Hospice care concentrates on alleviating symptoms, pain, and stress that come from a serious illness. It is specifically for patients who are in the terminal phase of their life, and no longer wish to seek aggressive or curative treatments. Hospice Care can be provided in a hospital, a nursing home, assisted living, a patient’s home, or any place that a patient may live. Hospice Care focuses on the whole patient – physically, emotionally, and spiritually. Paradigm Hospice Care focuses on the living, encouraging our patients and families to maximize and enjoy each and every day.
Hospice Care is:
- For persons who have a terminal prognosis of six months or less
- Dependent on prognosis
- Medicare Part A benefit
- An interdisciplinary team approach to care
- End-of-life care
Spirituality plays an integral role in the care of the terminally ill. Hospice philosophy promotes patient/family centered care that is palliative, holistic and interdisciplinary. Historically, spiritual care has been a major component of hospice care that is consistent with these values. Some issues related to the role of spirituality in medicine and hospice care include the difference between spirituality and religion, the patient-physician relationship, provision of spiritual care, and who provides this care. Guidelines for spiritual caregiving include self-knowledge of one’s own spiritual needs, authenticity and honesty and respect for the beliefs and practices of the patient and family.
Many times religion and spirituality are confused. Spirituality encompasses people who are religious and have connection to a faith tradition, as well as people who do not perceive themselves to be religious at all. A person can be both spiritual and religious. A person does not have to be religious, but still can have spiritual concerns. Religion can help spirituality. Having no religious belief does not necessarily exclude spiritual concerns.
Religion has to do with faith concerns, denominations, traditions, doctrines and rituals. Religious concerns can be Christian, Jewish, Muslim, Hindu, Buddhist, Taoist, Sufi, Kabbalistic or other expressions of religious institutions. In hospice, we are interested in the experience of the patient/family’s religious life, if that is important to them. We try to ascertain the patient’s level of participation in his/her religion, the significance of the faith community now, and if that community and clergy are meeting religious needs. If not, Paradigm Living Concept Hospice Care will be the bridge to bring the two together, or may, through spiritual counselors, try to help meet the religious needs. We offer traditional practices, such as reading scripture, prayer, rites of forgiveness and reconciliation, meditation and in Christian tradition, the Eucharist or Communion. What does the patient desire that might help them connect to God more closely? That is a question we are interested in and can help the patient experience the God they worship more fully and completely.
Spiritual care is a factor in the holistic care concept of Paradigm Living Concept Hospice Care. Some of the primary concerns of a dying patient are spiritual questions related to sense of purpose, the meaning of life, self-image and hope for the future. The knowledge that we will die soon demands us to explore our beliefs.
Consistent with all hospice concepts, spiritual care should give the patient the opportunity to assess and self-evaluate within a defined spiritual perspective; to investigate beliefs, not just take them for granted. Under no circumstances should a hospice chaplain bring his or her own salvation agenda to a patient’s bedside or in any way impose personal religious or denominational beliefs. Some of the spiritual needs we look for are:
- re-examining beliefs
- exploring beliefs of an afterlife
- reconciling life choices
- exploring one’s contributions and achievements
- examining loving relationships
- discovering meaning
- the need for fellowship and spiritual conversation
- prayer and meditation
- religious rituals, such as communion, confession scripture
The Paradigm Living Concept Hospice Chaplains are there to meet the spiritual needs of all hospice patients whatever their faith or belief stance. All persons have spiritual concerns when facing death. The hospice chaplain may, through encouragement, permission to express feelings, observation and feedback, and clarification of conceptual tools and meaningful symbols and images, help hospice patients explore their belief stance, personalize it and use it creatively to cope with living and dying.
Grief is a word that brings to mind sorrow and loss. But in reality, it’s so much more. Grief is a natural response to losing a loved one. It provides an opportunity to work through complicated feelings and learn how to live in a new way. Bereavement coincides with the imminent dying and death of the individual and consists of two stages: separation and mourning.
Separation occurs when the loved one’s consciousness diminishes and awareness of the environment vanishes. At this time, the family fully experiences their loss and the loneliness of separation. Self-absorption is the hurdle for the family to overcome now. Paradigm Livng Concept Hospice intervention is directed toward promoting intimacy, if family members are to be supported in their ability to grieve within their family network.
