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首先介绍,在生命尽头的关爱有几种形式? Asked where they would like to spend their last days, most people always say at home, surrounded by people they love. In real life, though, only one in five achieves that. More than 30% die in a nursing home, where almost no one wants to be, and over half end up in a hospital, often in an intensive-care unit, heavily sedated and attached to life-saving equipment until their doctors give up the battle.【参考资料:有at hospitals and nursing homes,有at home,有hospice(临终关怀服务)。】然后开始重点阐述“临终关怀”:一、什么是“临终关怀”服务 的 对象&目的?Hospice care is a system of care that helps those with an incurable illness(对象) to focus on making the most of whatever time is left(目的). They offer a range of support, often alongside active treatment for an illness. The focus of modern hospice care is on helping people to live well until they die. Dying in a hospice care can bring families(对象) peace and allow a closeness which isnt always possible at home.【参考资料:临终关怀(palliative care = hospice care = terminal care)并非是一种治愈疗法,而是一种专注于在患者在将要逝世前的几个星期甚至几个月的时间内,减轻其疾病的症状、延缓疾病发展的医疗护理。临终关怀是近代医学领域中新兴的一门边缘性交叉学科,是社会的需求和人类文明发展的标志。】2、 “临终关怀”具体有什么服务?1. physical care:(1) improving respiratory function(改善呼吸)using respirator;(2) alleviating pain(止痛)pain killer(eg: morphine , dolantin),music therapy,massage, acupuncture and moxibustion (3) diet supplement(补充营养)(4) keeping comfortable positions、warm、clean bodies(舒适体位、保温、清洁)2. mental care:临终患者可能有这些情绪:melancholy,angry,self-denial,临终关怀工作者要“态度真诚,用爱心、耐心教育引导患者,缓解他们的压力,尽量实现患者为完成的愿望尊重患者,以及陪伴ta。3. spirituality care: For patients who have religious faith,spiritual workers can help them find relief in religious instruction,such as immortal,paradise【参考资料:(一)身关怀:透过医护人员及家属之照顾减轻病痛,再配 合天然健康饮食提升身体能量。(二)心关怀:透过理念之建立减轻恐惧、不安、焦虑、埋 怨、牵挂等心理,令其安心、宽心、并对未来世界(指死后)充满希望及信心。(三)道业关怀(或灵性关怀):回顾人生寻求生命意义或多半透过宗教学说及方式建立生命价值观,如永生、升天堂、往西方极乐世界等。】3、 进入“临终关怀”的条件、团队组成、资金来源:(1)条件:在美国,必须两位医生判定患者自然病程只有6个月以下;(2)团队组成:doctor、nurse、social worker、counselor、therapist、spiritual advisor、trained volunteer。(3)资金来源:private expenditure、social insurance、commercial insurance、charitable funds。四、“临终关怀”的简要历史与在中国的现状:(1) 公元11世纪,耶路撒冷的十字军医院收治一些没有康复希望的人;(2) 20世纪50年代,英国护士桑德斯(Cicell Saunders)在伦敦建立ST.Christophers Hospice医院,为现代临终关怀医院奠定基础;(3) 1988年天津医学院临终关怀研究中心的建立,临终关怀服务开始在中国发展;(4) 现在大约有100多家临终关怀机构,几千位从事这项工作的人员。五、影响“临终关怀”发展的因素:(1)资金不足;(2)传统观念束缚,“临终关怀”观念未普及。文章大概1-2段:General introduction of cares at the End of Life3-5段:Differences between terminal cares provided at hospitals and nursing homes6-8段:Terminal cares, provided at home,shall have some other helps too.9-14段:Introduction of palliative cares ( meanings,applicable conditions,provider,sponsor )15-19段:Characters of hospice cares ( no cutative treatment,not permanent ).文章缩写版本Decades ago,most people died at home,but as medication advances,more and more people choose hospice care at the end of life.If given chances,each person and his/her family should consider which type of care is the most suitable.And how many types of care do we have?We have cares at hospitals,nursing homes,homes and can get palliative cares,which is similar to hospice cares.The advantages of choosing cares at hospitals are that there is always medical staff available who know what needs to be done for someone who is dying.But this may have less personal cares and privacies for patients,so the nursing homes services are acceptable because they can provide cares more privately.Choosing cares at homes are also good options.Because this can let patients feel warmer.In order to relieve the burden of patients family,some other supports are necessary,such as medical conselor,visiting nurses,special equipments(commodes) and so on.In addition to this,palliative cares are meaningful sometimes.Palliative cares now often refer to a comprehensive approach to improving patients quality of lives who are living with potentially fatal diseases,through using both curative and alleviating treatments meanwhile if it is useful.At some point,however,curative treatment may no longer make sense,even make the patients more uncomfortable.Hospice is designed for this situation.Different from palliative cares,attempts to cure illness are stopped.But it doesnt mean discontinuing all treatments.On the base of staff participating in palliative care teams,spiritual advisors and trained volunteers are available too.Choosing hospice doesnt have to be a permanent decision. You can change your mind at any moment.
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