In 1974, the first hospice was established in the U.S. In 1982, Congress enacted a law that added hospice care to the Medicare program (a health care program for the elderly), which provided financial support for hospice services and laid the groundwork for the development of the U.S. hospice industry. The policy change led to an immediate wave of hospice care everywhere. For more than a decade, hospice services in the U.S. have progressively increased in their ability to manage compounded pain and symptoms, and services have evolved from small, voluntary organizations to a variety of formal nonprofit and for-profit agencies.
Factors in the development of society have contributed to a significant increase in the demand for hospice care, such as the aging of the population, concerns about dying with dignity, and increased costs of end-of-life care for a variety of organizations. The hospice industry in the United States has grown rapidly, with the number of hospice programs increasing at a rate of nearly 17% per year. Today, the National Hospice Organization (NHO) has more than 3,100 active and planned hospice programs in all 50 states. In 1998 alone, approximately 540,000 patients and their families received such services in the United States. Some of the better-known hospices in Japan are Yodogawa Christian Hospital (Osaka), St. Ranzanfontaine Hara Hospital (Hamamatsu), and St. John's Kyokai @ Machi Hospital (Tokyo), and the number of hospices continues to grow.
In 1987, Japan first established the National Sanatorium Matsudo Hospital and later the National Cancer Center Higashi Hospital. Inclusion in planning
By United Nations standards, more than 10 percent of the population over the age of 60 enters an aging society. China entered an aging country in 2000. According to statistics, in 2005, the number of people over 60 years old in China has reached 145 million, accounting for 11% of the total population, and it is still increasing at a rate of 3.3% per year. By 2050, there will be more than 100 million people over 80 years old. Cai Jiao, director of the Labor Institute of the Chinese Academy of Social Sciences, said that in the future, China's total elderly population will be the largest in the world, and the proportion of the elderly population will also be the largest in the world. Elderly care will undoubtedly be a heavy burden that China will soon bear. Among them, the living care and medical care of the elderly who are old and seriously ill is the difficult point in the future of the old age problem.
Not long ago, Wang Zhenyao, director of the Department of Social Welfare and Charity Promotion at the Ministry of Civil Affairs, revealed that China has 9.4 million disabled elderly people nationwide and 18.94 million partially disabled elderly people. He said that due to the lack of social care, one incapacitated elderly person affects at least two families, so there are many families plagued by the problem of care for the incapacitated elderly.
In fact, when Songtang was starting to develop, the Chinese government and society were also gradually considering the problem of elderly care. As early as 1992, the then Minister of Health Chen Minzhang said: the Ministry of Health is prepared to make hospice care one of the priorities of China's tertiary health care industry, and include it in the development plan, so as to promote its healthy development. 2004, some of the country's regional hospitals in the accreditation standards added the content of hospice care, to pay attention to it from the policy orientation.
The above facts, in Zhu Lin's view, mean that Songtang's career prospects are unlimited. As the wheels of industrialization rumble by, even China and East Asian countries, which are y imbued with Confucian prudence and heartfelt mourning, can't resist the era's formulaic procedures for dealing with death. As renowned psychiatrist and necrologist Elizabeth Ross says in her Death and Dying, "One last important thing is that the process of dying today is in many ways more horrible and repulsive, that is to say, more solitary, mechanized and dehumanized. ...... The process of dying has become isolated and impersonal. becomes isolated and dehumanized, with the terminally ill forced to be transported from their familiar surroundings and rushed to the hospital." All one can do in this process is to make death a little more dignified.
Direction of development
The current state of end-of-life care in the United States is the way forward for China. As a developing country, much can be learned from the hospice care in the United States.
(1) The impact of population aging on society is common in all countries, not only in developed countries, but also in developing countries, there is the same demand for end-of-life care. With the development of population aging in China, especially with the emergence of a large number of one-child children in cities, the social demand for end-of-life care will become stronger and stronger. The experience of the United States has shown that hospice care is a cost-saving and effective method of care, and an important way to address the difficulties of caring for families of the terminally ill. In view of the fact that family planning has become a basic state policy in China, society should focus on end-of-life care while advocating eugenics, so that the endangered elderly can be given as much access as possible to hospice care, and bid farewell to life with dignity and peace.
