Jack Kerouac Essay Example | Topics and Well Written Essays - 1250 words

Jack Kerouac - Essay Example However, this work cannot be discussed out of context. Therefore, it is important to also discuss the Beat Movement and its relation to Jack Kerouac to better understand the literary piece, and to provide substantial arguments. John Kerouac and the Beat Movement John Kerouac is the acknowledged leader of the literary artists belonging to the Beat Movement. This movement promotes countering the cultures during the 1950s, whereby resisting conformity expectations of the middle class American culture. This movement was joined by literary artists, who exploit their literary talents to convey and create works with values and topics of poverty, immigration, sex, drugs, eastern philosophers (Buddhism) and American Jazz musicians. These values and topics have been evident in the work of Kerouac, On The Road. This piece has expressed the perceptions and rationality of those belonging to the movement. Through a fictional story, it depicts the group, whereby they refuse to acknowledge various d ominating values and beliefs during the period. In particular, the Beat rejects materialism and conformity, which was said to be the expectation of the American middle class. Rejection of Conformity in Middle Class American Based on the work of Kerouac, the main aim of the Beat Movement (based on the book) is to restore the authenticity of humans in the culture of the prepackaged life--- that is conformity. To note, this era was a proliferation of freedom repression. It is apparent that the Beat Movement aspires to influence the society in reinventing the dominant culture through writings. By narrating his and his friends travel experiences, he instills the importance of freedom in a world governed by norms. Their deviation from uniformity was characterised by their travels on the road. Despite believing in the power of language, the Beat movement continues their fight by living what they write. That is, they are able to deliver their sentiments by living â€Å"freely† with d rugs, religion, voluntary poverty, affirmation to third sex and alcoholism. These elements are distinctively clear in their writings, as well. Moreover, it is often emphasised from the book that residing in a particular area is never permanent. This paper perceived this reflects the ambition of the Beat to create a new value and faith outside the values which forcibly shape their lives and beliefs. Provided with this, the Beat pointed out that the ultimate dream is not to conform to society, but rather it is the freedom from the conservative society they belong to. They perceive such conservatism as a curtailment of their freedom to express themselves. Hence, the primary rationale on why the Beat rejects conformity is the hopes of circumventing the restrictions associated with the expectations of the American middle class. On the second note, the book demonstrated that the Beat rejected American Middle class restrictions as it also promotes materialism and consumerism in the capital ist society. This means that the Beat rejects conformity as they do not believe in materialism. Acquiring this value does not guarantee happiness despite one’s abounding wealth. The Beat recognised the importance of spiritual fulfillment, which will not be attained by materialistic values. The characters’

Sub-Prime Mortgage Crisis and the East Asia Research Paper

Sub-Prime Mortgage Crisis and the East Asia - Research Paper Example The subprime mortgage crisis in the United State was more severe than the great depression because several assets and derivatives had been purchased and sold in the unstable market. Moreover, the subprime mortgage crisis had several liquidity risks compared with that of the exchange traded products. According to Justin and Boris (2011), commercial banks finance in the East Asia asks for the mortgages without considering the credit evaluation of the borrowers. Thus, the paper will evaluate the financial crisis issues that were triggered from the U.S sub-prime mortgage crisis, and affected the East Asian economy. The sub-prime mortgage crisis The sub-prime mortgage crisis was a result of the speculative issues in the housing market that commenced in the United State in 2006. It has caused severe impact across the East Asia countries in the form of financial crisis and the country’s credit crisis. Justin and Boris (2011) indicate that the forces caused by the sub-prime mortgage c risis will probably run out of control for years, causing the collateral damage. The disruption in the East Asia countries credit market is of historic proportions and will have significant economic impacts. Moreover, the crisis has caused essential societal changes that affect the consumer habits and the values. Justin and Boris (2011) indicate that the East Asia economy was affected where the GDP was recorded 4.2, 4.8, 5.7 and 1.9 per cent from 2005 to 2008. This led to the ever recorded a decrease in GDP in 2009 that amounted to -4.0 since 1980. Therefore, this crisis has significantly affected the Europe and Asian countries, and most of the Asian countries have rearranged their financial and banking industry. Delgado and Burge (2009) claim that the proximate cause of the sub-prime mortgage crisis was the busting of the housing issues in the East Asia during the summer of 2007 when subprime defaults commenced to rise and foreclosures increased. It then spread to prime loans and o ther types of consumer credit, and the financial institutions with the subprime related products were severely affected. The Asian countries were severely affected by the sub-prime mortgage crisis during the early stage of the crisis because the banks were not exposed to the dangerous assets that were engineered and crafted in the United State. According to Delgado and Burge (2009), the data gathered in the Economist and Financial Times, the $500 billion was written off by banks globally in the 2008. The financial institutions in Japan accounted for only five percent, and its sectors were relatively resilient. The global financial crisis has affected the China and Japan very strongly as they stand among the most opens in the world. Foreign capital inflows declined significantly as commercial banks and foreign institutional investors withdrew funds to meet redemptions in their countries. According to Delgado and Burge (2009), private capital flows in China slowed from $516.7 billion to 2007 to an estimated $134.4 billion in 2008. Table of the GDP of the East Asia countries 2007 2008 2009 China 11.9 9.7 8.5 Japan 2.1 0.5 -0.2 Korea 5.6 3 3.9 2.1 Modified from: IMF (2008a) According to Ghon (2008), the Banking leading declined that was as a result of the direct and indirect equities. During 2009, the capital flows were estimated to be only $44.1 billion, and in the beginning of 2008, stock markets declined by about 62 percent in China (Ghon, 2008). Thus, the Chinese stocks markets had been the worst performer in

