The aim of this pilot study, which was carried out under the auspices of the Grahamstown Hospice, is to evaluate the functioning of families with a terminally ill member, in order to establish whether these families require family therapy. The Family Assessment Device (FAD), based on the McMaster Model of Family Functioning, was used. Data from 20 families was analysed and the extent to which these families constitute a clinical sample is highlighted. In terms of the dimension of General Functioning, 15 families emerged as functioning at a problematic level. Communication emerged as the most dysfunctional of the seven dimensions of the FAD, with 17 families functioning at a problematic level. As a result of these findings it is argued that family therapy should be incorporated into the range of services offered by hospices. Limitations of this study and directions for future research are also discussed.

No description available.

Our society is one in which death has become a predominant influencing factor of our social context, with the dramatic rise in AIDS related deaths. Yet the institutions that accommodate the terminally ill or the dying, have become stale, clinical and mechanical in both their architecture and their processes. This thesis proposes to re-address the physical environment of hospital and clinical architecture that facilitate the process of dying. The design of this Hospice and Educational Facility aims to reintroduce life within the architecture through the embodiment of movement, visual interest, meaning, memory, choice and integration. The project is located within the Mamelodi community along the Eastern edge of the Pienaar River, bordering a green space. The Mamelodi community is vibrant and rich, filled with self-expression and opportunities, and despite its impoverished services and urban fabric it provides the perfect platform for such a facility. Especially when combined with the indomitable spirit of the people who live there. The Project integrates with and serves the immediate context of Mamelodi. Through the facilities provision of functions - including hospice and outpatient functions, education, interaction, architectural language, as well as the community-accessible permaculture garden and redeveloped green space. AFRIKAANS : Met die drastiese stygings in vigsverwante sterftes het die dood 'n wesenlike invloed op ons sosiale verwysingsraamwerk geword. Ten spyte hiervan word die argitektuur en funksionering van instellings waar die sterwingsproses begelei word, as klinies, onpersoonlik en meganisties beskou en ervaar. Hierdie verhandeling beoog om die meganistiese en kliniese ervaring van sterwensbegeleiding in 'n hospitaalomgewing te verander deur die ontwerp van 'n hospice en opvoedkundige instelling. Die doel hiervan is om 'n argitektoniese taal te skep wat beweging, visuele verbeelding, doelgerigtheid, keuse en integrasie verpersoonlik.Die gekose terrein vir hierdie projek is geleë in die 'ou' Mamelodi-gemeenskap, langs 'n sytak van die Pienaarsrivier en aangrensend aan 'n gesoneerde 'groen' sone. Die Mamelodi-gemeenskap is kleurryk en opwindend, wat die ideale platworm vir ontwikkeling bied: die huidige lae vlakke van dienslewering en infrastruktuur, gekombineer met die ontembare gees van die inwoners bied 'n gulde geleentheid hiervoor. Aan die eenkant sal die projek met die omliggende en wyer gemeenskap van Mamelodi integreer en aan die ander kant sal dit die gemeenskap met nuwe fasiliteite voorsien, naamlik 'n hospice, buite-pasiëntdienste, geleenthede vir opleiding en interaksie, 'n herontwikkelde 'groen'-ruimte, asook 'n toeganklike tuin [wat ekologies selfonderhoudend is] vir die gemeenskap se gebruik. / Dissertation (MArch(Prof))--University of Pretoria, 2011. / Architecture / unrestricted