(2) Although there are different types of hospices in the United States, most of them are non-profit organizations with obvious welfare. This is also a revelation to China's development of hospices: in the process of developing hospices, attention should be paid to both the multiple channels and their welfare nature, and more needs to be organized by the government to develop.
(3) Endangered patients need multifaceted services, hospice care will transfer the work of family members to the community, so that the socialization of care work, in essence, is to transfer the family responsibility to the community to assume. Social commitment is inseparable from the economic conditions, the development of hospice services must start from the national situation and national strength, China's hospice care business can not be started in a flurry, should be gradual, gradual expansion. The task at hand is: society needs to re-conceptualize the need to help individuals facing the end of life to die with dignity and comfort, and to emphasize the compassionate help that family members or caregivers can provide to the dying.
(4) Hospice care in the United States has embarked on the path of institutionalization, with hospice services mostly included in health insurance, thus expanding the coverage of hospice services and enabling more patients to enjoy this benefit. In the specific operation, the United States and the development of a set of strict rules and regulations, not only through a full range of services to ensure that the system's enjoyment of the benefits, but also completely from the reality of the financial resources, the services provided will be limited to the scope of the economic conditions allow, to ensure that hospice services in a healthy, orderly and lasting operation.
(5) Although hospice care requires society to pay more for its services, receiving hospice services can reduce a large number of, even huge, medical expenses for those patients who are suffering from incurable diseases. Medicare costs can be maximized if the high and ineffective costs of a few are shifted to productive treatments for the majority of others. It is thus recognized that the moderate development of end-of-life care is of great practical significance for the reform of China's health insurance system.
(6) The development process of hospice care in the United States also shows that a strong economic foundation is not enough, and the promotion of hospice care requires a revolution in people's concepts. First, it is necessary to change the traditional concept of death. Each culture has a different attitude toward death. Hospice services cannot be carried out in a culture where it is taboo to talk about death. Dying patients, their families and doctors should adhere to materialism, and when death comes, they should face the reality, acknowledge death and recognize that further treatment is ineffective, and only under such circumstances can hospice care be concretely implemented. Secondly, the traditional concept of using health resources should be changed. Hospice care has changed the past for any patient without exception to implement the practice of medical treatment, recognizing that medical treatment is ineffective for some dying patients, the objective reality, by providing them with comfortable care to replace the unnecessary consumption of health resources, which essentially embodies the patient and the majority of the people in the true spirit of humanitarianism. Therefore, hospice care is not only a necessity for social development and population aging, but also a sign of the development of human civilization.
Development results
China's first Songtang
China's first hospice, Songtang, has been established for 23 years, but the Chinese people are not familiar with the sensitive word "hospice".
China's first hospice, Songtang, was established 23 years ago, but Chinese people still have a hard time accepting the sensitive word "dying.
At 2 p.m. in Beijing's Tongzhou district, the Songtang Care Hospital is conducting its daily routine in its courtyard. In the courtyard, a daily outdoor class is underway: passing balls, chatting and sunbathing. The "trainees" are two rows of white-haired old men in wheelchairs wearing uniform fruity-green and fruity-red smocks, tossing colorful balloons at each other and chatting animatedly about topics the other may not understand. They are 80 years old on average, and are members of the "middle class" (the elderly in Matsudo are divided into small, medium and large classes according to their age). The "instructors" are nurses and caregivers dressed in nurse's uniforms or staff uniforms, who accompany them in picking up a ball, or at any time because of a look, immediately half squatting down, asking questions or tying shoelaces. Two hours later, the elderly were pushed into the building separately. Some haircuts, some singing, some tantrums, some looking for a right-eyed patients chat, some and the "royal nurse" game, some chasing after the head nurse to their own children hang up a phone.
"Songtang" is China's first hospice, and when it was founded 23 years ago, it was difficult for Chinese people to calmly accept the sensitive word "dying," and some people even jokingly referred to Songtang as a "bad luck hospital" (""松堂"). Some people even jokingly called Songtang Hospital an obscure "previous stop on the Eight Treasure Mountain". The hospital has grown from one elderly person in 1987 to two, seven, 20, 50, and year by year to a stable number of nearly 400, totaling **** more than 30,000 elderly people over the past 23 years. "Everyone's life will come to an end, and our society focuses too much on eugenics and neglects eugenics of death. What the hospice can do is to try not to let the dying leave with regrets." Vice President Wang Guoyi said.