Ecotourism In Dominican Republic Tourism Essay

Ecotourism In Dominican Republic Tourism Essay Ecotourism has grown rapidly since the late 1980s, which is the fastest development of all the events in the tourism industry. The word ecotourism is from ecological tourism. According to the definition of ecotourism is Responsible travel to natural areas that conserves the environment and improves the well-being of local people.'( Martha Honey,1990).Furthermore, ecotourism also includes that traveling to natural destinationsà £Ã¢â€š ¬Ã‚ building environmental awarenessà £Ã¢â€š ¬Ã‚ respecting local culturesà £Ã¢â€š ¬Ã‚ supporting human rights and democratic movements Nowadays, more and more countries and national organizationsà £Ã¢â€š ¬Ã‚ including many individuals show high respect for worldwide ecotourism. Some countries like Kenyaà £Ã¢â€š ¬Ã‚ Nepalà £Ã¢â€š ¬Ã‚ Australiaà £Ã¢â€š ¬Ã‚ Antarctica and Dominica. There are also many famous organizations such as World Tourism Organization (WTO)à £Ã¢â€š ¬Ã‚ United Nations Environmental Programmers (UNEP)à £Ã¢â€š ¬Ã‚ The International Ecotourism Society (TIES). It is considered that that is the reason why ecotourism can develop so fast that it can affect the world and our planet Earth greatly. (Transitions abroad, n.d.) The Dominican Republic, as the name Natural Isle of the Caribbean goes, the country which is an island nation in the Caribbean Sea. As well as having many mountainous rainforestsà £Ã¢â€š ¬Ã‚ it is home to many rare plantsà £Ã¢â€š ¬Ã‚ birds and animals in its limited 754  square kilometers. This is the reason that led to the Dominican Republic becoming an ecotourism island. Many people still believe that the lack of terrain and development funding is the other key why many people and global organizations claim that the Dominican Republic is well-known for its ecotourism industry. Although the Dominican Republic has many different cultures and customs like French cultureà £Ã¢â€š ¬Ã‚ Spanish custom and local culture, for example, traditional Aztec culture and traditional Indian culture ,these different cultural phenomenon did not affect the natural system .Otherwise, natural ecotourism plays an important part in the Dominican Republics economy. All in all, people can learn more about Ecotourism in Dominican Republic. This research paper will examine four main aspects of ecotourism in the Dominican Republic: International and national organizations supportà £Ã¢â€š ¬Ã‚ Advantages Disadvantagesà £Ã¢â€š ¬Ã‚ the success of Ecotourism programmes and Future developments. With the remarkable improvement of peoples living standards ¼Ã…’ecotourism has aroused wide public concern. USAID ¼Ã…’an American organization, has put a lot of efforts into developing ecotourism. USAID programs brought the public and personal sectors together, in order to support sustainable ecotourism development. USAID also gave a helping hand to creating a vision and seeking a key to ecotourism in the Dominican republics future. Laying emphasis on increasing leadership roles of local small- and medium-sized enterprises (SMEs), increasing the communication of society à £Ã¢â€š ¬Ã‚ developing marketing toolsà £Ã¢â€š ¬Ã‚ reopening the local airport ,and strengthening the quality of the services of ecotourism while using natural resources.(USAID ¼Ã…’2009) The Tourism Sector Development Program, funded by the European Special Framework of Assistance ¼Ã‹â€ SFA,2006 ¼Ã¢â‚¬ °is an ecotourism program which is two years old, being implemented by the Ministry of Tourism and Legal Affairs (MT LA). Improving on the competitiveness of the tourism sector  in the Dominican Republic is an important part of this program. Another aim of this program is to seek to build the main connection of the society and ecotourism between tourism and the agricultural and rural parts. Furthermore, it aims to improve the Dominican Republics position in the market place through increased marketing and promotions. The Tourism Sector Development Programme focuses on society tourism products development in the Dominican Republic. Help is given to these communities in the areas of foundation development; human resources development and business planning; package and tour development and marketing. The main developing marketing is in the key markets of Europe and Caribbean and a range of additional materials to aid in the marketing of the ecotourism in the Dominican Republic. (ODT, n.d.) In many peoples opinion, ecotourism is the symbol of ecosystem and ecology. It cannot be denied that ecotourism benefits not only our society, but also the nature system. Firstly, people who have ecotourism in some natural places can educate others by teaching them about plants and animals, which promotes conservation of natural assets. Secondly, ecotourism can give people a deeper understanding of the local nature, and many professors predict that ecotourism can bring people closer to nature. Ecotourism can enhance the cultural integrity of the local people. Thirdly, it is considered that ecotourism can open peoples minds and broaden their horizons. Furthermore, countries and governments also get finical achievements. Many people think that visitors may become more aware of the surrounding environmental wealth. With the emphasis laid by governments, ecotourism will attract many people from home and abroad, so local people and visitors have to spend money during the activities in ecotourism. Money can go back into the country through this cycle, the more energy governments put on it, the better this system will go back to the country. Moreover, this cycle system can provide employment. In addition, this cycle system provides financial incentives to encourage local people to protect their environment.