Adapting the home to the continuum of care is not a new concept. Hospice has effectively incorporated the patient’s home for end-of-life and palliative care for many decades now. Perhaps Hospice and similar programs may provide a model for how a “heal in place” paradigm might work.
As a model, hospice has much to offer. For one, hospice is incredibly “patient centered,” adapting care initiatives to the individual’s environment, capabilities, social, spiritual and personal needs. Even the patient’s hopes and expectations are folded into the care plan. Additionally, “The ‘front line’ of care has always been provided by family and friends for a great majority of patients.” In this model “Clinicians who understand and encourage helpful family involvement in patient care can bolster and be assisted by rather than feel interrupted by and undermine this important source of care.” In addition, the clinician who is aware of the burdens of care, and can direct the caregiver to a source of support, will help foster quality of life for patients and families. The medical professional can uniquely guide and provide sources of care…in all four elements of physical, psychological, social and existential experience. The importance of interdisciplinary teams for this care cannot be overstated. A “heal in place” program would essentially build on these elements of hospice only from a curative rather than palliative care plan.
A quote from an article by Johanna Turner on the American Hospice Foundation website remarks “Hospice care is medicine’s finest example of patient self-determination and family empowerment. It’s about listening first, then finding ways to make each day be what you and your family want it to be.” It seems to me that this is the leading impetus behind healthcare reform and might work well for living with disease and managing health as well.