Skim Reading

Take five minutes to skim-read the following selection and to take notes on it. Then see if you can answer the questions that follow by referring to your notes but not referring back to the text.

The hospice program is a fairly new method of caring for the dying. While there is no solid definition of hospice, it is generally considered a program with two objectives. The first objective is to keep patients free from pain on a continuous basis. The second objective is to provide the dying with a homelike atmosphere in which to spend their final days.

Hospices reach their goals through one of several approaches. Some hospices work on an outpatient basis and thus have no physical facility from which to work. Outpatient hospices depend on team efforts of professionals from several institutions. An outpatient team could consist of a member of the clergy, social workers, nurses, doctors, and psychologists. A second approach some hospices have adopted is to work on an inpatient basis, using a building that is set up to have a homelike atmosphere. These buildings include some sort of sleeping quarters, eating facilities, and lounges or some other recreational area. In these inpatient facilities, the patients decide when to eat, sleep, and relax. Still other hospices use a combination of inpatient and outpatient services. Services are provided in the home when possible and in the hospice facility when necessary.

Even if a hospice operates only on an inpatient basis, it still differs from hospitals and nursing homes. Hospices differ from other health care facilities in four major ways. First, there is a lack of scheduling and structure in hospices. For one thing, there are no time schedules (with the exception of medication schedules) forced on hospice patients. This means open-ended visiting hours, mealtimes, bedtimes, and so on. Patients can adjust more easily to their condition if they are allowed to live by their own life patterns in the "no-schedule" atmosphere. Lack of structure means something else too: no restrictions on diet or activity. If a patient wants to have a favorite dessert at every meal or if a visitor brings a patient a special snack, the patient is allowed to have the food. If patients desire to try a strenuous activity one day and the activity tires them out so much that they must spend the next day in bed, so be it. The patient's schedule is what he or she wants it to be.

Another aspect of hospices that differs from other care facilities is that the facility personnel concentrate solely on the patient and don't become involved in side activities such as research and teaching. Patients' psychological needs, for example, are a main concern to hospice personnel. If a patient needs to talk over his or her feelings with someone in the middle of the night, personnel are there to listen. Personnel have time to be with patients because they have no other duties to distract or detain them.

View of pain control is another aspect of hospice care that sets it apart from care in hospitals and other facilities. In traditional health care institutions, patients may be expected to bear pain until it is unbearable. In hospices, patients are given medication as often as necessary to keep pain from surfacing at all.

Finally, unlike the philosophy of most health care facilities, the hospice theme includes the patient's family in the care cycle. Family needs are mainly psychological. Hospices provide the family members with counseling to help them accept the eventual death of their relative. Once the family member has died, hospices also provide the family with bereavement follow-up services.

1		What are the two objectives of the hospice program?
2		What are three ways that hospices reach their goals?
3		What are three ways that hospices differ from other health care facilities?