The Movement of Hospice Care - Essay Example

Hospice care Hospice care has been one of the most fundamental developments in the in the history of nursing and palliative care and hospice can be comprehended as a kind of palliative care or a philosophy of care which is concerned with the analgesic treatment of the symptoms of a terminally ill patient. Therefore, the hospice care deals with the symptoms of a terminally ill patient which are physical, emotional, spiritual or social in nature. In a reflective analysis of the history of the hospice care, it becomes lucid that the concept of hospice as a place to treat the incurably ill has a long history of evolvement which dates back to the 11th century. Although the modern hospice care started in the 17th century, it was Dame Cicely Saunders who pioneered the foundational principles of the modern hospices in the 1950s. The movement of hospice care, which has met with several types of criticisms through its development, has enjoyed a rapid expansion in the UK, the US and several other nations. "Pioneered in England, hospice took root in the United States during the 1970s and was added as a benefit to the Medicare program in the early 1980s. Its origins lie in a grassroots movement that lay outside the medical mainstream and was informed by an ethic of compassion, dignity, and service. More or less self-consciously, hospice care was initially designed for people who were dying of cancer, and who had a functional family support system and a home where they could be cared for away from the high-tech hospital environment. Over time, the vision and the values of the hospice movement have developed and matured." (What Is Hospice Care 2003, p 6). The movement of hospice care has undergone development through various stages in the history of nursing and it is essential to compare and contrast nursing role, processes, etc during the twentieth century and early twenty first century. The various stages of the development of the hospice care include the periods 1920-1929, 1930-1945, 1946-1959, 1960-1975, and 1976 to present, and the nursing role, processes, etc in the hospice care has improved through these stages. In the health care industry, hospice has been a considerably newcomer, although the origins of hospice are in antiquity. The modern hospice care program has its origin in the mid-1960s in the founding of St Christopher's Hospice in England. The hospice movement has been significant development in health care industry as it has provided several strategies for the treatment of people who are no longer candidates for curative or rehabilitation services. "Traditions of kindness for sick and dying patients are to be found in all societies from antiquity. The beginning of the modern hospice movement is usually attributed to Dame Cicely Saunders, who founded St Christopher's Hospice in London in 1967. Two years later Elizabeth Kubbler Ross published her book, On Death and Dying, based on her experiences talking with dying patients in a Chicago hospital In 1953 the first advanced mammal, a dog named Knowsy (because he knew what was on the 'other side') was successfully resuscitated. Further advances in resuscitation and advanced life-support led to the propagation of cardiopulmonary resuscitation (CPR) and intensive care units during the early 1960s." (Hallenbeck, 2003, p 3). Therefore, the modern hospice movement has undergone vital improvements since its founding and the role of the nurses as well as the process of the care has gone through various stages. In a reflective analysis of the history of hospice care in the twentieth century, one realizes that there have been several developments in this nursing care with regard to the role of the nurses and the process of the care. Significantly, hospice can be comprehended as a philosophy of caring which respects and values the dignity and worth of every human being. Therefore, a good hospice care may be understood as the practical expression of the personal and professional commitment in the nursing care. Hospice care, which is meant for people approaching death, cherishes and emphasizes life, through its processes of helping patients to live each day to the fullest. In the early 1900s, St. Luke's Hospice and the Hospice of God were open to serve the destitute dying in London. In another development, the Irish Sisters of Charity open St. Joseph's Hospice in East London in 1905 in order to care for the sick and the dying. In the year 1935, there was growing interest "in the psychosocial aspects of dying and bereavement, sparked by the work of Worcester, Bowlby, Lindemann, Hinton, Kuber-Ross, Raphael, Worden and others." (Tomczak, 2004). During the period between 1957 and 1967, there was crucial development in the hospice care industry during which Cicely Saunders, a young physician previously trained as a nurse and a social worker, developed the most popular processes in the hospice care. While working at St. Joseph's Hospice and studying pain control in advanced cancer, Saunders pioneered in the regular use of opioid analgesics 'given by the clock' in place of waiting for the pain to return before giving drugs. This process has been adopted as the standard practice in good hospice and palliative care in the contemporary nursing care. In 1967, "Dr. Saunders opened St. Christopher's Hospice in London, emphasizing the multi-disciplinary approach to caring for the dying, the regular use of opioids to control physical pain, and careful attention to social, spiritual and psychological suffering to patients and families. [In 1968,] Many hospice and palliative care programs opened in Great Britain in the years following, adapting the St. Christopher's model to meet local needs, offering in-patient and home care." (Tomczak, 2004). Therefore the major advancements in the hospice care process have followed the contributions of Cicely Saunders. As opposed to the blind optimism to improve the health condition of aged and dying patients, the pioneers of hospice care, such as Cicely Saunders and Kbler-Ross, realized the relevance of caring the dying patients. They were remarkable in recognizing the mistake of the earlier health care practitioners who had the blind optimism to improve the health condition irrespective of their health condition. "It was easiest to recognize the mistake in considering those patients who were overtly dying, yet the power of belief in the cult of cure was (and still too often is) so strong that it denied the very existence of dying patients as a class of people. Deaths, if they occurred, were aberrations; in the cult of cure people did not die, they coded. Kbler-Ross wrote that the greatest barrier to her initial request to speak with dying patients in the hospital was a broad denial that such patients even existed." (Hallenbeck, 2003, p 4). Significantly, Cicely Saunders was convinced, through her experiences as a nurse, social worker, and physician, that dying patients were often neglected and ignored, suffering gratuitously for want of basic symptom management as well as attention. It is from this realization that the new social institution known as hospice was developed. In the contemporary healthcare practice, hospice care has become an inevitable branch of nursing practice and the role of the nurses as well as the processes of the care has improved considerably. Due to the works of several important practitioners in hospice care throughout the history, there have been advancements in the various aspects of the practice. "In the view of most practitioners today, hospice is not limited to any single disease or to any one set of life circumstances for its patients and families. Accordingly, hospice has been expanding in recent years to reach people dying of something other than cancer, who lack family support systems, and who live in institutional settings. Its growth and its capacity to assist dying patients and their families demonstrate the health care and human benefit hospice offers." (What Is Hospice Care 2003, p 6). Significantly, hospice care has become an essential component of standard of end of life care and an important part of accepted medical practice, although it is still a separate and distinct system in various ways. In conclusion, there have been vital advancements in the nursing role, processes, etc. in the hospice care. References Hallenbeck, James. (2003). Palliative care perspectives. New York: Oxford University Press US. p 3. Tomczak, John F. (2004). A Short History of Hospice and Palliative Care. Retrieved August 07, 2009. http://www.myseniorsite.ca/eldercare-tomczak27.htm "What Is Hospice Care (2003). The Hastings Center Report. 33. (2). p 6. Read More