Home-Based vs. Hospital Care for Terminal Patients

Cancer is a disease that affects human beings. It can be caused by numerous factors, and these include: food and drinks, industrial chemicals and metals, prolonged usage of certain medicines and inadequate/ insufficient dietary that requires a patient to seek immediate medical attention since its consequences can be fatal (Colling & York, 2009).

There are many occasions when a patient is diagnosed with a disease that makes them seek for health care. A patient’s family members are, therefore, required to decide on how to care for him/ her. Health care system is the organization of people, institutions and resources to provide care for people who are in need of help. This provides a family with two choices, which is to choose on having their patient admitted and remain in the hospital or to administer hospice and palliative care at home. Many patients when faced with the reality that they are on their dying bed require special care and attention. It is because of this that the hospice and palliative care systems were developed (Colling & York, 2009).

According to Forman (2003), for a patient to be considered for the alternative or medical health care, some principles were to be followed. First, a patient must have accepted death and is ready to face it. Secondly, if alternative home care is to be implemented, a family must ensure that there is an active home based care. Consequently, a family and patient must have accepted each other and have established a single unit among them. There should also be a bereavement care for a family in case a patient dies. Lastly, the care in which a patient is exposed to must be managed by skilled personnel from both sides of care systems. When these principles are reached by a patient and a family together with care providers, a family may accord its patient a care that they deem helpful between medical care, hospice and palliative care.


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Hospice care refers to the programs that are developed to provide comfort to the dying patient and ensure that they have everything they need during their last days. On the other hand, palliative care is an alternative care system that is defined as comforting and person centered measures for individuals with advance, life-threatening illness. This system tends to increase the number of patients that are exposed to alternative care (Forman, 2003).

In a research that was carried out regarding hospital based care and hospice and palliative care, there was rise in the number of patient readmissions to hospital for care. The readmissions to hospitals have been used to measure and explain the quality of hospital based care, compared to others. The research shows that they have been increasing from 9% to 48% in the number of readmissions. This was caused by progression of chronic illness and patient frailty, which were associated to substandard care, such as poor resolution during discharge of the patent and inadequate post discharge care. This means that the level of care that patients are exposed to after being discharged from hospital was very low, hence causing the readmissions to increase in hospitals. Therefore, in the case of the given scenario, the best care system that the family should be advised to pick for Ella is hospital based care (Benbassat & Taragin, 2000).

Ella should be left in a hospital rather than being engaged in a hospice and palliative care. This is because hospice and palliative care are home based and require certain principles to be fulfilled before being practiced. For instance, there should be an active home based care in place. In the family of Ella, there is no established home based care, which makes it hard for Ella’s home care to be successful. Consequently, there should be a single established unit for them to be able to maintain home based care. However, in Ella’s family, there is no established single family unit, because of the grievances that each of the family members are facing (Zerwekh, 2009).

There are several possible scenarios that a family might face which may make them have different reactions to the situations. For instance, if Ella decides to stick to alternative and contemporary practices, there are high chances of a negative reaction from the family. This is because the family will have to change their normal life, so that they can be able to accommodate her home based care. Consequently, if Ella decided to follow mainstream medical advice, there is a high chance the family will support her. This is because the family members will have time to deal with their own grievances rather than constantly looking after Ella (Zerwekh, 2009).

In the scenario where Ella’s husband insists that his family traditions should be adhered to by the family members, there is a high chance that the family members will support him because they have always done the same thing. The impact of this scenario depends on the family traditions; for instance, if the family has a tradition of unity among them, it will be much more convenient for Ella to have home based care. On the other hand, if the family members have discord among them, it will be utterly hard for the family to be integrated into a single unit, so that they can be able to provide care to Ella, which means that Ella will have to experience hospital based care (Zerwekh, 2009).

There are several considerations that a doctor can impose in case Ella has to be taken back home. These considerations are meant to ensure that Ella experiences quality care during her last days. To start with, the medical officer should ensure that Ella’s family is able to provide quality home care and hire the necessary personnel to take care of her medical needs. Consequently, the discharge officers should be able to do a follow up to ensure that Ella gets proper post discharge care and attention (Benbassat & Taragin, 2000).

Patients are always mislead on which root to take in terms of how to handle their heal situation. This has forced numerous patients to seek medical attention, some of which are odd and kind of primitive in nature. The lack of awareness has, therefore, made people form their own hypothesis and personal perspective on how life threatening diseases are acquired as well as treated. This has led to the emergence of alternative and other complementary medical care systems that people use. The new alternative and complementary medical care systems are ones, which do not use the mainstream mode of treatment. Some of their practices used in alternative medical care systems seem to be primitive. However, both medical systems have their advantages and disadvantages. Some of the advantages of home based care are: psychological healing and rest. This is as a result of being close to relatives and family members who care about them, hence giving them psychological relaxation, which can prolong the life of a patient. Furthermore, in a home based care, patient can benefit from improved and specialized quality of care. This is because a care provider has only one patient to care for, and can, therefore, provide them with best medical care. On the other hand, the advantages of hospital based care are: a patient is exposed to qualified professions and quality professional care from specialized doctors and nurses. Consequently, a patient gets to interact with others, having the same conditions, which gives them a sense of belonging and which in turn makes them psychologically relaxed and ready to accept death as their fate (Benbassat & Taragin, 2000).

However, much as both systems have advantages, they also have their own disadvantages based on which system is being used. The disadvantage related with home based care is that the life of a patient mainly relies on a family member’s reaction. The hospital care system, which is the mainstream form of caring, has its disadvantages such that a patient can be psychologically hurt if he/ she sees one of them dying. This makes them to be afraid of death while they are supposed to accept death (Benbassat & Taragin, 2000).

Medical care systems have varying impact on a patient’s life both socially and psychologically. Since during this time both a patient and a doctor experience different challenges that can be sub divided into two categories. Psychological issues include: change of diet, a doctor might instruct a patient not to consume certain foods and drinks. A patient might want to be in a secluded environment. Some patients might need company throughout the medication period; this gives them an assurance that they are cared upon. A doctor’s psychological perspective will also be affected, because he/ she will try not to fail in saving a patient’s life (Brown, 1996).

As a disease advances, a family will likely be affected too. There is a big likelihood that they are going to come together so as to offer moral support to a patient. From such unity, a patient’s family can facilitate on how the medical bills will be paid. The position of  family members on the issue will be divided based on the condition of each family member. For instance, those with life threatening diseases will suggest a hospital care system, because they will be afraid of death (Brown, 1996).

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