Huang Ziqi, founder and president of the hospital, who changed his name to the same one for the hospital, believes that people actually have to participate in society without the end of their lives, and that people can't be in concrete coffins too soon. In addition to providing comprehensive life care for the elderly without the ability to take care of themselves, more importantly, psychological care, care, not only provided by the family, but also the whole society to create a more harmonious and beautiful living environment, which is the basic needs of the dying. "The dying period lasts about 280 days, which is a delicate number." Every human being is in the womb for more than 280 days, and after a lifetime of growing up in October, he or she finally becomes an "old child" and needs a "social womb" like Songtang Caring Hospital to provide final care, so that the elderly can complete the final growth of their lives with dignity and even happiness, which is similar to a kind of "social womb". The last growth of life, similar to a kind of - slow euthanasia.
Somewhat surprisingly, the experience of walking into Matsudo Hospital is quite different from what one might expect when standing outside the hospital. Instead of the horror of death that pervades the place, there is an open acceptance. Perhaps these old people, whose lives were characterized as irreversible by the tertiary hospitals, when they unplugged all kinds of tubes from their bodies and gave up all kinds of risky measures to fight against their illnesses, just in this hospital, which focuses on "physiological and psychological care", they became more open to it. Every doctor, nurse and even caregiver here is the most optimistic psychiatrist, they will not be careful to avoid talking about death, and will not be terrified with the old man's condition was brought into the emotional valley, they are humane care and psychological techniques for each old man's "dying 280 days" to warm up. 84-year-old cerebral infarction old man was shouted as "Zhen Zhen Beauty", "Zhen Zhen Beauty". The 84-year-old brain-attacked old man is called "Zhen Zhen Beauty", the bedridden old man in his seventies who has been in bed for more than 50 years is called "Ms. Zhang", and there is also the 90-year-old Japanese singer and the 80-year-old talented man. ...... The nearly desperate doctor-patient relationship here has turned into something similar to the old man's relationship with the elderly. The almost desperate doctor-patient relationship has been transformed into an atmosphere similar to that of an old children's paradise. Sickness, fear, loneliness, negativity, irritability and despair are replaced by evoked warmth, temporary hope and occasional excitement.
Because the hospice care at Matsudo is not limited to the elderly, but many sick and abandoned babies are also brought in, the two extremes of life are presented at the same time in Matsudo. There is nothing more heartwarming than seeing a baby babbling in its cradle next to an old man's wheelchair at the entrance of a hospital room, and the other old people passing by will stop to tease the baby. Although they are unable to talk to each other and are all about to go to the other end of life, the feeling of despair and hope intertwined with each other makes the dying days of these old people a little more solid.
Beijing Hospice Address
Address: Honghua Compound, Xihongmen North Road, Xihongmen Town, Daxing District, Beijing
Transportation: Metro Line 4 to Xingu Station, transfer to Bus 474 to Welfare Farm, get off. Or Chongwenmen subway station, transfer to 610 bus, Beijing station, transfer to 827 bus, are transferred to the "welfare farm" get off the "welfare farm" to the west 20 meters, the crossroads to the north, 400 meters, that is, to the Wanming Hospital.
Metro Gongzhufen Station, transfer to 631 bus, Metro Changchun Street Station, transfer to 676 bus. Metro Gongyixiqiao Station, transfer 377 bus, are transferred to the "Kowloon Villa" get off, get off the footbridge to the east of the road to see the Xihongmen Village 100 meters to the east, 100 meters to the south, 100 meters to the east, that is, to the Wanming Hospital.
Shanghai Hospice Hospital Address
Address: No. 127, Songhua River Road, Yangpu District, Shanghai (near Yanji East Road)
Transportation: Railway: Line 8, Yanji Middle Road Station or Huangxing Park Station.
Bus: 118, 145, 863, 220, 115, 874, 135, 868, 103, 142, 137.