Hospice Care: The Changes in care for the dying Lynette Ruckman, MSN, RN

End-of-Life: Modern Aspects Meaning of death-changing definitions Death-failure of medicine, not natural occurring Bio-power-life no longer controlled by higher power, but managed/manipulated by man Modern biomedical model-preservation of life, medicalization of life and death

End-of-Life: Modern Aspects Right to die Utilitarian-individual sovereignty, society not to interfere Feminist-physician as “gatekeeper” of right to die reflects patriarchal system in which ender disparities are prominent

Modern Hospice Care History-Religious background with Cicely Saunders designing first hospice Hospice was philosophy-physical, emotional, and psychological support 1974-First US hospice by nurses during “war on cancer” 1980-HCFA/CMS instituted financial support, National Hospice Study

Modern Hospice Care Medicare Hospice Benefit Led to hospice being profit-driven Changed foundation of care of hospice- bureaucracy Organizations developed to aid the terminally ill- Death with Dignity Laws

Nursing Care Definitions of care Feminine Ethic-selfless, sacrificing ideal Feminist Ethic-connection, having a voice Nursing care has changed from emotional/spiritual holistic to technological care Ethical standards-ANA Code of Ethics for Nurses

Nursing Care for the Dying Can nurses truly care for the dying? Patient autonomy-nurses are to advocate Active legislative voice-having a voice in laws Implementing care theories into practice Watson’s Human Caring Theory