Information has been sparse on the hospice psychosocial support offered through the American hospice system. This study examined the hospice psychosocial services that are available and utilized within the United States. In addition, the characteristics of patients and families who utilized these services were comprehensively assessed. Data from the 2007 National Home and Hospice Care Survey (NHHCS) was analyzed in this cross-sectional study (National Center for Health Statistics [NCHS], 2007). Hierarchical linear regression, hierarchal logistic regressions as well as chi-square test of independence were used to analyze the data. It was hypothesized that for profit hospice ownership status would predict less availability and utilization of psychosocial services when agency size, chain status, and patient total activity of daily needs are controlled. Ownership status was a significant predictor of medical social service availability where for profit agencies were more likely to have this service available. Conversely, hospice patients at for profit agencies were less likely to utilize medical social services as well as bereavement services. Overall, patient and caregiver utilization rates of psychosocial services were low with the exception of medical social services, bereavement services, spiritual care services, & safety training services. The majority of individuals that used these services were married, White, non-Hispanic, 74-75 year old cancer patients with no cognitive impairment. Most were Medicare recipients with advanced directives in place and had 4 ADL needs. Routine home care patients with an average care continuum of about 2-2 ½ months accounted for most of those who used these services. The majority of these patients lived in a private residence with family members and had spousal caregivers. These results suggest that the psychosocial services that are being provided have an overall low utilization rate despite availability regardless of ownership type. Further, psychosocial services are disproportionately underutilized by racial and ethnic minorities. In addition, these results highlight the disparity that exists between racial groups that are admitted under hospice care. Further interdisciplinary research needs to be conducted in order to address this disparity in order to determine alternative forms of care that are specifically tailored to a diverse patient population.

The rationale for this study arose from the researcher’s own practice as a children’s hospice counsellor, being given the challenge of providing emotional support to all those wishing to access a counselling service within a children’s hospice. How could one counsellor fulfil such a responsibility? What was meant by the term “support?” What part did the hospice’s multi-disciplinary team play within the provision of this support? Such questions, the researcher felt, needed to be put to a wider audience and the aim of this study was to examine children’s hospice counsellors’ practice of assessing needs and implementing pre and post bereavement support to children/young people and their families who access a U.K. children’s hospice service. A phenomenological approach was adopted and in-depth, semi-structured interviews with seven children’s hospice counsellors were transcribed verbatim. The researcher identified salient information and categorised forming themes using thematic analysis. Quotes were selected that captured the semantics of these themes.The main findings were that pre-bereavement support activities were being provided by members of the hospices’ multi-disciplinary teams. The assessment of needs during the this stage was found to be carried out by members of the nursing staff encompassing medical as well as psycho-social needs. It was also discovered that children’s hospice counsellors were more actively engaged in post-bereavement support and informally assessing bereavement needs. In addition, bereavement needs assessment was being carried out by a variety of professionals who had had some involvement with the family during the pre-bereavement stage.Implications of the findings suggested that counsellors could be more actively involved in pre-bereavement assessment of families’ needs. It was also indicated from the results that in-depth training on anticipatory grief and the grieving process, as well as supervision of other professionals supporting family members, could be delivered by children’s hospice counsellors.It was recommended that the subject of assessment of both pre and post bereavement needs of the diverse client groups accessing support services be opened up for wider debate and dialogue within the arena of children’s hospice services and paediatric palliative care.

No description available.

This study examines barriers limiting access to hospice care for elderly African Americans. Ethnic background plays a critical role in the development of attitudes, beliefs and expectations related to death and issues surrounding hospice care. The purpose of this study was to identify barriers that may limit access to hospice care for African Americans. A questionnaire was administered to 56 elderly African Americans in three religious settings and an African American senior citizens center. The questionnaire was designed to obtain information concerning African Americans' attitudes toward death and dying; religious beliefs; health beliefs; familiarity with hospice and prospective use of hospice. The results of the study indicate a number of barriers in access to hospice care for African Americans including: hospice knowledge barriers; education/outreach barriers; cultural knowledge barriers related to death/dying values; family/social support barriers; hospice organizational/provider barriers; health care organizational/provider barriers; and reimbursement barriers.

