Hospice and skilled nursing care fill different medical roles.

Two of the specialty areas within the health-care field are skilled nursing homes and hospice care. A skilled nursing home provides a residence for ill or recovering people who cannot care for themselves. Hospice care provides support and care for people with a limited life expectancy; the goal is to enable them to live as fully and comfortable as possible in their remaining days.

1.History

o     Skilled nursing homes have become a common form of care for elderly and incapacitated people, with approximately 6 percent of older adults living in such facilities. Prior to the 19th century, the nation's elderly typically were cared for by family members in homes. Later, alms houses took care of a community's aged and incapacitated residents, and these evolved into the skilled nursing homes of today.

Hospice care developed in the last half of the 20th century with the focus of providing specialized care for dying patients. The concept behind hospice was that terminal patients and their families could benefit from more focused symptom control and specialized end-of-life care.

2.  2.Focus

o      A skilled nursing home provides 24-hour medical care, including nursing services, wound treatments, assistance with activities of daily living, meals, medication management as well as physical, occupational and rehabilitative therapy following an accident or illness. The facility is not a hospital, and in most cases, not equipped to provide intensive medical treatment.

Hospice care typically is provided at a patient's place of residence. Hospice consists of a team of providers, who manage the physical, medical and spiritual needs of a person at the end of life, and provide support for the family as well. Pain management, medication administration and personal care are provided as needed.

3.  3.Staff

o      At a skilled nursing home, all patient care is under the supervision of a medical doctor, called a medical director. Direct patient care is provided by registered nurses, licensed practical nurses, medication assistants, nursing assistants, dietitians and therapists. Also on site are janitorial staff, housekeeping staff and kitchen staff. Patient care is provided 24 hours a day.

Hospice care is also under the care of a physician; the team also includes registered nurses, licensed practical nurses and nursing assistants. While the doctor and nurse are on-call 24 hours a day, they are not actually present with the patient all the time. The majority of hospice patients rely upon family members to assist with their care, including activities of daily living and personal care. Chaplain services are available if desired by the patient and family.

4.  4.Availability

o      Skilled nursing homes are available in most communities in America. When deciding upon a skilled nursing home, it is best to visit more than one, then weigh the strengths and weaknesses. All must be certified and inspected by the state to ensure proper levels of care. Some facilities specialize according to needs, such as providing Alzheimer's units or specialized wound care.

Hospice care organizations are increasing in America. They usually are centered around hospitals or cancer care units. Sometimes the staff also travels to rural areas to provide patient care. Someone is available on-call 24-hours a day.

Your physician can help you decide whether to pick a skilled nursing home or hospice. It is also possible to receive hospice care while residing in a skilled nursing home, when a terminal illness has been diagnosed.

5.  5.Considerations

o      You should factor in insurance and Medicare requirements when deciding what type of care a patient needs. Check with your insurance and/or Medicare representative about what services would be covered for a skilled nursing home or hospice care. This will help you make the best financial decisions regarding treatment. For a complete list of services covered by Medicare, visit the agency's website.      

        By Sarah Leslie Gagan, eHow Contributor

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