(Meldrum & Clark, 2000) Studies have indicated that the median duration of people availing hospice care is 30 days, which indicates that hospice merely makes living last days of life easier, where there is a lesser rate of hospitalization in the last 30 days of life for those who have enrolled in hospice care centers. (Christakis & Escarce, 1996) Some of the problems that Christakis & Escarce, identify in their paper are to do with the regulations, whereby, a patient relinquishes his right to receive medical treatment to prolong his life, if he or she signs up for hospice care
(Saito, Landrum, Neville, Ayanian, Weeks, & Earle, 2011) Another study further indicates that hospice care results in lower rates of hospitalization in the last 30 days of life. (Gozalo & Miller, 2007) This indicates that patients are able to die in a comfortable environment and are not subjected to painful treatments
It has to be noted here that hospice care can be given at specialized centers or can be at home, where in Japan, it was observed that caregivers, more than patients in home hospice care believed that they should be receiving care from day hospice centers. Among the studies conducted on the services provided by hospice centers it was noted that hospice centers that were larger had less restrictive admission policies for patients, (Lorenz, Asch, Rosenfeld, Liu, & Ettner, 2004) and were able to provide the full range of services including nursing care, physician care, medication management, psychosocial care, and caregiver support
Their efforts helped to culminate the awareness of inadequacies in the current systems. (Meldrum & Clark, 2000) In 1979, she worked with other experts in the field to publish her work 'Advances in Pain Research' where she used patient's drawings, some of which depicted being impaled by an iron, along with their case histories and research in order to develop her argument
Many patients and caregivers using home palliative care services need access to day hospices." (Miyashita, Misawa, Abe, Nakayama, Abe, & Kawa, 2008, p
Studies have shown that hospice care whether aggressive or non-aggressive can give comparable or better results compared to patients who are not enrolled in hospice care. (Saito, Landrum, Neville, Ayanian, Weeks, & Earle, 2011) Another study further indicates that hospice care results in lower rates of hospitalization in the last 30 days of life
However, according to a study, the changing policies, and the deregulation of the health services sector has made the offering of health services a commodity offering in competitive market where hospices compete with each other. (Ward & Gordon, 2006-2007, p
In a recent study by Abel, Pring, Rich, Malik, & Verne (2013), the authors conducted a "retrospective cohort study on deaths of all patients known to a hospice in a 2.5-year period to see if use of ACP affected actual place of death, hospital use and cost of hospital care in the last year" (Abel, Pring, Rich, Malik, & Verne, 2013, p
Although the studies researched in this paper reveal coordinated care management programs such as integration of early palliative care have revealed positive results, this study says these types of programs have not been successful. "Many care coordination and disease management programs designed to improve beneficiaries' care and reduce their need for hospitalizations have been tested, but few have been successful" (Brown, Peikes, Peterson, Schore, & Razafindrakoto, 2012, p
4) Goodman, Fisher, & Chang (2011), presented a report discussing the effectiveness of communities and hospitals in relation to care for seriously or terminally ill patients. They state: "Without high-quality care coordination, patients can bounce from home to the emergency room and back into the hospital, sometimes repeatedly" (Goodman, Fisher, & Chang, 2011, p
The article discusses how the perceived notionS of palliative care include the same as end-of-life care. But, it argues that "palliative care is focused on the relief of suffering, in all of its dimensions, throughout the course of a patient's illness" (Smith et al
In an article by Temel et al. (2010), they examine the effect of introducing: "palliative care early after diagnosis on patient-reported outcomes and end-of-life care among ambulatory patients with newly diagnosed disease" (Temel et al
Some literature serves the purpose of presenting statistics. Vitas Care shows on aveage the statistics for medicare patients: "1 in 5 Medicare patients re-admit within 30 days 1 in 3 Medicare patients re-admit within 90 days 14-17% general population re-admit within 30 days 30 day re-admissions cost Medicare $12-15 billion" (VITAS Innovative Hospice Care of Connecticut & Kinzbrunner, 2009, p
Whereas the restraining force is be the attitude of conformity to the norm, which can lead to refusal to the change being adopted. Secondly, the unwillingness to take risk also might hinder the implementation of change, doubled with the fear of the unknown (Marquis & Huston, 2006)
Financial and economic statements Hospices individually operate under a wide variety of financial models, including for-profit and not-for-profit systems. Most use "a managed-care model, with insurance companies providing per visit and per diem reimbursement" (Baxendale & Dornbusch 2000, p
Recently, the National Hospice and Palliative Care Organization survived what could have been a critical blow to its financial status. The American Recovery and Reinvestment Act of 2009 placed "a one-year moratorium on cuts in Medicare funding for the more than 4,700 hospice programs nationwide" (Perkins 2010)
Throughout a woman's life, her relationship with her mother, or mother figure, plays an extremely important role (Shaw, 2005). The death of such a person is a huge shock that affects each woman in a unique way (Carson, 2005)
D The main purpose of the group will focus on the women and their needs. It will provide them with a safe environment where they can work through the problems and issues arising from their bereavement (Ford-Martin, 1999)
Nonetheless, nobody can truly understand what women in this situation go through, unless they had been through it themselves. Daughters and mothers share a very particular and unique bond (Shaw, 2005)
The group leader could then set up a web presence for the group, where members log in online and share their thoughts whenever they feel the need. This would be greatly beneficial for the healing process, as group members can feel connected with the group and its support systems on a continuous basis (Tuck, 2005)