Finding Care At the End of Life
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Decades ago, most people died at home, but medical advances have changed that. Today, most Americans are in hospitals or nursing homes at the end of their lives. Some people enter the hospital to get treated for an illness. Some may already be living in a nursing home. Increasingly, people are choosing hospice care at the end of life.
There is no "right" place to die. And, of cour, where we die is not usually something we get to decide. But, if given the choice, each person and/or his or her family should consider which type of care makes the most n, where that kind of care can be provided, whether family and friends are available to help, and, of cour, how they will manage the cost.
HOSPITALS AND NURSING HOMES
George is sixty-four and has a history of congestive heart failure. One night he is taken to the hospital with chest pain. George and tho clost to him had previously decided that, no matter what, the doctor should try to do everything medically possible to extend George'
s life. So, when George needed care, he went to a hospital, where doctors and nurs are available around-the-clock. Hospitals offer a full range of treatment choices, tests, and other medical care. If George's heart continues to fail, the hospital intensive care unit (ICU) or coronary care unit (CCU) is right there. Although hospitals have rules, they can sometimes be flexible. If George's doctor thinks he is not responding to treatment and is dying, the family can ask for relaxed visiting hours. If George's family wants to bring personal items from home, they can ask the staff if there are space limitations or if disinfection is needed. Whether George is in the ICU, CCU, or a two-bed room, his family can ask for more privacy.
In a hospital tting, there is always medical staff available who know what needs to be done for someone who is dying. This can be very reassuring for that person, as well as for family and friends.
Who pays for care at the end of life? 青蓝工程实施方案How to pay for care at the end of life depends on the type and place of care and the kind of insurance. Medicare, Medicaid, private medical insurance, long-term care insurance, Veterans Health Administration (if VA-eligible), or the patient and his or her family are common sources of payment. See To Learn More at the end of this ction for links and telephone numbers for rvices that are Federal government programs. |
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More and more people are in nursing homes at the end of life. In a nursing home, nursing staff is also always prent. A nursing home, sometimes called a skilled nursing facility, has advantages and disadvantages for end-of-life care. Unlike a hospital, a doctor is not in the nursing home all the time. But, plans for end-of-life care can be arranged ahead of time, so that when the time comes, care can be provided as needed without first consulting a doctor. If the dying person has lived in the facility for a while, the staff and family have probably already established a relationship. This can make the care feel more personalized than in a hospital. As in a hospital, privacy may be an issue. You can ask if arrangements can be made to give your family more time alone when needed.
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The doctor wants to move my relative to the ICU. What can we expect? The ICU (intensive care unit) and CCU (coronary care unit) are types of critical care units; that is, they are parts of a hospital where more riously ill patients can benefit from specially-trained staff that have quick access to advanced equipment. The medical staff in ICUs and CCUs cloly monitor and care for a small number of patients. Doctors who work in the units are called intensivists. Patients in the ICU or CCU are often connected to monitors that check breathing, heart rate, pul, blood pressure, and oxygen levels. An IV (intravenous) tube may supply medicines, fluids, and/or nutrition. Another tube called a Foley catheter may take urine out of the body; a tube through the no or stomach area may provide nutrition and remove unwanted fluids. A breathing tube through the mouth or trachea (windpipe) may be attached to a ventilator or respirator to help with breathing. Often the external supports—designed to be ud for a short time—will maintain vital functions while the body heals. 唐伯虎点秋香经典台词衣字成语But sometimes, even with intensive care, the body can't heal, and organs start to fail. When this happens, survival is unlikely. In this ca, the health care team might talk to the family—and the patient if he or she is conscious—about considering whether or not to continue intensive treatment. |
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HOME
Home is likely the most familiar tting for someone who needs end-of-life care. Family and friends can come and go freely. Care at home can be a big job for family and friends—physically, emotionally, and financially. But, there are benefits too, and it is often a job they are willing to take on. Hiring a home nur is an option for people who need additional help.
In order to make comfort care available at home, you will have to arrange for rvices (such as visiting nurs) and special equipment (like a hospital bed or bedside commode). Health insurance might only cover the rvices or equipment if they have been ordered by a doctor. Work with the doctor to decide what is needed to support comfort care at home. If the dying person is returning home from the hospital, sometimes a hospital discharge planner, often a social worker, can help with the planning. Your local Area Agency on Aging might be able to recommend other sources of help (e To Learn More to learn how to contact your Area Agency on Aging).
A doctor has to be available to overe the patient's care at home—he or she will arrange for new rvices, adjust treatment, and order medicines as needed. It is important to follow the doctor's plan in order to make the dying person as comfortable as possible. Talk with the doctor if you think a treatment is no longer helping.法宣在线学习登录
王者荣耀网名女生PALLIATIVE CARE AND HOSPICE
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Doctors can provide treatment to riously ill patients in the hopes of a cure for as long as possible. The patients also receive symptom care or palliative care. For example, in time George developed anemia along with his heart failure. Managing the anemia can improve some of the symptoms troubling George. It might also make it easier for him to do things like get dresd or bathe on his own. Treating his anemia is part of palliative care.