(Heritage, n.d.) One of the extra ecotourism industries is called ecotourism business. Human beings have little or no adverse impact on environment. Just what is mentioned in the financial ecotourism cycle system, ecotourism business provides local employment. It is thought that little waste is generated. In the end, ecotourism business provides human beings with educational and enlightening experiences. Ecotourism is a responsible tourism to the natural environments. Although ecotourism is one of the fastest growing additions to the tourism industry, some people predict that ecotourism has a large number of disadvantages, such as costs to the peopleà £Ã¢â€š ¬Ã‚ community and the ecological balance. Many local people firmly believe that how to protect the ecotourism system is the largest problems in the environmental development. It is undeniable that there are also many other elements affecting this system. Another major element is the increasing human activity. People like jogging and relaxing in the natural environment, which means agricultural clearance. That is the reason why so many professors think the ecotourism are the production waste and effluent pollution. Ecotourism tends to Imaging if a place became an ecotourism tourist attractions, many businessmen want to attract many people, so the environment may be damaged. Increasing use of environmental resources by the humans leads to pollution, even in the smallest places, causing environment problems. Different places have different cultures. There may be competition for ecotourism income between various groups leading to social disharmony. The bar graph has drawn great public attention in the Dominican Republic, which has compared the economic freedom and world average. Thanks to the Dominican Ecological Corridor Network, developed in 1995 ,as a key to connect the paradigm of the new trends for the recovery of the ecological balanceà £Ã¢â€š ¬Ã‚ the natural resources and the sustainable production of these materials. Although the figure of economic freedom vs. world average looks very large, the figure is decreasing day by day. In fact, many figures is closer to world average like property rightsà £Ã¢â€š ¬Ã‚ .corruptionà £Ã¢â€š ¬Ã‚ labor freedom and monetary freedom. To peoples amazement, there are also many figures surpassing world average. For example, investment freedoms has surpassed at roughly 5%;government size has surpassed about 28%;others like facial freedom has surpassed about 6% ,and trade freedom has surpassed 2%. No matter how closer the economic freedom to the world average, how larger the declining of the Dominican republics economic freedom to the world average, people always see the distance not only between economic freedom and world average, but also between ecotourism and peoples According to the WTO line graph for the period between 1989 and 1998, there was a stable growth of international tourism arrivals at 10% and international tourism receipts at 9%. (Weaver, 2001) This tabular data compares tourist arrival numbers in the different parts of the world from 1995 to 2020. Annual percentage increases a significant declining in all markets during 1995 to 2020 in the whole world. In fact, international arrivals are forecasted that the growth from 673 million in 2000 to 1.05 billion in 2010, and 1.6 billion in 2020. Factually, these projections are based on increasing figures rates every year of 4.2% to the end of the 1990s and the figures will at between 4% and 5% during first decade of the 21st century. Europe was the first since 1995. According to the research, the tourist arrivals in Europe will still higher than other places, such as Pacificà £Ã¢â€š ¬Ã‚ Americaà £Ã¢â€š ¬Ã‚ Africa and Middle East. People in the Dominican Republic are serious about making the country into a model of ecotourism in the Caribbean areas. It is necessary for human beings to further understand the expectations and behavior of visitors to natural areas and features. People can gain further experience from their trips without bringing about any negative effects on the tourist attractions that they visit, so people must be prepared to try their best to educate people in handling the issue of sustainable development and conservation as the relations to the specific sites. People have the potential to take on the challenge and realization of the chances that ecotourism is the way forward. ¼Ã‹â€ Xavier ¼Ã…’n.d. ¼Ã¢â‚¬ ° Ecotourism attracts ecological professors and socialists, focusing on individual growthà £Ã¢â€š ¬Ã‚ volunteering and environmental responsibility. Responsible ecotourism means minimizing the negative aspects of traditional tourism on the environment and improving cultural integrity of local people. Furthermore, environmental evaluationà £Ã¢â€š ¬Ã‚ cultural factors and promotion of recycling are also playing important roles in ecotourism. Ecotourism allows the government to have more chance to preserve the natural environment. It is obvious that ecotourism has a high sense of responsibility when it comes to promoting harmony between human beings and nature.

