The Hospice journal
-
The Hospice journal · Jan 2000
Association between administrative and ownership characteristics of hospices and their proportion of inpatient deaths.
Hospice patients are more likely to die at home than patients involved in conventional medical care, but the proportion of home deaths varies between programs. A study of the effect of hospice administrative characteristics on inpatient death rates is presented. ⋯ This difference was explained by the presence of dedicated inpatient hospice units: Programs with such units demonstrated higher inpatient death rates than those without (42% versus 11%; P < .00001). Though not necessarily causal, these associations should be of interest to patients, physicians, families, and policy-makers.
-
The Hospice journal · Jan 1999
Review Case ReportsBalancing the focus: art and music therapy for pain control and symptom management in hospice care.
Pain and symptom management are a major part of hospice care. Literature and direct experience suggest that pain can be resistant if psychological, emotional, or spiritual issues are not addressed. ⋯ Brief clinical examples demonstrate the use of art and music therapies for pain reduction with a variety of hospice patients. Information regarding appropriate education and training necessary for art and music therapists to practice in their field is presented.
-
In the twenty years since the National Hospice Organization began, hospice has grown tremendously. However, it still only serves a small percentage of terminally ill patients. ⋯ These barriers to care include societal attitudes towards death, diversity issues, socioeconomic issues, and eligibility issues. In order to develop and serve more of the population, hospice agencies must be flexible, creative, and use ingenuity to bridge the gaps that occur for some terminally ill patients.
-
The Hospice journal · Jan 1999
Clinical TrialLong-term patterns of morphine dosage and pain intensity among cancer patients.
Cancer pain remains a worldwide problem and some patients continue to be undermedicated because of concerns about tolerance and drug dependence. The aim of this study was to document the morphine intake of patients with chronic cancer pain in an inpatient palliative care unit and to describe the long-term pattern of morphine use and pain intensity in this patient population. With IRB approval and written informed consent, patients admitted over a 64-week period to the palliative care unit at the Royal Victoria Hospital, Montreal, were candidates for this study. ⋯ Three of 17 patients spent more than four months in the unit and had less than good pain control. All of these patients had neuropathic cancer pain. These results support the conclusion that pain was well controlled for most cancer patients, and that increases in daily morphine dose, when it occurred, generally developed over a period of weeks to months, and a pattern of rapid escalation in morphine dose did not occur.
-
The National Hospice Organization grew out of efforts by the founders of the earliest hospice programs in the United States to protect their emotional investments in hospice care, to advocate for hospice interests in Congress and other public policy forums, to define standards for the fledgling movement, and to provide education on the nuts and bolts of running hospice programs for others who were interested in starting hospices in communities from coast to coast. Unlike the model of St. ⋯ S. hospices started as home care-based programs, often largely manned by volunteers. Among the crucial issues that have dominated the work of NHO during its first 21 years were passage and maintenance of the Medicare hospice benefit, ideological battles over the hospice philosophy, and efforts to extend hospice care to other populations, such as people with AIDS.