Death and dying in the elderly hospital : nursing home vs. hospice

The purpose of this research paper is to provide an investigation of the terminal care being received by elderly Americans in hospitals, nursing homes, and hospices.Traditionally, hospitals and nursing homes have segregated the elderly from their families and deprived them of the dignity and comforts of dying in familiar and personalized surroundings. The last decade has seen a resurgence of interest in issues surrounding human dying, such as terminal care for the dying patient and its psychological impact for patients and their family.The rising cost of care for terminal illness has placed additional burdens on all involved, and this burden predictably takes its social and psychological toll. Many technological advances in the care of the terminally ill are now under attack on the grounds that, although intended to alleviate suffering, they intensify it for all involved by prolonging life past "meaningful levels." The moral burden of whether to use life support systems can cause ambivalence, anxiety, and emotional turbulance among the persons involved. In addition, the astronomical financial costs can make the problem seem worse.One of the cruelest dilemmas of modern technology is the frequent need for the patient, physician and family member to "choose" whether or not to prolong life for the terminally ill. Out of these combined dilemmas, the hospice movement has arisen and with it an increasing emphasis on hospice home care for the terminally ill.This paper will examine the advantages and disadvantages of hospital, nursing home, and hospice care for the terminally ill elderly patient from a social and psychological viewpoint, and in terms of needs of the dying person, his family and the medical personnel providing terminal care.Personnel involved in a ministering terminal care could also benefit from the findings of the study, particularly as they relate to the psychological impact of providing such care.The discussion of anxiety about death among personnel, persons receiving care, and family mercers in either setting will provide a quantifiable criteria for determining which type of program can best serve the needs of the patient and the family.The basic assumption of this study is that nursing home and care represents a psycho-socially advantageous method of providing care to terminally ill patients in comparison to regular hospital care. Hospice care is preferred over the nursing home as well as over the hospital. Since this study is vainly descriptive, there are no testable hypotheses; however, there are several questions for which answers are sought and will be addressed in this study. These questions are:(1) What are differences in attitudes, fears, and concerns about death and dying in terminally ill persons in hospitals, nursing homes, and hospices?(2) What are fears, attitudes and concerns about death and dying in the families of terminally ill persons in hospitals, nursing homes and hospices?(3) What are fears, attitudes, and concerns about death and dying in medical personnel involved in providing care for terminally ill persons in hospitals, nursing homes, and hospices?Thesis (M.A.