Deck 8: Coping With Dying: How Communities Can Help

Question 1

Long-term care facilities discharge to the community annually:

A) Approximately 30% of their residents
B) More than 65% of their residents
C) More than 90% of their residents
D) Less than 10% of their residents
E) Less than 25% of their residents

Answer 1

A

Question 2

The primary goal in responding to needs of the dying is .

A) relief from distressing symptoms of disease
B) supporting family and significant others
C) providing medical care without technology
D) making available nursing care on a 24-hour basis
E) None of these

Answer 2

A

Question 3

In American society today, hospitals primarily offer care for .

A) chronic illnesses
B) acute illnesses
C) terminal illnesses
D) psychiatric illnesses
E) accidents

Answer 3

B

Question 4

In American society today, long-term care facilities primarily offer care for .

A) chronic illnesses
B) acute illnesses
C) terminal illnesses
D) psychiatric illnesses
E) homebound patients

Question 5

In 2014, what percentage of persons 65 years of age or older were estimated to be residents in long-term care facilities in the United States?

A) Less than one percent
B) Less than three percent
C) More than 10 percent
D) About 18.5 percent
E) 33 percent

Question 6

In America in 2014, what percent of all deaths occurred in long-term care facilities?

A) 50 percent
B) 34 percent
C) 20 percent
D) 16 percent
E) Seven percent

Question 7

Dying persons who seek hospice care do so because .

A) they are poor and cannot afford hospital care
B) they are religious and seek spiritual comfort
C) they need nurses at the bedside around the clock
D) they desire relief from distressing symptoms
E) they are homeless

Question 8

The SUPPORT study of end-of-life care in the U.S.

A) failed to improve care or patient outcomes
B) showed significant improvements in bereavement care
C) minimized aggressive cure-oriented treatment
D) helped reduce the frequency and severity of pain in its dying patients
E) used focus groups as its primary methodology

Question 9

The hospice philosophy combines professional skills and human presence through .

A) primary nursing care
B) interdisciplinary teamwork
C) team nursing
D) multidisciplinary teamwork
E) individualized patient care management

Question 10

Another name for a "nursing home" is .

A) hospice
B) long-term care facility
C) retirement center
D) adult daycare center
E) None of these

Question 11

Nursing homes differ from hospitals in that they .

A) lack facilities for acute care
B) have resources for chronic care
C) have resources for home care
D) lack facilities for rehabilitative care
E) lack resources for chronic care

Question 12

Modern nursing homes were organized .

A) as primary agents of medical care
B) around the beginning of the 19th century
C) mainly to perform an educational function
D) All of these
E) None of these

Question 13

Up to the 19th century, care of the sick and dying occurred mainly .

A) in hospitals
B) at home
C) in nursing homes
D) in almshouses
E) in long-term care facilities

Question 14

Hospital care in the United States was greatly changed by .

A) the development of almshouses
B) the theory that health and disease are to be seen "as general states of the total organism"
C) the Civil War
D) All of these
E) None of these

Question 15

Which of the following formal or institutional programs may serve persons coping with dying?

A) Hospice programs
B) Long-term care facilities
C) Hospitals
D) All of these
E) None of these

Question 16

The phrase "hospice is a philosophy, not a facility" means .

A) one must go outside the existing system of care in order to meet the needs of dying persons
B) hospice care depends upon constructing specialized buildings
C) the central consideration in hospice care is the principles that govern the services
D) All of these
E) None of these

Question 17

In contemporary American society, the largest portion of deaths occur .

A) in hospitals
B) in hospice programs
C) in home care programs
D) in long-term care facilities
E) in retirement centers

Question 18

The hospice philosophy emphasizes .

A) physical care for dying persons in a facility
B) affirmation of life and living for both dying persons and their family members
C) maintaining close ties in the community for support
D) having physicians visit patients at home
E) None of these

Question 19

The hospice philosophy of care is best described as offering:

A) Physical care
B) Nonindividualized care
C) Holistic care
D) Spiritual care
E) Psychosocial care

Question 20

Hospice care serves family members of dying persons by .

A) offering ongoing support to bereaved survivors after the death of a loved one
B) enabling them to help to care for their loved one while he or she is dying
C) including them in the unit that receives care
D) All of these
E) None of these

Question 21

How many hospice programs were estimated to be operating in the United States In 2014?

A) 1,500
B) 2,200
C) 3,700
D) 5,200
E) 6,100

Question 22

The Medicare hospice benefit:

A) Pays most of its benefits directly to hospice programs
B) Emphasizes home care
C) Offers reimbursement on a prospective, flat-rate basis
D) All of these
E) None of these

Question 23

Admission criteria in hospice programs that receive Medicare reimbursement typically require .

A) a prognosis of more than six months to live
B) a willingness to forego cure-oriented interventions
C) a diagnosis of cancer with metastasis
D) the individual to be free of pain and independent
E) the absence of a key caregiver in the home

Question 24

Hospice care in the United States is .

A) reimbursed through retrospective, fee-for-services
B) funded by Medicaid, but not Medicare
C) limited to patients with cancer
D) All of these
E) None of these

Question 25

Treatment of the common cold is a form of .

