The Hospice journal
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The establishment of the first Department of Pain Medicine and Palliative Care in a Medical Center in the United States is noteworthy. Since the design of the Department integrates a full-functioning hospice program within it, that has both a dedicated inpatient unit and extensive home care program, this Department represents a milestone in the development of the hospice movement, with full interrelationship between palliative care and hospice care. This paper will explore this interrelationship, its implications, and some of the background.
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The Hospice journal · Jan 1998
ReviewPain and the barriers to its relief at the end of life: a lesson for improving end of life health care.
Pain among cancer patients is a common distressing symptom that frequently affects physical functioning, social interaction, psychological status, and quality of life. Despite the extensive body of knowledge available regarding cancer pain assessment and management, it often remains untreated, thereby diminishing the quality of patient care at the end of life. Recommendations on how to remove these barriers, as well as to improve care of the dying in general, need to be implemented by the U. S. government.
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The Hospice journal · Jan 1998
Overview on ABIM End-of-Life Patient Care Project: caring for the dying: identification and promotion of physician competency.
The American Board of Internal Medicine's project to improve end-of-life care was initiated in response to lack of attention given to death and dying in the United States. The project focuses mainly on physician competency in residency and fellowship training. With this data, recommendations can be made to improve physician training in end-of-life care treatment.
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The Hospice journal · Jan 1998
Issues in prison hospice: toward a model for the delivery of hospice care in a correctional setting.
This paper examines issues in prison hospice care based on the author's nine years experience as a prison hospice worker and trainer and on data gathered by the National Prison Hospice Association (NPHA) from a number of federal and state prison medical facilities with operational or developing hospice programs, including both scatter-bed and hospice unit models, employing inmate hospice volunteers and the services of outside community hospice agencies and volunteers. The paper discusses DNR orders and curative vs. palliative care decisions, pain management, AIDS care, interdisciplinary care teams, staff and volunteer training and supervision, and the need for compassionate early release and community placement programs. The author proposes a set of preliminary guidelines for the delivery of hospice care in the correctional setting.
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As the concept of hospice has evolved in the United States, it has become apparent that there is a significant need for increased physician participation in all aspects of the care of terminally ill patients provided by hospice programs. Four distinct physician roles have emerged: the attending physician, the consulting physician, the hospice medical director, and the hospice team physician. As the roles of the hospice medical director and team physician have become better defined, many physicians are finding that palliative medicine and full time hospice employment is a rewarding career option. The increased involvement of physicians in all aspects of hospice and palliative care will result in measurable improvement in the quality of patient care that hospice programs provide to terminally ill patients and families.