Mourning begins when the reality of impending death hits. The obstacle for the family to overcome here is guilt. Human grief is as strong and as unique as the relationship that has been severed. Grief is a personal experience, different for each member of a family who is grieving over the loss of the same person.
Paradigm Living Concept Hospice intervention is geared toward fostering relief expressed through mourning. The family members may have reached the limits of their own endurance and may initially confess relief that their loved one has died and that they remained with the person through that time. Echoes from previous losses may then surface, and this grief, if uncompleted, may hinder relief. The mourning process is relieved only when the deceased person enriches the continued family life.
Each person’s grief is distinct and individual. What makes your grieving process unique is the personal relationship you had with your loved one, the expressions of your individual feelings and thoughts, and possibly even your physical symptoms.
No matter what shape your grieving takes, you never have to go through it alone.
Turn to Paradigm Living Concepts Hospice Bereavement Services – Grieving is a continuous process that involves many changes over time. It takes longer than you expect, and may also take more energy than you imagined. You might experience physical symptoms, mood swings, and even guilt or anger. If You’ve lost someone close to you, your grieving can take many forms. You might find yourself asking questions such as these;
- Why do I feel so lost and alone?
- Why am I so angry?
- Am I losing control?
- When will these feelings end?
- Is there anyone I can talk with?
All of these feelings are normal and are indicators that you are making your way through the grieving process. Paradigm can help you journey through grief, and provide you with an understanding of the feelings and reactions you might expect and experience.
Your grief is personal, but you’re not alone.
Paradigm provides support and comfort to families and friends of patients. We’re here to guide you through your personal grief, and help you copy with your loss. Paradigm’s approach to hospice care creates a patient and family environment of hope, comfort, and dignity. This approach continues throughout the bereavement process, with services and counselors to help families heal.
Individual attention: Finding your path – Bereavement coordinators are available to assist you, whether you have concerns during your loved one’s illness or you are worried about the impact of the situation on you and your family.
Continuous contact – A caring relationship A bereavement coordinator, as part of your hospice team, will remain in contact with you for up to 13 months. Care is extended through phone calls, mailings of bereavement literature, support groups, and a memorial service. Your relationship with your coordinator is based entirely on your needs, and will change as you do.
The medical social worker in a hospice is a core member of the interdisciplinary team. Several essential roles comprise the responsibilities the social worker has to the patient, family, and co-workers:
Assessment: the MSW provides a complete and detailed assessment of the patient’s emotional, personal support, financial, and spiritual needs; assessment also includes family needs and the resources available to the patient and family.
Plan of Care: a thorough care plan is developed by the MSW and implemented with the goal of maximizing the patient’s ability to maintain quality and meaning in his or her life.
Education: the MSW participates in education with patient and family, covering appropriate topics for each of their needs. Education , but is not limited to, topics of hospice philosophy and operation; community resources; principles of grief; issues connected with death and dying; coping skills and techniques; symptoms of impending death; responses to pain and nutrition needs; roles of the hospice team.
Counseling: the MSW is a trained and licensed staff member who assists the patient and family with acceptance of terminal prognosis and course of illness and death; intercedes in the area of patient/family interpersonal issues and conflicts; facilitates anticipatory grief; assists patient and family with role changes and other adjustments brought by a terminal diagnosis; other issues that may be identified which impede the patient’s quality of life.
Assistance with concrete needs: part of the social worker’s role is to answer questions about community resources and to help the patient connect with appropriate supports. This includes assistance with obtaining financial support; health insurance; alternate care settings as needed; additional care in the home; funeral planning; completion of advance directives, such as Living Wills and Powers of Attorney; and obtaining information needed to complete other tasks important to the patient.
Advocacy: an important role for the MSW is to advocate on behalf of the patient and family to ensure that they obtain the assistance and care needed in order to accomplish the patient’s wishes regarding his or her course of illness and death.
Support: as a member of the interdisciplinary team, the social worker provides emotional support, facilitates a compassionate and non-judgmental environment around the patient, and offers a non-judgmental listening ear to the patient, family and co-workers.