Contrast between Sam and Hallys Father in Athol Fugards Master Harold

Contrast between Sam and Hally's Father in Athol Fugard's "Master Harold" . . . and the Boys "Any white man is a master of all black men"; "the black society is primitive"- these are some of the ideas that have been nursed to Hally in South Africa's apartheid society. The question is: are those bigoted stereotypes true? Of course they are false! In the play Master Harold and the Boys, Sam is a black man, and Hally's father is a white man. However, Sam's superiority over Hally's father is obvious through the contrast between their relationships with Hally. Ironically, it is evident that, most of the time, the relationship between Hally and Sam is closer to a father-son relationship than that between Hally and his father. One of the most important things that a father can te...

Quality Control Essay

As products and services evolve, consumer expectations tend to increase so that yesterday’s quality product becomes tomorrow’s junk. Quality revolves around meeting customer expectations, expectations that may be stated or implied. One action that sums up quality from a business perspective is when the customer returns after the sale and the product doesn’t. The statistical definition of quality is a little more precise than other definitions, such as the customer-based concept, and is based on mathematics. When you measure quality statistically, you look for variation in a measurement between what the ? ustomers asks for and what you produce. The less variation you have, the higher the quality of your product or service. All processes have some natural variation; you use statistics to detect abnormal variation that could cause you to produce a bad product or service. You can also use statistics to avoid testing every item that you produce. By testing a sample of what you make or deliver, you can use statistics to measure its quality and find out whether it meets customer requirements the statistical definition of quality is a little more precise than other definitions, such as the customer-based concept, and is based on mathematics. When you measure quality statistically, you look for variation in a measurement between what the customers asks for and what you produce. The less variation you have, the higher the quality of your product or service. All processes have some natural variation; you use statistics to detect abnormal variation that could cause you to produce a bad product or service. You can also use statistics to avoid testing every item that you produce. By testing a sample of what you make or deliver, you can use statistics to measure its quality and find out whether it meets customer requirements. After you as an organization decide on a definition of quality you need standards against which to measure your quality. Many standards are driven by the desire to safeguard the health and well-being of the people who use the products or services companies provide. Quality standards also are critical in support of international trade. Almost every industry has an association or trade group that sets quality standards against which companies can measure the quality of their products or services. The International Organization for Standardization (ISO) is an international body made up of the national standards organizations for almost every country. Quality assurance focuses on the ability of a process to produce or deliver a quality product or service. This method differs from quality control in that it looks at the entire process, not just the final product. Quality control is designed to detect problems with a product or service. Quality assurance attempts to head off problems at the pass by tweaking a production process until it can produce a quality product. A process called the Plan-Do-Check-Act, or the PDCA cycle is a powerful tool that requires planning improvements to your process by looking for problems that affect the quality of your product or service. Make improvements by implementing small changes to minimize disruption to your process. Check production results to see if you’ve actually made an improvement. Act on what you discover and roll it