د فيصل الناصر - Faisal Alnasir is a Professor and Chairman at Dept Of Family & Community Medicine at Arabian Gulf University

1. The Hospice Care
Faisal Abdul-Latif Al-Nasir
FPC,MICGP,FRCGP,FFPC,PhD
Professor of Family Medicine
Ex-Vice Predident
Arabian Gulf University

2. Who is OldWho is Old: >60 Years???: >60 Years???
‫طفل‬ ‫البربعين‬ ‫سن‬ ‫في‬ ‫السنسان‬ ‫إن‬‫طفل‬ ‫البربعين‬ ‫سن‬ ‫في‬ ‫السنسان‬ ‫إن‬ ……
‫مراهق‬ ‫الخمسين‬ ‫سن‬ ‫وفي‬‫مراهق‬ ‫الخمسين‬ ‫سن‬ ‫وفي‬
‫شاب‬ ‫الستين‬ ‫سن‬ ‫وفي‬‫شاب‬ ‫الستين‬ ‫سن‬ ‫وفي‬
‫خضراء‬ ‫وجنة‬ ‫مخضرم‬ ‫السبعين……شيخ‬ ‫سن‬ ‫وفي‬‫خضراء‬ ‫وجنة‬ ‫مخضرم‬ ‫السبعين……شيخ‬ ‫سن‬ ‫وفي‬

3. ‫للبحـــرين‬ ‫السـكاني‬ ‫الهرم‬‫للبحـــرين‬ ‫السـكاني‬ ‫الهرم‬
‫للسنوات‬‫للسنوات‬19501950––20002000--20502050
Population Pyramids, 2000
1950 2000 2050
60+
0-59
Male Female
Age
Percentage Percentage Percentage

4. • Poor raw material
• Prevailing poverty
• Fast ageing in parallel with rapid social
changes
– urban vs. rural ageing
– changes in family structure
– Epidemic in Africa such as AIDS
The reality in the developing world

5. The developed worldThe developed world
becamebecame richrich before itbefore it
becamebecame oldold..
Developing countries areDeveloping countries are
becomingbecoming oldold
before they becomebefore they become richrich..

6. End of Life
Ageing is good for you – remember: there is
only one alternative to it!

7. End of Life
Ageing is good for you – remember: there is
only one alternative to it! DEATH

8. End of Life
Ageing is good for you – remember: there is
only one alternative to it! DEATH
Every person is different, and the paths to
death will vary.

9. Definition
The word "hospice" stems from the Latin
word "hospitium" meaning guesthouse.
It was originally used to describe a place
of shelter for weary and sick travelers
returning from religious pilgrimages.

10. History
In UK
During the 1960's, Dr. Cicely Saunders, established St.
Christopher's Hospice near London.
St. Christopher's organized a team approach to
professional care-giving, and was the first program to use
modern pain management techniques to compassionately
care for the dying.
In USA
The first hospice established in New Haven, Connecticut in
1974.
Today there are more than 3,200 hospice caring for nearly
885,000 people (in 2002).

14. What is Hospice care?
Is the choice made to enhance life for a dying
person.
Traditional care emphasizes the use of medical
interventions, hospitalization and drugs to cure
or control disease. It may involve aggressive
and expensive high-tech medicine.
Hospice is an appropriate choice, when cure is
possible and when cure is not possible.
However, it is not the only choice.

15. -A special concept of care designed to provide
comfort and support to patients and their
families when a life-limiting illness no longer
responds to cure-oriented treatments.
-Hospice care neither prolongs life nor
hastens death.
What is Hospice?

16. -Hospice staff and volunteers offer a
specialized knowledge of medical care,
including pain management.
-The goal of care is to improve the quality
of a patient's last days by offering
comfort and dignity.
What is Hospice?

17. What is Hospice?
-Hospice care is provided by a team-
oriented group of specially trained
professionals, volunteers and family
members.
-Hospice addresses all symptoms of a
disease, with a special emphasis on
controlling a patient's pain and discomfort.

18. What is Hospice?
-Hospice deals with the emotional, social and
spiritual impact of the disease on the patient
and the patient's family and friends.
-Hospice offers a variety of bereavement and
counseling services to families before and
after a patient's death.

19. Why Hospice?
It is important to die with dignity and peace

20. Why Hospice?
Hospice provides relief from pain.
The physical pain arising from a terminal
illness may be debilitating, frightening
and dehumanizing. Hospice providers
have the skills and resources to permit
persons to live as pain-free, as
comfortable, and as full a life as possible.

21. Why Hospice?
Hospice care focuses on maintaining
patients' quality of life, as opposed to
aggressively treating their illnesses.
Hospice provides support.
Provides physical comfort of the dying
person, also social and spiritual support
for the patient and his or her family.

22. Who are the Patients?
•The are typically in their last six months of
life.
•Approximately 2/3 of hospice patients are
over the age of 65.
•Not only patients with cancer, but patients
with pulmonary disease, heart disease,
neurological disorders, Alzheimer's
Disease, and AIDS.

25. Hospice Staff
Multi-disciplinary team consisting of:
physicians, nurses, aides, social
workers, spiritual care givers,
counselors, therapists and volunteers.
Trained volunteers are an integral part of
hospice service. In USA Over 95,000 people
volunteer for hospice annually. Volunteers
provide over 5 million hours of care and
service annually.

27. Staff Training
They are specially trained to provide
medical assistance and to deal with
the loneliness and fears experienced
by both the patient and his or her
loved ones.

28. The experience of caring for people at the end
of their lives Can be very difficult.
Seeing the suffering of the dying may cause
feelings of helplessness and anticipation of
future losses. Working with the dying can be
exhausting because of the various emotions that
are shared. Those who do this work with the
dying must understand themselves as important
and valuable individuals.

29. Staff Training
There is a great need for psychosocial and
psychological death education for nursing
home staff.

31. Staff Training
They works with the patient and his or her
family to develop a personalized care plan.
They respect patient wishes and help foster
communication amongst family members

33. Hospice Goals
•Stages of Dying
•Problems associated with a terminal illness
•How caregivers can help the dying
•Grief/Bereavement issues
•Care for the caregivers
•Exercises, handouts

34. What to Expect Before Death
The Dying Process: Physical and Psychological
Symptoms
•Signs of Approaching Death
Sometimes caregivers do not know how to tell when
their patient or loved one is dying. But patients often
tend to show specific symptoms when they are nearing
death.
•Emergency Profile
What rational decisions will need to be made in times of
crisis.

35. What to Expect After Death
Grief
Grieve after lose of beloved.
Every person's journey through grief is different.
Correspondence details and logistics
After the death, loved ones will be faced with
overwhelming logistical details and paperwork. The
person(s) responsible for taking care of these
details will need to correspond with appropriate
organizations, institutions, and businesses to inform
them of the death of the family member.

45. :(‫السل(م‬ ‫)عليه‬ ‫طالب‬ ‫أبي‬ ‫بن‬ ‫علي‬ ‫الاما(م‬ ‫قال‬
‫ونا(م‬ ‫المضجع‬ ‫في‬ ‫أرق‬ ‫الستين‬ ‫أحدكم‬ ‫بلغ‬ ‫إذا‬ ”
‫وجع‬ ‫بل‬ ‫وأن‬ ‫المجمع‬ ‫في‬ “