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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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