Throughout history, a hospice has been
a location dedicated to providing lodging and care to the ill and the
destitute, as well as to pilgrims and travelers. In general, hospices were
maintained by monastic orders that would ensure that these visitors were
adequately cared for. In 1967, Dr. Cicely Saunders adopted the term to describe
a facility in which terminally ill patients could receive palliative care and
comfort during their last weeks.

The first hospice, St. Christopher’s Hospice,
was established by Dr. Saunders in London. Since the creation of these palliative
care facilities, countries throughout the world have begun to offer hospice
care to dying individuals. Today, the place or central location in which the
care is administered is no longer the fundamental aspect of hospice care.
Instead, hospice refers to the nature of the care and palliative treatment
conducted by doctors, nurses, and volunteers.

Unlike aggressive treatment intended to cure fatal but reversible diseases, hospice
care seeks to comfort individuals with terminal diseases during their final weeks of life. Hospice
care providers acknowledge that dying is a natural and necessary part of life.

The most important aspect of this process is to minimize suffering and ensure
that a patient is as comfortable as possible. This form of palliative care does
not seek to quicken or postpone death. It simply assists in preparing
individuals and families for death with the hope of minimal suffering for the
patient.

The large majority of individuals that seek hospice care are suffering
from cancer. However, a hospice will provide care to an individual of any age
no matter what type of illness he/she is suffering from. This type of palliative
care is beneficial for individuals who wish to spend their final weeks in their
own home, or in a comfortable, homelike environment.

Though some hospices are
established and funded by specific religious denominations, they may offer care
to a large community and would not refuse care due to a patient’s religious
beliefs. 

In most cases, discussing end-of-life care is difficult for both a patient and
his/her family. However, in instances of terminal illness, aggressive treatment
options generally prolong suffering and increase pain. Hospice care can provide
both patients and families with comfort and support through the process of
death. A patient may wish to speak with friends, doctors and clergymen about palliative
care. Most health insurance providers cover hospice care, including private insurance companies, Medicare, and Medicaid in the majority of states.

A hospice will
help an individual to determine whether or not he/she is eligible for
palliative care coverage. In the event that an individual’s insurance does not
cover hospice care, and he/she can not afford this care, a hospice may provide
care to him/her utilizing supplemental foundation funds.

When people imagine a hospice, they generally conjure
images of elderly patients suffering from terminal diseases. However, the elderly are not the only people
who are at risk for terminal illnesses, and therefore, are not the only
patients who can be found at hospices. Thousands of children throughout the
United States suffer from terminal illnesses.

In order to address the care and
comfort of these children, children’s hospices have been established. Children’s
hospices specifically cater to the needs of children that are facing death in
the coming months. They also offer respite care and grief counseling in order
to assist families. The children found in children’s hospices are suffering
from incurable diseases, such as cystic fibrosis or cancer, including leukemia,
brain cancer, and osteosarcoma.

These patients have not responded to
treatments, and further attempts at treatment would only increase pain and
prolong suffering, not cure the illness. Once a child is diagnosed with a
terminal illness, it is common for families to consider children’s hospices,
where the patients will have access to continuous medical attention and
beneficial hospice programs.

When a child is diagnosed with a terminal illness it is often devastating for a
family. The family may attempt to provide care for the child at home. However,
this can require constant attention and care twenty-four hours a day, seven
days a week. This is physically, emotionally, and financially exhausting for a
family. The responsibility of caring for a sick child may cause extensive
stress and anxiety, creating yet new tensions within the family.

In order to
decrease the discord present in the child’s environment, a family may decide to
consider hospice programs. Like at a hospice facilities for adults, the responsibility of addressing
the care and comfort of patients in children’s hospices will fall to medical
professionals. Doctors and nurses will administer medication to reduce pain,
constantly monitor a child’s condition, and ensure that a patient remains
comfortable.

At a hospice, a child will have access to emotionally beneficial hospice
programs, such as play therapy, music therapy, and art therapy. There are also hospice
programs that arrange activities between siblings so that they are able to
spend quality time together.

Hospice programs provide terminally ill children with beneficial services,
especially children too young to understand the concepts of life and death.
They may question what they did wrong to deserve their fate. Placing them in a
hospice will allow them to communicate with other children who are experiencing
similar situations.

This may help to negate the sense of isolation and
seclusion that is often faced by terminally ill children. Because hospice
doctors and nurses assume the responsibility of caring for patients, families
will have the opportunity to spend quality time with a child without having to
maintain the role of caregivers. This will provide them with the opportunity to
simply enjoy the time that they have left with their child. 

When an individual is diagnosed with a
terminal illness, he/she has the option of obtaining hospice care. In many
instances, an individual and his/her family decides that it is best for him/her
to enter a hospice facility. At a hospice, a patient has continuous
access to medical attention should the need arise. The medical staff employed
at a hospice can ensure that a patient remains comfortable and can administer
medication to reduce pain.

The services that are offered at hospices often make
these facilities an attractive choice for patients. However, this does not mean
that this option is appropriate for all individuals. While there are many
benefits to hospice facilities for both patients and their families, some
individuals simply can not stomach the idea of remaining in a hospice for their
final weeks.

Many individuals would much rather remain in the comfort of their
own home. In some cases, this simply is not possible. Nevertheless, if a
patient adamantly desires to remain at home, then his/her family should do
everything in their power to fulfill this desire.

Home hospice care can be very taxing on a family. Home caregivers are required
to devote a great deal of time, energy, and dedication to the care of a loved
one. Caring for a terminally ill individual is very physically and emotionally
draining process. Often, terminally ill individuals require constant
supervision. Their condition must be monitored regularly so that any changes
can be addressed. Home caregivers must ensure that a dying individual is
receiving constant attention. A home hospice aide will educate a family about
the proper way to care for their loved one.