out to the entire process. The most basic quality control technique is to inspect the results of your production or service-delivery process to make sure it conforms to customer requirements. In quality control terms, conforming means that an item meets customer specifications, and nonconforming means it doesn’t. You inspect your product or service by measuring one or more of its properties and comparing the measurements to customer specifications. Although inspection can ensure that 100 percent of the products or services delivered to your customers are good, it can be a very expensive process, especially for high-volume, low-value items. Also, inspection is impossible for items where testing can damage the product. The introduction of a quality control process into an organization can be a major shock to its system. The following components are crucial if you want to lessen the shock and gain acceptance within your organization. Advertise acceptance of the program from important stakeholders within your organization. Communicate the reasons for the change and the benefits it will bring to everyone in the organization. Train employees in the new ways of the organization. You want workers doing the right things consistently because success helps to gain support. Like most other changes, quality control is best introduced in small bits. One way to do this is to create a pilot project that allows you to make a small change to a small part of your process to see the change’s effect. If the results are good, you can implement the change on a wider basis; if the change is bad, you’ve limited the damage done. As an example I made a small research on Quest Diagnostics to make a scenario to explain how a company works on quality control. Quest Diagnostics is the nation’s leading provider of diagnostic testing, information and services. The clients include patients and consumers, physicians, hospitals, health insurers, employers and government agencies. Each year the company performs personal health testing on over 100 million patients, over 250 million diagnostic laboratory tests, and more than 6. 5 million gene-based tests. Quest Diagnostics Inc. develops tests that help people live longer, healthier lives. Some of the most notable technological advances include earlier detection of Cervical Cancer. Cervical cancer is almost 100% curable when detected early and clinical studies have shown that the Thin Prep Pap Test increases the early detection of precancerous cells. This test has been hailed as one of the most significant improvements in cervical cancer screening in over 50 years. Every year Chicago Business Unit cytology laboratory performs 1. 1 million Pap smear tests. Currently the business issue is time for Thin Prep Pap Test reports. Many of the clients have complained that the time for Thin Prep Pap Test reports is too slow. Clients also have complained that the patient care is affected due to slower time for test reports. The hypothesis of the business issue is that the time is too slow for reporting the Pap Test results. Management has planned to make improvements for time of Thin Prep Pap Test reports. In order to make improvements, the management needs to research on current workflow processes of Thin Prep Pap Test and then find the possible solution. In order to research the current workflow process of the Thin Prep Pap Test and finding possible solutions following research questions will be researched: What is the volume of Pap Tests? What barrier factors are affecting the time of the Pap test? What is the staffing situation? Is it efficient to handle the volume? What steps are involved in processing of the Pap Test? How much time is spent for each step? Which departments are involved in processing of the Pap Test? What is the current cost for the Pap test? What other new technology is available in the market for faster processing of the Pap tests? What is the cost of the new technology? Is there an approved insurance reimbursement for the new technology? Statistics serve many purposes within quality control. Statistics allow you to determine which processes or parts of processes are causing your company the most problems.

