Ida expressed a belief that hospice providers euthanize all their patients. Tim explains that hospice does not euthanize people. He goes on to explain that the overriding objective of hospice care is to develop a working partnership with the patient. Tim will help Mrs. Osmani in identifying any problems with her care and developing goals to address these care problems. Mrs. Osmani expresses concerns about the role of Dr. Frimet in her care. She says that she trusts Sandra and Tim, and although she wants to begin hospice care, she does not want to lose her physician-patient relationship with Dr. Frimet. Tim assures her that Dr. Frimet can remain her primary care physician, and Sandra explains that she will make frequent reports to Dr. Frimet, who will continue to provide medical orders for her care. At the end of the meeting, Tim schedules a meeting for Mrs. Osmani and Marina with the bereavement and spiritual counselor for next week. Sandra gives Marina a magnet with the hospice contact phone numbers, and Marina later places it on the refrigerator for easy access. Before leaving, they each schedule follow-up home visits and ask if Mrs. Osmani and Marina have any further questions. Questions 1. How did Dr. Frimet present hospice care to Mrs. Osmani? Why was hospice care a good choice for her? 2. What are the actions of the nurse and the social worker in explaining hospice services? Were their explanations helpful? 3. Were all of Mrs. Osmani’s concerns and emotions adequately addressed during this visit? 4. How could the social worker have better addressed the feelings and concerns of Mrs. Osmani and her caregiver? Responses 1. Dr. Frimet informed Mrs. Osmani that she has a limited life expectancy. He did not seem uncomfortable informing her of her terminal illness, and he did not neglect to explain hospice care as an alternative to her current treatment. Hospice can be offered to patients only when the attending physician determines that the patient has a time-limited Common Myths and Barriers Although hospice and palliative care allow patients the autonomy in dealing with their own illness, there are still misconceptions that contribute to fear and resistance. These misconceptions then cause barriers to care delivery (NHPCO, 2021). Many people consider hospice synonymous with death, giving up hope, euthanasia, or assisted suicide (Landers, 2017).
prognosis and curative care is no longer appropriate. During their initial meeting, the hospice nurse and social worker spent extensive time discussing hospice care with Mrs. Osmani and Marina, her caregiver Mrs. Osmani and Marina understands that hospice is not going to take over Mrs. Osmani’s care. Although an aide can come in several hours a week and a nurse will oversee the patient’s care, the primary responsibility of care remains with Marina. This is a good option for both Mrs. Osmani and Marina. 2. When Mrs. Osmani appeared worried about her home visits with hospice staff, Sandra took the time to alleviate any fears and explain in detail what services she would perform each week as Mrs. Osmani’s hospice nurse. This dialogue encouraged Mrs. Osmani’s trust in Sandra and the rest of the hospice team. When learning about Mrs. Osmani’s fear that patients under hospice care are euthanized, Tim, the hospice social worker, clearly explained that hospice does not euthanize patients. Mrs. Osmani seemed reassured by hearing that Tim’s role includes identifying any problems that Mrs. Osmani may have and helping to alleviate her suffering. 3. Although Tim recommended appropriate safety measures, he neglected to discuss Mrs. Osmani’s many losses. In fact, both Sandra and Tim failed to address Mrs. Osmani’s potential emotional concerns. Her husband and both children have died, she has lost many friends, and her best friend has Alzheimer’s disease. Clearly, she may have bereavement issues because of her losses. 4. Although it is not Tim’s primary job as the social worker to address bereavement issues, as an illustration, he could have taken the time to see how much of a concern Mrs. Osmani’s losses are to her and whether they are compounding any other losses she may be experiencing. Although he did recommend an initial visit with the bereavement and spiritual counselor, he did not take the time to discuss the counselor’s role. Because Marina cares deeply for Mrs. Osmani, her anticipatory grief needs should be examined as well.
Zimmermann and colleagues (2016) found when palliative care was introduced to patients, they reported feeling shock and fear, resistance to it, and a lack of relevance to them. The American Hospice Foundation (n.d.-a) identified common myths of hospice and palliative care that are listed in Table 4.
Table 4. Common Myths of Hospice Myth #1: Hospice is a place. Myth #2: Hospice is only for people with cancer.
False: Hospice is a philosophy, and hospice care takes place wherever the patient calls home. False: More than one-half of hospice patients have diagnoses other than cancer. Hospices serve many HIV/AIDS patients and patients at the end stages of chronic diseases such as COPD, Alzheimer’s, cardiovascular disease, and neuromuscular diseases. False: Although most hospice patients are older, hospices serve patients of all ages. Many hospices offer clinical staff with expertise in pediatric hospice care. Almost 20% of hospice patients are under 65 years of age. False: As a family-centered concept of care, hospice focuses as much on the grieving family as on the dying patient. Most hospices make their grief services available to the community at large, serving schools, churches, and the workplace. False: Recognizing that terminally ill people may live alone or with family members unable to provide care, many hospices coordinate community resources to make home care possible. Or they help to find an alternative location where the patient can safely receive care.
Myth #3: Hospice is only for old people.
Myth #4: Hospice is only for the dying person.
Myth #5: Hospice can help only when family members are available to provide care.
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