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The spirit of The Hospice team. is to encourage quality of existence for patients
and families. Because of this abiding philosophy, pain and symptom control lie
at the very heart of the Hospice program of care. Medical and pharmacological
therapies control a range of debilities that, if untreated, sap a patient's strength,
will, and even human dignity.
Professional expertise and an individualized care plan make possible a control of
pain rarely achieved in other health care settings. Nowhere is this more evident
than in the work of the hospice physician, nurse, and pharmacist. The physician,
nurse, and pharmacist are important team members in evaluating pain and treat-
ing it pharmacologically. Artists, social workers, clergy, nurses, and professional
and lay volunteers work with psychological and spiritual pain. As a team, they re-
view the patient's status daily. In addition, consultants in several fields of health
care complement the efforts of the medical and nursing staffs.
Prior to admitting a patient to the Hospice program, the Hospice physician confers
with the family's physician. They retain open lines of communication. In the home
care program, the family's physician acts as the primary physician. The role of
the Hospice physician varies from case to case. In the inpatient unit the Hospice
physician assumes the primary physician role. In both programs, medical direction
is available twenty-four hours a day.
The care plan must be creative, innovative, and flexible to respond to the constant-
ly changing challenges of irreversible illness. Some symptoms can be relieved by
simple measures such as repositioning, massage, relaxation techniques, and distrac-
tion through arts and other activities. Yet medications are often crucial in alleviat-
ing physical discomfort.
In treating the patient, the Hospice physician and pharmacist are guided by repeat-
ed assessments, with adjustments in medications, and times of administration so that
the patient will be as comfortable as possible.
An important principle in the Hospice regime approach is that drug doses are care-
fully adjusted to each patient's physical make-up. This assures pain relief without
loss of alertness. The Connecticut Hospice goal is to control symptoms while main-
taining optimum functioning.
At Hospice, the patient's needs dictate the medication level. Medications are ad-
ministered on a regular schedule, to eliminate not only pain, but also the fear of
pain. Ease of administering is a key consideration also. Patients are spared injec-
tions whenever possible to make their lives more comfortable. Over 90 percent
of the medications at Hospice are taken orally. Because of this, it is often poss-
ible for patients to be cared for at home.
When a medication is not available commercially in the exact dosage needed, the
Hospice pharmacist is able to meet individual needs. An active participant in pa-
tient care, the pharmacist attends morning rounds and weekly team meetings,
serving as a source for current drug information and a consultant for changing
drug regiments. Both the Hospice pharmacist and physician strive to educate
others on the goals and parameters of hospice caregiving. Advances in symptom
control present diversified and constant challenges. As Hospice physicians and
pharmacists discharge their demanding duties, they are in the forefront of
palliative care. Hospice remains identified by its excellence of symptom
management and support.
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