Hospice Care: Enhancing Quality of Life Through Family Involvement

This report focuses on hospice care, emphasizing the crucial role of family caregivers in providing quality care for terminally ill patients. It explores the challenges faced by family members and the importance of their involvement in care plans. The report utilizes the PICO framework to formulat...Read More

1
Running Head: HOSPICE CARE
HOSPICE CARE
Name of the Student
Name of the University
Author Note

2
HOSPICE CARE
Hospice Care
While the term "hospice" may cause the notion of giving up life, it is a mission to provide
a man a mental, physical and spiritual relief in the best possible way of life. Yet studies have
shown that those people who have selected hospice have been almost a month longer than those
who have chosen no hospice. Hospice is a treatment approach that is interdisciplinary. It is
holistic, comprehensive, person-centred and personalized to individual needs (Oechsle, 2019). A
family member usually serves as the primary caregiver and allows the loved one to assess, if
necessary (Ateş et al., 2018). The caregiver is active in the fight against illness of a loved one,
and later in the hospice. What is important for the caregiver of the family is to find the best
therapies to keep the optimistic hope alive. Thus, it is fundamentally crucial to include family
caregivers in the care plan of a hospice patient in order to get a quality outcome. People have
always been relying on families as a group to help their older people emotionally and assist them
with their household and personal care. With today's social programs and health systems,
professionals look forward for family carers with little or no experience to managing daunting
processes and facilities for the severely ill care patients at home. Also, many family carers are
concerned about a life-threatening mistake (Chi et al., 2018). Therefore, in the case study
provided, the nurse must involve the family caregivers of the terminally ill patient and
understand their concerns and feelings in order to enable the delivery of an enhanced and quality
palliative care.
Research problem
Although, there is a rising awareness about the involvement of family caregivers in the
hospice care plan of a dying patient, their involvement is often withdrawn which not only hinders

3
HOSPICE CARE
the delivery of an enhanced care but also impede the family members from assessing their basic
right and willingness of assisting their loved ones during the end of life. Also, Family care is
important for patients with life-limiting conditions in the community, but there is limited
information regarding possible palliative home care strategies (Ozaki et al., 2017). Thus, this
paper will focus on two aspects of the problem area:
1. To explore the effectiveness of involving and understanding family caregivers in the
hospice care to provide quality care.
2. To discover Evidence Based strategies for facilitating home based hospice care for
seriously ill patients.
PICO question
PICO is a well-known evidence based framework for formulating and answering a health
related research question. PICO framework is also used to develop search strategies in research
papers like systematic reviews. It has the following components:
 P – Patient, Problem or Population
 I – Intervention
 C – Comparison, control or comparator
 O – Outcome(s)
Therefore, for this research area, the research question using PICO framework can be developed
as follows:
“How much effective is the role of family carers in the management of hospice patients with
evidence-based treatment strategies to provide a quality care?”

4
HOSPICE CARE
PICO Table
PICO Elements Examples
P (Population) Terminally ill patients
I (Intervention) Family carer involvement; Evidence based
strategies; Holistic care
C (Comparison) Withdrawing family caregivers
O (Outcome) Quality care
Table 1: PICO elements relevant to the given case scenario
Source: Created by the author
2 Databases
Databases like PubMed and Cochrane library were searched with keywords.
Database Table
Database Total number of
articles
Title of the Article selected Authors
PubMed 7 Hospice family caregiver
involvement in care plan
meetings: a mixed-methods
randomized controlled trial.
Parker Oliver et al.
(2017)
Table 2: 1 Database result
Source: Created by the author

5
HOSPICE CARE
Search strategy
For conducting this research 2 databases were extensively searched including PubMed
and Cochrane Library using keywords like “Hospice care”, “Family carer involvement in
hospice care”, “Evidence based strategies for hospice care”, “End-of-life care”, “Caring from
terminally ill patients”, “Home‐based hospice acre”, “Understanding family’s perspective in
hospice care”, “palliative care” and other related keywords and a combination of them. Studies
that were conducted in and after 2015 were included to get the recent findings on the research
area. A total of 12 articles from both of these databases were available out of which only 5
articles were matching the inclusion criteria. From those 5 articles, only 2 have been found to be
relevant to the case scenario and therefore, they were used to answer the PICO question in this
paper. However, there were some limitations, such as the selected language was English. Articles
specially written in English were chosen and no other language was entertained. Articles with
insufficient information were omitted.
2 Evidences
1. The article by Parker Oliver et al. (2017) focused on the involvement of family caregiver
in the care plan of hospice patients. The authors highlighted that involving these family
caregivers need training prior to engage them with the hospice care team for managing
serious ill patients and provide quality care. Untrained family members struggle with
hospice patients with complex medical treatment regimes. Thus, the study recommends
conducting meeting and training to the family caregivers and involving them in the care
management of the hospice patients.
2. According to the article by Uslu Şahan, Fatma and Terzioğlu, Füsun (2017) instead of
traditional practices and expertise during the phase of palliative care, palliative care

