, and businesses to inform them of the death of the family member. 

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