Metabotropic glutamate receptors and neuronal degenerative disorders

Spirituality plays an integral role in the care of the terminally ill. Hospice philosophy promotes patient/family centred care that is palliative, holistic and interdisciplinary. Historically, spiritual care has been a major component of hospice care that is consistent with these values. Some issues related to the role of spirituality in medicine and hospice care include the difference between spirituality and religion, the patient-physician relationship, provision of spiritual care, and who provides this care. Guidelines for spiritual caregiving include self-knowledge of one's own spiritual needs, authenticity and honesty and respect for the beliefs and practices of the patient and family.     

The Sacred Circle: a conceptual framework for spiritual care in hospice

Hospice care has consistently recognized the need to integrate spiritual care into holistic plans of care for dying patients and their families. Designing and implementing spiritual care interventions can be potentially difficult for hospice practitioners who have not had specific training in theology or pastoral care. Matthew Fox, a theologian, has developed a model of spiritual development that utilizes an ecumenical, ethical framework that can be directly applied to the care of hospice patients and families. This model employs a Sacred Circle approach that begins with an emphasis upon the sense of awe and wonder (the Via Positiva), moves into the next cycle by recognizing problems and negative emotions (the Via Negativa), that then flows into the creative solutions to problems (the Via Creativa), which finally transforms the problem into a new level of understanding (the Via Transformativa).     

Ethics in hospice care.

Discusses 4 ethical issues that arise in hospice care: (1) What are the ethical responsibilities to the patient, family, and authorities when hospice workers discover that a patient has been given incompetent and shoddy care at a previous institution? (2) Hospices that advertise themselves as offering complete care should be prepared to deal with psychological and legal issues as well as medical ones. (3) The idea of treating the entire person must include responding to the likelihood that the patient and family may raise profound philosophical and religious questions. (4) Hospice staff should periodically examine themselves on a spiritual or philosophical level. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tumor cell recognition by lymphocytes: is the MHC always essential?

More than a year has passed since the Center to Improve Care of the Dying and the Corcoran Gallery of Art sponsored the symposium entitled: A Good Dying: Shaping Health Care for the Last Months of Life. Using the National Hospice Foundation sponsored exhibition, Hospice: A Photographic Inquiry, as a backdrop, the symposium included presentations on the current state of hospice care as well as the obstacles that limit access to hospice care. This article represents an update on many of the activities of the National Hospice Organization and the greater hospice community as we continue to improve access to quality hospice care.     

St. Francis Hospice: Medicare and health care reform

The St. Francis Hospice Program is symbolic of more than 100 years of Franciscan dedication to the people of Hawaii. Since Mother Marianne's arrival in November of 1883, the Sisters of the Third Franciscan Order Syracuse, New York have responded to the calling; "the charity of Christ impels us." It is through this calling that care and comfort for the terminally ill is a part of the mission of St. Francis Healthcare System. The magnificent spirit through which Hospice services have been made possible, is a reflection of God's great generosity to us throughout the years.     

Ethics consultation

Hospices in the U.S. were surveyed in 1990 to find out whether service to blacks and Hispanics was affected by admission criteria and hospice service characteristics of hospices located in or near these populations. Hospice characteristics such as reimbursement patterns, staff interventions, and admission criteria were different depending upon the percent of blacks and/or Hispanics in the hospice service area or actually served by the hospice. Care for Hispanics was more dependent on Medicaid and free care than blacks whose care was financed primarily by Medicare and Medicaid. Hospices identified problems in serving Hispanics as language, reimbursement, and severity-of-illness issues. Hospice admission criteria, especially the primary caregiver requirement, were identified as impeding access for blacks. Hispanics were perceived as presenting the most access and service problems and as the most underserved.     

Feasible criteria for enrolling end-stage dementia patients in home hospice care

Hospice care is considered appropriate for end-stage dementia patients (Luchins & Hanrahan, 1993), yet less than 1 percent of hospice patients have a primary diagnosis of dementia (Hanrahan & Luchins, 1995). This pilot study tested the feasibility of providing palliative care for dementia patients. A common eligibility requirement for admission to hospice is that the patient is likely to die within six to seven months. The uncertain survival time of dementia patients thus prevents access to hospice programs. Therefore, enrollment criteria were developed based on the characteristics of advanced dementia and a history of medical complications. With these criteria established, it was then possible to enroll 11 patients over two years. The enrollment criteria proved successful in that the median survival time was five months, with an average of seven months. Eight of the 11 patients died during the study. Hospice care was well accepted by family caregivers and appeared to meet the patient's needs.     

An alternative to traditional medical care for the terminally ill: Humanitarian, policy, and political issues in hospice care.