6
HOSPICE CARE
nurses shall adopt evidence-based methods for patients and their families; promote
standardization of treatment; prevent unnecessary activities and enhance the quality and
quality of life for patients and their families. The need for nurses with other palliative
health team members to have the most evidence-based palliative care activities has
therefore intensified. When making decisions about the care of their patients with
evidence-based palliative care practices, nurses shall take careful, cautious, clear and
logical use of information proven by research results, as well as the preferences of
patients. The aim of evidence-based palliative care practice is to provide patients with
available resources with appropriate treatment. Evidential activity is to insure that
patients make the right choice by providing them with evidence-based clear information
on the benefits and risks of these alternatives. Patients of life-threatening illnesses
experience problems due to numerous effects from or under the influence of the illness
itself and its quality of life. It is therefore advised that nurses with other palliative team
members will periodically assess the stress, distress and dyspnea during clinical treatment
of the patients in need of palliative care.
First 2 steps of Evidence-based Practice
Step 1: Ask- Two databases, that is, PubMed and Cochrane Library were searched to
find the relevant articles. Certain keywords like “Hospice care”, “Family carer
involvement in hospice care”, “Evidence based strategies for hospice care”, “End-of-life
care”, “Caring from terminally ill patients”, “Home‐based hospice acre”, “Understanding
family’s perspective in hospice care”, “palliative care” etc. were used to find related
studies. The time frame of the articles that were selected were conducted between 2015
and 2020.

7
HOSPICE CARE
Step 2: Acquire- A total of 12 relevant articles were available in both of these
databases (7 articles from PubMed and 5 articles from Cochrane Library). All the
extracted articles were screened by reading the abstract of the article. Those lacking a
proper abstract and adequate information on the research area were omitted. A total of 2
articles were identified as Evidence for the above research area.
Conclusion
In order to facilitate an enhanced and quality care of the patients suffering from
terminally illness in the hospice care settings, it is important to involve family caregivers and
follow evidence based guidelines. This paper, thus, identifies 2 major evidences by conducting a
literature search from two databases to validate the problem area and answer the PICO question.

8
HOSPICE CARE
References
Ateş, G., Ebenau, A. F., Busa, C., Csikos, Á., Hasselaar, J., Jaspers, B., ... & Groot, M. (2018).
“Never at ease”–family carers within integrated palliative care: a multinational, mixed
method study. BMC palliative care, 17(1), 39.
Chi, N. C., Demiris, G., Pike, K. C., Washington, K., & Parker Oliver, D. (2018). Exploring the
Challenges that Family Caregivers Faced When Caring for Hospice Patients with Heart
Failure. Journal of social work in end-of-life & palliative care, 14(2-3), 162-176.
Oechsle, K. (2019). Current advances in palliative & hospice care: Problems and needs of
relatives and family caregivers during palliative and hospice care—An overview of
current literature. Medical Sciences, 7(3), 43.
Ozaki, A., Tsubokura, M., Leppold, C., Sawano, T., Tsukada, M., Nemoto, T., ... & Ohira, H.
(2017). The importance of family caregiving to achieving palliative care at home: a case
report of end-of-life breast cancer in an area struck by the 2011 Fukushima nuclear crisis:
A case report. Medicine, 96(46).
Parker Oliver, D., Demiris, G., Washington, K., Kruse, R. L., & Petroski, G. (2017). Hospice
family caregiver involvement in care plan meetings: a mixed-methods randomized
controlled trial. American Journal of Hospice and Palliative Medicine®, 34(9), 849-859.
Uslu Şahan, Fatma & Terzioğlu, Füsun. (2017). Evidence-based approaches in palliative care
nursing. Anestezi Dergisi. 25. 30-36.