Most people are always reluctant to mention hospice care and keep it secret.
If a person’s health problem is so serious that he needs hospice care, it is really not something what should celebrate. But Jon Radulovic, spokesman for the National Organization for Hospice and Palliative Care in the United States, said: “Hospice care is not to give up, but to let patients live as well as possible with the disease.”
Hospice care originated in Britain and the United States.
The term hospice originated in the Middle Ages and was originally intended as a shelter for tired or sick travelers, but the modern usage of the word originated from 1948 when a doctor named Dame Cicely Saunders opened the St. Christopher hospice clinic in suburban London.
Twenty years later, Saunders introduced hospice care to the United States while giving lectures at Yale College of Nursing. Hospice care attracted the attention of Florence Wald, dean of Yale College of Nursing, who flew to London to learn about hospice care. In 1974, Wald opened the first hospice care program in the United States in Branford, Connecticut, and quickly spread to other parts of the United States.
Since the first hospice program in the United States was launched in 1974, the number of hospice programs has been increasing, reaching 5,800 in 2013. Patients can find nearby programs through various channels.
Hospice programs are everywhere. Perhaps every community, even in remote areas, can provide this service.
Hospice care in the United States and Africa focuses on family services.
In the United States, hospice programs often go deep into families, while in other countries, especially Europe, programs are often carried out in hospitals or other medical institutions, such as St. Christopher hospice in London. The reason may be that professional institutions are more convenient to implement treatment than patients’ homes. The hospice care model in the United States is to really go deep into patients’ places.
Some countries routinely do hospice care at home, such as the United States. According to the survey, 70% of Americans prefer to live at home at the end of their lives. In sub-Saharan African countries, hospice care programs are also conducted at patients’ homes, largely due to the lack of sufficient medical institutions to accommodate patients.
Hospice services in the United States rely on volunteer participation.
Another difference between the United States and other countries is that 5% of hospice services must be provided by trained volunteers. The rest is done by teams of nurses, doctors, social workers, therapists and many other medical professionals.
Volunteers and patients may not do clinically related things when they are together, but they will read books or provide companionship to patients and also give family members a chance to rest.
5% of hospice care services provided by volunteers are required by the US Free Medical Guidelines and are applicable to all hospice care programs paid by free medical care. Volunteer-driven is the source of hospice care in the United States.
Hospice Care Helps Patients Relieve Pain
Hospice teams give priority to relieving patients’ pain, and doctors and nurses are responsible for prescribing painkillers for patients. Hospice care does not involve prolonging life or accelerating death. Radulovic said, “For hospice care, you must realize that curing diseases is impossible, but any treatment that can relieve pain is also very difficult.”
Hospice care can help people at the end of their illness.
Hospice care services can be provided to anyone who suffers from incurable diseases and has a survival period of not more than 6 months without using life-prolonging drugs.
In the early 1970s, Most hospice programs serve cancer patients, Today, the majority (64%) are not cancer patients, but suffer from other end-stage diseases, such as Alzheimer’s disease, heart disease, lung disease or other life-threatening diseases. Hospice care services cover patients of all ages, and doctors confirm that patients meet the requirements of hospice care. Hospice care itself does not set limits on service hours.
If the patient survives for more than the expected six months, they can still receive hospice care. As long as they are still suffering from end-stage diseases, they can receive hospice care when their life expectancy does not exceed six months. However, if the patient’s condition improves, the patient may no longer be eligible for hospice care.
Patients receive hospice care services free of charge.
Most hospice care services are usually completely free and paid for by Medicare, Medicaid or private insurance companies. For a small number of Americans without medical insurance, most programs will not close the door to patients. For patients without medical insurance, these programs are paid for by social charities.
Hospice care programs provide help to patients’ families and friends.
Hospice care is different from other palliative care programs. In addition to caring for the patient himself, hospice care also cares for the patient’s family, friends and other people who care for the patient, providing them with support, consultation, comfort and education.
After the death of the patient, hospice care continues in the form of counseling services. Whether it is psychological problems or family problems, the hospice care team will continue to provide support and help.
Present Situation of Hospice Care in China
Since the 1990s, some general hospitals in big cities across the country have explored and set up hospice care wards, and have tried to set up hospice care wards in tumor hospitals. According to incomplete statistics, there are about 200 different types of hospice care institutions in cities in China, with nearly 10,000 medical personnel engaged in hospice care. [1]
According to a survey conducted by the China Life Care Association, Most hospice care institutions are located in large cities, and some hospice care institutions in medium-sized cities, small cities, villages and towns and rural areas are almost blank. The vast majority of hospice care institutions belong to the health system. Hospice care institutions organized by affiliated hospitals of colleges and universities have obvious advantages of integrating teaching, learning and research. A small number of hospice care institutions organized by community health service centers [1]
Responsible Editor: Ji Lingyan