AEGiS-11IAC: Role of in-hospital palliative care service.

11th International AIDS Conference


Vancouver, British Columbia — July 7-12, 1996

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Role of in-hospital palliative care service.

Int Conf AIDS 1996 Jul 7-12; 11:223 (abstract no. Th.B.192)
Fisher A, Vohr F, Wacker M; Stratogen Health, Providence, RI, USA. Fax: 401-781-2687.

ISSUE: When existential domains of AIDS patients, families, friends and lovers clash, the resulting sickness, death and bereavement can be chaotic.

PROJECT: One's existential domain refers to those things that define a person's existence and presence in life, his physical, personal, and spiritual relationships at any given time. These may change. Profound personal changes replace old relationships with new. Family relationships may be torn asunder. Add to this scenario HIV-AIDS and the resulting sickness, death and bereavement can be chaotic. Lovers, parents, relatives and friends may want to be involved, often to the exclusion of each other. Caring and grieving is mixed with resentment, anger, hostility and frustration. The surviving lover, part of the deceased's existential domain, may find himself (herself) and friends unwelcome outsiders. This is where an experienced palliative care/hospice team can be at its best and calls for quick and skillful learning by all, and enormous patience. Hospice/palliative care staff must quickly assume the role of teacher, negotiator, diplomat and referee. Collision of existential domains is avoided, participation by all is allowed along with healing and resolution of guilt, fear, resentment, anger, ignorance and unexpressed love. Failure to accomplish this results in more pain. Lovers, as part of the existential domain, must be validated. The Rhode Island Palliative Care Service, available to AIDS patients, was established in March, 1995. Until that time approximately 80% of these patients were discharged home with death following quickly. Reasons for continued hospitalization until death have included unavailability of family/companions, fear of the dying process, and complexity of the medical support required (both real and perceived). A summary of these factors and illustrative cases will be presented.

RESULTS: Patients, families, friends and lovers were relieved of the guilt and pain of unexpressed love; the existential domains of all were respected. Patients were cared for in settings outside the hospital. The Palliative Care Service was well accepted by patients ad their significant others.

LESSONS LEARNED: A palliative care service can facilitate a positive interaction between existential domains of patients, families, friends and lovers and thereby facilitate a healthier grief process in all the survivors.

Keywords: AEGIS, Hospices, Palliative Care, Hospitals, Death, Bereavement, Grief, Family, Pain, Hospitalization, Attitude of Health Personnel, Attitude to Death, Acquired Immunodeficiency Syndrome, Health Personnel, Rhode Island, Human, ICA11KWDaegis,hospices,palliativecare,hospitals,death,bereavement,grief,family,pain,hospitalization,attitudeofhealthpersonnel,attitudetodeath,acquiredimmunodeficiencysyndrome,healthpersonnel,rhodeisland,human,ica11

960707
ThB192

Copyright © 1996 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.