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A Perspective on the end of life: Hospice Care.

A Perspective on the End of Life: Hospice Care Thomas J. Simms, RN, CHPN

The article provided an insightful look at the history of hospice. Although the origins of hospice are somewhat unclear, Simms said the actual term comes from the Latin word "hospis," which means "host and guest." The article is interesting and informative, especially for those who are not familiar with the concept of hospice. Those working in hospice may enjoy the historical perspective provided by Simms.

Simms described the chronological development of hospice from biblical times to the current. It is interesting to note that the hospice benefit became a permanent benefit under Medicare in 1985, 143 years after the first institution dedicated to the care of the dying was established in France by Mme. Jeanne Gamier.

By 2001, there were approximately 2283 Medicare-certified hospice agencies. These agencies cared for 579,801 patients. By 2004, there were 3,650 Medicare-certified hospice agencies caring for approximately 1,060,000 patients. The National Hospice and Palliative Care Organization (NHPCO) estimates "that for every patient who receives hospice, there is at least one more who could benefit from the comprehensive services available but who does not receive this special care," (Simms, 2007).

Simms discussed the services and benefits available for the patient and family under the Medicare hospice benefit. Medicare and NHPCO identify standards of care to ensure quality of hospice programs. Hospices can also seek accreditation by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) or the Community Health Accreditation Program (CHAP), which strive to maintain or improve the quality of these programs.

Simms identified barriers to the acceptance of Hospice care. He stated that people are reluctant to contemplate the end of life. In a 1999 survey by NHPCO, fewer than 1 in 4 Americans put their wishes for end-of-life care in writing. Another perceived barrier was a lack of knowledge of the Medicare benefits, which leads to confusion by both patients and providers. Simms argued that another barrier was the perception that electing hospice implied "giving up." Improving awareness and knowledge about Hospice is essential and Simms stated that the National Hospice Foundation has consistently shown that "almost 80% of Americans would prefer to die in their homes, free of pain, surrounded by family and loved ones." He accurately concluded that "Hospice can make this happen."

Simms, T.J. (2007). A perspective on end of life: Hospice Care. Retrieved on March 2, 2007 from http:// www.medscape.come/viewarticle/549702

summary review by Ruth Politi MSN RN
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Author:Politi, Ruth
Publication:Nevada RNformation
Geographic Code:1USA
Date:May 1, 2007
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