They will be provided with effective
medication and will be taught how to administer this medication in the event
that it is necessary to reduce pain. A home hospice aide will also inform a
family about the various symptoms that present themselves as a given condition
progresses.

In short, all inquiries and aspects of patient care will be
addressed by a home hospice aide, in order to ensure that home caregivers are
comfortable caring for their loved one. Home hospices aides will make frequent
visits to the home to assist in the care of the patient.

Despite the assistance offered by home hospice aides, many home caregivers
continue to find home care very difficult. This is often due to a patient’s
inability to move or function effectively on his or her own. Often, individuals
who require hospice care are elderly and have difficulty completing regular
activities. They need assistance in all daily routines, including bathing,
using the bathroom, and eating. This can be physically exhausting for home
caregivers.

The emotional effects of caring for a dying individual are often
much more painful than the physical effects. In most cases, home caregivers are
loving family members of the patient. It may therefore be very difficult for an
individual to watch a loved one deteriorate and suffer. However, allowing a
patient to spend his/her remaining time in the comfort of his/her home may be
important to the patient. Knowing that he/she has fulfilled the desire of
his/her loved one may be helpful for a caregiver.

In many cases, a terminally ill
individual will request to spend his/her remaining time in his/her own home.
Indeed, it is common for hospice patients to shun the idea of entering into a
facility or a hospital. In instances such as these, the family of a dying
individual will be required to take on the care of the patient.

Hospices will
offer home hospice services to patients who choose to remain in
their own home and their families. However, some patients are not comfortable
with the idea of dying in their homes. They may feel that this will be too
difficult on their family. Otherwise, a patient may not want his/her family to
assume the caregiver role.

In these cases, terminally ill individuals may
choose to enter hospices. Hospices provide dying individuals with a secure and
comfortable location to spend their final months. These facilities can be found
in most major cities. In smaller or more rural communities, hospice patients may
be relocated to hospitals or nursing homes in order to receive extended
treatment from hospice caregivers. Hospices offer numerous advantages to hospice
patients and their families.

When terminally ill individuals choose to enter hospices, they have access to
essential and beneficial medical care at all times. If their symptoms worsen, a
doctor or a nurse will be available to administer medication that will diminish
any pain the patient is experiencing. While in a facility, hospice patients
have access to services aimed at
ensuring their comfort, including therapy, counseling, and spiritual guidance.

A physical therapist will often be on hand to assist hospice patients in
remaining mobile. A patient will also have the ability to socialize with
individuals experiencing similar situations. A terminally ill individual often
feels isolated from his/her family, as they have not experienced the fear and
anxiety that he/she is now facing, and this likely only to intensify in a paid
facility. However, the ability to communicate with other terminally ill
individuals about their feelings and experiences may help to provide a patient
with some measure of relief and comfort.

When an individual enters a hospice facility, doctors and nurses become
responsible for his/her care. Therefore, it is important for a family to ensure
that a facility employs a medical staff that can more than adequately address
the needs of their loved one. If it does not, the needs of the patients may go
unmet.

In many cases, there are multiple hospice facilities within the same
city. Before an individual enters into a hospice, he/she and his/her family
should visit more than one location. One facility may have a more effective
staff than another, or more suitable services to address the needs of certain
patients. If a family locates a facility that they are comfortable with, this
will allow them to continue spending time with their loved one without having to
assume the role of caregivers.  

As much as most skilled nursing facilities emphasize a “homey” environment in their operations and treatment of residents, they are still are offering semi-public services to those with the means to be housed in such places. As such, they are bound, much as all businesses are, to sets of standards at both the state and federal level.

Regarding whether nursing home laws are primarily a manifestation of state or federal laws, really, both jurisdictions exert a great deal of influence on the consistent approval of facilities. State health departments use in-person visits as their main instrument to gauge nursing homes’ accordance with nursing home law.

At least once a year, state surveyors will occupy skilled nursing facilities for their compliance with upwards of 100 different nursing and building operation codes, including the preparation of food according to standards of cleanliness and correctness as far as meeting the nutritional needs of individual residents goes, the safe storage of medical and non-medical supplies, non-restrictive protection of patient safety, and the general attitude of the staff and residents. As noted elsewhere, neglecting one or more of these areas may force the assessment of fines, additional reviews by surveyors, recommendations to cut federal funding, and takeovers by agents of the state.

As for federal nursing home laws to be met, again, compliance with benchmarks for Medicare and Medicaid receipt are not to be overlooked. One particular condition for the continued allocation of Social Security Act funds is the completion of what is known as the Minimum Data Set (MDS) instrument, authorized and reviewed by the Center for Medicare and Medicaid Services (CMS), itself governed by the U.S. Department of Health and Human Services (DHHS).

The MDS is an assessment tool that gauges how well residents/patients are performing in terms of their physical health and overall well-being. According to nursing home law, minimum data sets must be filled out for all residents within a facility, and accurately, at that. It goes without saying that other nursing home laws may not be violated in the act of completion, namely that of an individual’s right to privacy in matters of his or her medical history.

Aside from the CMS and state health bureaus, other organizations have an interest in upholding the nursing home laws of the United States. One group in particular that exerts a sizable influence on applications of nursing home law in this country is the American Health Care Association.

AHCA, as it is known for short, is a non-profit, nationwide coalition of health care providers that advocates on behalf of all long-term residents in nursing facilities to get the highest quality of care possible, directly exerting pressure on Congress to amend nursing home laws along the lines of these pursuits. Meanwhile, the Joint Commission on Accreditation of Health Care Organizations serves as an additional watchdog on nursing homes and like facilities to insure that they are offering the best care for the greatest value possible.