The Hospice Handbook: A Complete Guide

by Larry Beresford

Overview

In recent years hospice care has gone from a little-known medical alternative to a major movement in health care. By emphasizing palliative care and pain management rather than curative treatment, hospices allow the terminally ill to spend the last days, week, or months of their lives in their own homes, cared for by their families under the supervision of a team of specially trained hospice workers that includes doctors, nurses, social workers, and volunteers. The Hospice Handbook assures us that the terminally ill do have options, and the quality of their lives can still be within their control.

Product Details

ISBN-13:	9780316091381
Publisher:	Little, Brown and Company
Publication date:	03/04/1993
Edition description:	1st ed
Pages:	192
Product dimensions:	5.50(w) x 8.25(h) x (d)

Table of Contents

	Foreword	ix
	Acknowledgments	xiii
	Introduction	xv
1	What Is Hospice Care?	3
	What Is a Hospice?	8
	Beverly	11
2	For Whom Is Hospice Intended?	13
	Requirements for Enrollment in Hospice	15
	Grace	24
3	The Services Provided by a Hospice	26
	The Hospice Team	31
	Diane	48
4	Additional Hospice Services	50
	Inpatient Care	50
	Hospice Bereavement Services	58
	Betty V.	62
5	The Referral Process: Making the First Call	64
	The Physician's Role in Hospice Referrals	68
	Linda	74
6	Hospice Providers, Coverage, and Access Issues	76
	Models of Hospice Programs	76
	Coverage for Hospice Care	84
	Questions Consumers Can Ask a Hospice	96
	Barriers to Hospice Access	101
	Beverly	106
7	Pain and Physical Realities	109
	Betty C.	116
8	Legal Issues	119
	Anna Walton	123
9	The Place for Hope in Hospice	125
10	Issues in the Future of Hospice	131
	High Tech and Hospice	133
	Hospice Care for People with AIDS	135
	Children and Hospice	143
	Afterword: What Does Choosing Hospice Really Mean?	147
	Appendix	151
	Notes on the Text and Suggestions for Further Reading	157

Editorial Reviews

Once way-stations run by religious orders to give respite to those on pilgrimages, today hospices provide care for dying people. Their philosophy of care is dedicated to the physical comfort and emotional support of the terminal patient. The hospice movement also affirms the idea that the patient deserves to be completely informed about his or her medical condition and treatment alternatives. Beresford, a San Francisco-based health policy writer, provides a complete, if somewhat dry, account of the hospice movement. But this is more than an intellectual discussion of a health-care policy; it also addresses practical questions. Beresford devotes the first two chapters to an explanation of hospice care and how to know when it is needed. In subsequent chapters he describes a typical hospice team (social worker, nurse, personal care aide and chaplain) and enumerates additional services, such as in-patient care. He explains the differences between community- and home health agency-based hospice programs and those that are based in hospitals or nursing homes. He also tackles insurance coverage, and his rundown of Medicare's hospice benefits is clear and concise (unlike most insurance forms). Finally, he reminds us that death, though inevitable, is rarely easy. His guide may make some of the tough decisions about choosing a hospice a little bit simpler. (Mar.)

Publishers Weekly - Publisher's Weekly

Quill created a stir in the medical community when he described in a New England Journal of Medicine article (later reprinted in Harper's ) how he prescribed barbiturates to a terminally ill cancer patient, knowing she planned to use them to take her life when her suffering became unbearable. In Death and Dignity , Quill discusses how the medical profession's emphasis on technology and ``life at all costs'' fails to acknowledge the suffering that accompanies terminal illness. He argues for a greater emphasis on ``comfort care'' and for giving power to the patient. Quill believes fewer patients would choose suicide as an escape if more efforts were spent on alleviating their suffering, both physical and emotional. He acknowledges, however, that comfort care has limitations and does not guarantee the elimination of suffering. Quill provides criteria for physician involvement in a patient's suicide. An important, thought-provoking addition to both medical and public library collections. The Hospice Handbook also looks at comfort care, but from a different perspective. While Beresford, a health policy writer who has covered hospice issues, would agree that the goal of comfort care is living life to the fullest, minimizing suffering, and facing death with dignity, he presents that goal with less emotion. He is more concerned with outlining the practical aspects of hospice care and presenting the services hospices can provide. Beresford's guide is designed to provide the information a person needs to make the decision of whether to use a hospice. Particularly helpful is his discussion of questions a consumer should ask the hospice, which might have been even more useful in list form as an appendix a person could photocopy to take to an interview. Also excellent is his thorough discussion of the financial aspects of a hospice. Recommended for popular medical collections.-- KellyJo Houtz Parish, Harrison Memorial Hosp., Bremerton, Wash.

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