A) cure-oriented care
B) palliative care
C) chronic care
D) a futile enterprise
E) long-term care

Question 26

In 2014, it is estimated that U.S. hospice programs served how many patients?

A) 2.75 million
B) 1.6-1.7 million
C) 975,000
D) 500,000
E) 95,000

Question 27

Pediatric palliative care .

A) is planned and delivered through the collaborative efforts of an interdisciplinary team, with the child, family, and caregiver(s) at its center
B) can be provided along with disease-modifying therapy or as the main focus of care
C) is both a philosophy and an organized method for delivering competent, compassionate, and consistent care to children with chronic, complex, and/or life-threatening conditions, as well as their families
D) All of these
E) None of these

Question 28

In the United States, when a dying person is accepted into a Medicare-qualified hospice program, regulations require that _.

A) the dying person be allowed only six months of care
B) the dying person must have other hospitalization insurance
C) the dying person must have money for unexpected expenses
D) the dying person cannot be involuntarily discharged by the program
E) care should be provided primarily in an inpatient facility

Question 29

In 2014, the largest number of hospice programs in the United States were .

A) divisions of home health agencies
B) based in nursing homes
C) hospital-based
D) agencies of governmental organizations
E) independent free-standing agencies

Question 30

The impetus for the development of the modern hospice movement came from .

A) National Health Services hospitals in England
B) the Royal Victoria Hospital in Montreal
C) St. Christopher's Hospice in southeast London
D) a community-based home care program in New Haven, Connecticut
E) None of these

Question 31

Home health care programs are distinguished by .

A) the skilled nursing care that they provide
B) the location in which care is provided
C) the illnesses for which care is provided
D) a desire to limit rising costs in health care
E) an emphasis on providing physical care

Question 32

Individuals who would most likely not be receiving care in a hospice program are those diagnosed with .

A) degenerative diseases
B) terminal cancer
C) an acute illness
D) All of these
E) None of these

Question 33

In 2014, it is estimated that U.S. hospice programs cared for approximately:

A) 15% of all deaths
B) 20% of all deaths
C) 27% of all deaths
D) 38% of all deaths
E) 46% of all deaths

Question 34

In health care to palliate means .

A) to alleviate symptoms of a disease without curing it
B) to make something seem tasty
C) to cure the underlying causes of a disease
D) All of these
E) None of these

Question 35

Research studies have shown that hospice care .

A) can extend length of life in hospice versus nonhospice patients
B) increases Medicare costs for patients
C) increased perceived disparities in care for African-American patients
D) was rated less than satisfactory by family members versus other institutional settings
E) should focus on shortening lengthy enrollments of patients

Question 36

In 2014, the leading diagnosis on admission to a U.S. hospice program was:

A) End-stage heart disease
B) End-stage kidney disease
C) Dementia
D) Lung disease
E) Advanced cancer

Question 37

Home health care programs may provide care for .

A) acute illness
B) chronic illness
C) terminal illness
D) All of these
E) None of these

Question 38

The primary goal of all palliative care is .

A) learning to communicate with other caregivers
B) providing cure-oriented interventions for underlying causes of distress
C) recognizing that in many circumstances "there is nothing more that we can do"
D) expanding the role of unconventional forms of therapy
E) minimizing distressing symptoms

Question 39

In American society today, hospice programs primarily offer .

A) chronic care
B) acute care
C) home health care
D) end-of-life care
E) None of these

Question 40

In 2014, it is estimated that how many Americans died while receiving hospice care?

A) 1.2 million
B) Just under 990,000
C) Approximately 870,000
D) 500,000
E) Fewer than 325,000

Question 41

What does it mean to say that the hospice philosophy strives to maximize present quality in living?

Question 42

What does it mean to say that the hospice philosophy affirms life, not death?

Question 43

Identify and explain three (3) key factors that made it necessary to develop a new mode of care for dying persons of the type that is embodied in the hospice philosophy. pp. 182-184

Question 44

It has been said that: "Until the middle of the 19th century, care provided in a hospital was usually no better than what could be obtained elsewhere." Explain this statement.
What did a good hospital provide prior to the middle of the 19^th century?

Question 45

Explain the meaning of the following statement: "What people need most when they are dying is relief from distressing symptoms of disease, the security of a caring environment, sustained expert care, and assurance that they and their families will not be abandoned."

Question 46

Explain the meaning and the services of pediatric palliative and hospice care. Give details and be specific.

Question 47

Compare and contrast the services offered by hospitals, long-term care facilities, home health care programs, and hospice programs. Make clear in each case to whom these services are addressed, what sorts of services are offered, and what are the goals of the services.

Question 48

Define the meaning of "palliative" care. Give an example illustrating how this type of care is different from other types of care. Show how palliative care may differ from hospice care.

Question 49

What were the principal factors that led to the development of nursing homes or long-term care facilities? Explain your answer.

Question 50

Define the meaning of the term "hospice care" in ways that will make it clear to those who have never heard those words before. Identify and explain five (5) aspects that are distinctive of hospice care.