This project attempts to describe how a hospice and palliative care partnership program works. Through the assessment of one such program, the researcher sought to find out the essential components of the partnership including how the two partner organizations interact and work together. Data was collected using various methods: document review of organization documents such as newsletters, annual or quarterly reports, brochures and other available literature e.g. materials on organizations’ website and on social media; in-depth interviews with stakeholders of both organizations that included staff and board members; observation of staff working; and participant observation during organization events. The findings of the research shows that in order for organizations to have an effective partnership program in place, both partners need to have strong leadership in place, possess a willingness to learn from each other, maintain regular communication, and visit each other regularly. With this in place, several outcomes of the program are likely such as: increasing advocacy for hospice and palliative care, increasing visibility of the organizations both nationally and internationally, and provides an opportunity for organizations to network with other organizations in their locality in order to achieve partnership objectives. The study further reveals that global collaborations in the field of hospice and palliative care began with the advent of the international hospice movement. The assessment of this hospice partnership demonstrates how organizations can establish working relationships and the results likely to come out of such an initiative.

Den palliativa vården är en helhetsvård där sjuksköterskor ska arbeta utifrån ett förhållningssätt baserat på de fyra hörnstenarna och de sex S:n. Det blir allt vanligare att vårdas den sista tiden i livet inom slutenvården utanför sjukhuset. Syftet var att belysa sjuksköterskors upplevelser av palliativ vård i särskilt boende och hospice. Studien genomfördes som en litteraturstudie som baserades på åtta kvalitativa vetenskapliga artiklar. I resultatet framkom tre huvudkategorier: känslomässiga upplevelser som innefattade sjuksköterskors emotionella påverkan av att vårda patienter i livets slutskede. Den andra huvudkategorin relationer avsåg samspelet mellan patienter, närstående och sjuksköterskor. Den tredje huvudkategorin arbetets olika utmaningar inkluderade underkategorierna sjuksköterskors kompetens inom palliativ vård, upplevelse av tidsbrist avseende tidens betydelse i vårdandet av patienter i livets slutskede. Kommunikation mellan professionerna som innefattade kommunikationen mellan sjuksköterskor och läkare samt teamarbete mellan sjuksköterskor, läkare, undersköterskor och övrig vårdpersonal. Att vårda patienter i livets slutskede i särskilt boende eller på hospice gjorde att uttryckte känsla av otillräcklighet. Sjuksköterskor arbetade under ständig tidspress där otillräckligheten var ett faktum vilket påverkade den palliativa vården negativt. Samarbete och kommunikation mellan sjuksköterskor, patient, närstående och övrig vårdpersonal var viktiga faktorer för god omvårdnad. Sjuksköterskors arbetsbelastning, arbetet under ständig tidspress och teamarbetet mellan vårdpersonal i särskilt boende och hospice bör belysas ytterligare genom vidare forskning för att utveckla nationella och lokala riktlinjer för palliativ vård i livets slutskede. / The palliative care is an overall care. The nurses’ must have an approach based on personal centred care. The care today is based in greater occurrence outside hospital services. It’s more common to die outside hospital services. The purpose was to illustrate nurses’ experiences of palliative care in nursing home and hospice. The study was conducted as a literature study based on eight qualitative scientific articles. The result showed three main categories: emotional experiences which included nurses’ emotional affects in caring of dying patients. The second main category relationships, intended the interplay between patients, relatives and nurses. The third main category different challenges of the work with associated subcategories: nurses’ competence in palliative care, experience of lack of time intended the valuable of time in caring of patients in the end of life. Communication between professions which included communication between nurses and physicians and teamwork between nurses, physicians, nurse assistants and other health care professionals. To care for patients in final stage of life in nursing home or hospice was emotional challenging. Nurses who constantly worked under time pressure experienced inadequacy which affected the palliative care negative. Corporation and communication between nurses, patients, relatives and other health care professionals were important parts for good nursing care. Nurses’ workload, work under constant time pressure and team work between healthcare professionals in nursing home and hospice should be illustrate through further research to develop national and local guidelines for palliative care in the end of life.

This qualitative and quantitative study focused on exploring hospice patient’s perceptions of family support. Family support was conceptualized as which family member they expect to receive support from, types of support provided, frequency of support, family communication about medical illness, and type of support that is perceived to be most helpful. Fifteen partcipants between the ages of 70 to 98 were interviewed using purposive sampling. Findings showed that although participants found both physical and emotional support helpful, more than half reported perceiving emotional support as the most helpful. Recommendations for social work practice and research were discussed.