Indicates that hospice services to the terminally ill offer palliative care rather than curative treatment, emphasizing pain control and supportive/psychological services, and introduces a section of articles on hospice matters. Hospice care is of interest to psychologists because it is a service intervention alternative to traditional medical practice. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The interdisciplinary bereavement team: defining and directing appropriate bereavement care

Hospice bereavement care often occurs in relative isolation from other program components; staff and volunteers are without the guidance, consultation and support provided through the interdisciplinary team that is enjoyed by personnel working in patient care areas. This article promotes a similar interdisciplinary team concept that has been successfully employed in one of the country's largest bereavement programs. Comprised of bereavement program staff, consultants from the patient care program, professional and lay volunteers, this interdisciplinary team defines and directs interventions provided by the bereavement care program.     

Advances in hospice care

Hospice care developed in part as a reaction to the impersonal and technology-dependent end-of-life care offered by modern medicine. Unique approaches to care that emphasize interdisciplinary team management of troublesome symptoms and the promotion of quality of life as defined by the patient, are finding their way into all aspects of health care. Symptom control measures have expanded to include chemotherapy, radiation therapy, and multimodal therapies. Both the development of a unique knowledge base and advances in research have fostered the integration of hospice and palliative care into mainstream medicine.     

Videothoracoscopy for diagnosis and treatment of respiratory tract diseases

Orthopaedic nurses often are well-educated in dealing with patients' physical and psychologic needs but lack education in caring for the spiritual needs of man. Nurses must realize they, themselves, have spiritual needs and must invest in clarifying their own values and beliefs as well as their patients. To perform a complete spiritual assessment, nurses need to become familiar with the concept of spirituality and what it means in the care of patients. Providing spiritual care is individualized and often complex. The nursing process enables the nurse to plan patient care. Providing spiritual care is a challenge orthopaedic nurses must recognize and assume responsibility for.     

A closer look at the role of spirituality in psychology training programs.

Should psychology training programs take steps to incorporate content related to spiritual and religious diversity in their curriculum? This article provides a critical discussion of research demonstrating minimal integration of spiritual and religious issues in psychology training, supervision, and course work. Unique aspects of training related to spiritual diversity and interventions across various subdisciplines in psychology are highlighted. Suggestions for integrating spiritual and religious diversity into psychology training are presented. For the benefit of students, clients, and their communities, psychologists are encouraged to obtain specialized training to enhance their spiritual and religious competency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using spiritual interventions in psychotherapy: Practices, successes, failures, and ethical concerns of Mormon psychotherapists.

Two hundred and fifteen (out of 300) randomly selected Mormon psychotherapists were surveyed and asked to indicate how frequently they use various spiritual interventions in psychotherapy and to describe successful and unsuccessful spiritual intervention case examples. The therapists indicated that they use a wide variety of spiritual interventions, including praying silently for clients, teaching spiritual concepts, encouraging forgiveness, and using the religious community as a support. Many spiritual interventions were perceived by the therapists as potentially therapeutic. Process guidelines for using spiritual interventions were offered by the therapists, and ethical concerns (e.g., dual relationships, imposing values) were raised. Implications for psychotherapy practice and training are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spiritual pain in dying people: the nurse's role

Spirituality is a vital aspect of health care, as it affects physical, psychological and social needs. In a dying person spiritual pain may preclude a peaceful death. Nurses are in an ideal position to assess, plan and provide care for those in spiritual pain. 'Being with' a person in spiritual pain is often more important than any intervention. Evaluation of relief from spiritual pain is often difficult but should be attempted.     

Volunteer Support, Marital Status, and the Survival Times of Terminally Ill Patients.

This study examines the possibility that volunteer support can influence how long terminally ill patients survive. Hospice patient files (N=290) were coded for marital status and volunteer support condition, respectively, the latter on the basis of whether visits from volunteers were requested and received (n=94), requested but not received (n=28), or neither requested nor received (n=168). Baseline health, disease type, and demographic dimensions were comparable across support conditions. Results indicated that when a baseline health status effect was controlled for (p     

Spirituality in aging: spiritual need or spiritual journey?

1. The current approach to spiritual assessment often makes the older client uncomfortable discussing his or her spiritual and religious orientation. 2. To provide therapeutic interventions, nurses must first become aware of themselves and their clients as spiritual beings. 3. A spiritual journey perspective views the nurse as one who can enhance the unique journey and growth of the individual client.     

The spiritual work of the dying: a framework and case studies

This article describes a systematic approach to understanding the spiritual work of the dying. It begins by defining "spirituality," "spiritual care" and "spiritual work" in order to create a common vocabulary. The remainder of the article uses vignettes from clinical experience to create a framework for understanding not only the recurrent themes in the spiritual work being done by the terminally ill but the support and interventions of the spiritual counselor as well. These case experiences are clustered under four headings: "remembering," "reassessing," "reconciliation" and "reunion." The article gives serious attention to the "supernatural" experiences of the dying as experienced by the hospice team.