Discussion Question One
Patients who are terminally or seriously ill will often prefer hospice and palliative care to being inpatients in hospital wards. Looking at the pros and cons of hospice and palliative care helps vet this option. One of the advantages of hospice and palliative care is that it allows the patients to live the final phase of their life with dignity, purpose, support and grace. When hospice care is provided at the home of the patient, hospice and palliative care enables the patient to spend the final phase of life in a comfortable and familiar environment, in the midst of loved ones. In this environment, the patient is the central focus of the caregivers (family members) with supervision and support of staff of the hospice (Robinson & Segal, 2014).
Another advantage of hospice and palliative care is that the specialized knowledge in care and support alleviates anxiety for both the patient and the family members (National Institute in Aging, 2014). In this regards, hospice and palliative care helps the family members and the patient maximize on the remaining time, achieve acceptance and improve the quality of life for the patient in the final phase. Hospice and palliative care also helps the patient avoid the dangers that come with over-treatment. Hospice programs afford the patient more monitoring than would have been the case in a hospital ward. In additional to the physical health, hospice and palliative care caters t the spiritual and emotional needs of both the patient and the family members. The training and support for the family members helps the patient feel they are not much of a burden to the family members (Robinson & Segal, 2014).
On the flipside, the major disadvantage is the flat per diem rate at which Medicare Hospice Benefits are paid. This payment mode presents several difficulties. Firstly, al medical expenses must be deducted from this flat rate. This means that any diagnostic tests that are indicated by attending physicians are the responsibility of hospice agencies. These diagnostic tests may not always be approved since most of them are expensive. Secondly, hospice care discourages inpatient hospitalization. This is because hospice benefits do not cover hospital stays. Thirdly, patients in hospice and palliative care cannot be enrolled in clinical trials or experimental treatments. This is because they are thought to be life-prolonging (Morrow, 2014).
Discussion Question Two
The increasing cost of health care has resulted in changes in health seeking behavior. Yes, people will still visit hospitals for medical care. However, home health has now become an alternative to nursing home placements and frequent visits to the physician. Among the many factors that have influenced the preference for home health is the increase in the cost of hospital care (Nies & McEwen, 2013). Home health is important in health containment, especially in managed care environments. Home health allows patient to be discharged from hospital in time, thereby cutting costs. Discharged patients are offered nursing services at home instead of skilled facilities where the cost of care is bound to be higher (Nies & McEwen, 2013).
While this is rather general, a look at the finer details will show why home health is becoming an alternative to nursing home placement and hospitalization. There is an increase in the number of people above sixty five years. This group of people is in need of nursing care. Home health costs less on average compared to care provided in institutions. For instance, routine care by a skilled nurse in a home costs a monthly average of 750 dollars. This is significantly less compared to routine nursing care in a hospital that costs a monthly average of 2000 dollars. Given these statistics, the increasing cost of health care, active support for home health by insurers and the promotion of home health by Medicare as alternative to hospitalization, home health is a better alternative to nursing home placement and hospitalization (Nies & McEwen, 2013).
Morrow. A. (2014). What Are the Advantages and Disadvantages of Hospice Care? Retrieved from> http://dying.about.com/od/hospicecare/f/adv_disadv.htm
National Institute in Aging (2014). End of Life: Helping With Comfort and Care. Retrieved from>http://www.nia.nih.gov/health/publication/end-life-helping-comfort-and- care/finding-care-end-life
Nies, M. & McEwen, M. (2013). Community/Public health nursing: Promoting the health of populations. St. Louis. Elsevier Saunders.
Robinson, L. & Segal, J. (2014). Hospice and Palliative Care. Retrieved from> http://www.helpguide.org/articles/caregiving/hospice-and-palliative-care.htm