Psychological Affects of End-of-Life Care

As people approach the end of their lives, they with their families and their caregivers, face many tasks and decisions. They may be psychological, spiritual, or medical in nature, but all end-of-life choices and medical decisions have complex psychological components, ramifications, and consequences that have a significant impact on the suffering patients and their caregivers. Hospice is a special healthcare option for patients and families faced with a terminal illness. At Hospice there’s a multidisciplinary team of physicians, nurses social workers, bereavement counselors and volunteers that work together to address the physical, social, emotional and spiritual needs of each patient and family members (â€Å"Hospice†). The main focus of Hospice is to address the issues that are most important to the patients’ needs or wants at the end of his/her life. The term â€Å"Hospice† comes from medieval times when it referred to a place of shelter and rest for w eary or ill travelers on a long journey (Hospice).The name was first applied to specialized care for dying patients by Physician Dame Cicely Saunders, who began her work with the terminally ill in 1948 and eventually went on to create the first modern hospice—St. Christopher’s Hospice—in a residential suburb of London (National). Her lecture, given to medical students, nurses, social workers, and chaplains about the concept of holistic hospice care, included photos of terminally ill cancer patients and their families, showing the dramatic differences before and after the symptom control care. This later resulted in the development of hospice care as you know it today (National).Caregiving is associated with physical, psychological, and financial burdens. Hospice nurses perform many traditional nursing duties such as observing, assessing, and recording symptoms. They still work closely with physicians, administering medications and providing emotional support, al though psychologists do not have much of a presence in the hospice movement. Medications that hospice nurses administer and the symptoms they record are not intended to aid a patient in his or her recovery, but rather to make his or her remaining days as comfortable as possible (â€Å"Hospice†). Being a nurse of any kind is very difficult, but dealing every day with a dying patient requires an  extraordinary temperament, one that symbolizes great caring and patience (â€Å"Career†).It can be especially trying on nurses to attend patients who are as young as or younger than the nurse themselves are. Palliative care highlights the total well-being of the patient as well as that of loved ones and caregivers. The caregiver is there to listen, support, encourage, comfort and help the patient. Their goal is to prevent, treat, or eliminate discomfort whenever and, however it appears, never about giving up hope (â€Å"Career†). Every caregiver may be required to provi de a variety of care tasks including physical, emotional, and practical.Research shows that families find personal care to be the most physically and emotionally challenging aspect of caregiving. Emotional care involves listening, talking, reading, or playing music (Collins). Providing the kind and loving companionship that patient may need during the end-of-life process. Handling insurance and other legal matters, taking care of financial concerns such as paying bills, coordinating visits with loved ones, friends and hospice staff is all a part of practical care (Collins). Along with discussing and ensuring that all of the patients’ wishes are carried out if also the healthcare power of attorney (â€Å"What†). In 2009; 66 million Americans (3 in 10 U.S. Households) reported at least one person providing unpaid care as a family caregiver (Collins). Under Medicare, hospice is primarily a program of care delivered in a person’s home by a Medicare – approved hospice.Reasonable and necessary medical and support services for the management of a terminal illness are furnished under a plan-of-care established by the beneficiary’s attending physician and the hospice team (Berry13). Hospice care is available under Medicare only if: the patient is approved for Medicare Part A, the patient’s doctor and the hospice medical director certify that the patient is terminally ill with six months or less to live if the disease runs its expected course, the patient signs a statement choosing hospice care instead of standard Medicare benefits for the terminal illness, or the patient receives care from a Medicare-approved hospice program (â€Å"Hospice†).Hospice care can be provided by an agency or organization that is primarily engaged in furnishing services to terminally ill individuals and their families. To receive Medicare payment, the agency or organization must be approved by Medicare to provide hospice services (Berry15). App roval for hospice is required even if the agency or  organization is already approved by Medicare to provide other kinds of health services. Medicare pays the hospice directly at specified rates depending on the type of care given each day. The hospice can charge five percent of the reasonable cost, up to a maximum of five dollars, for each prescription for outpatient drugs or biological for pain relief and symptom management related to the terminal illness (Collins).When Medicare beneficiaries choose hospice care, they give up the right to standard Medicare benefits only for treatment of the terminal illness. If the patient, who must have Part A in order to use the Medicare hospice benefit, also has Medicare Part B, he or she can use all appropriate Medicare Part A and Part B benefits for the treatment of health problems unrelated to the terminal illness. When standard benefits are used, the patient is responsible for Medicare’s deductible and coinsurance amounts (Berry 14 ). All services required for treatment of the terminal illness must be provided by or through the hospice.If not through the hospice then Medicare will not pay for treatment for the terminal illness which is not for symptom management and pain control. If you receive care given by another healthcare provider that was not arranged by the patients’ hospice or if the patient is receiving duplicate care Medicare will no longer fund in the patients’ healthcare (Berry14). When a patient is expected to live six months or less is when hospice is referred. Although many hospice patients have cancer as their primary diagnosis, hospice provides care to patients of all ages who are dealing with any potentially life-limiting illness, including Alzheimer’s, congestive heart failure, chronic obstructive pulmonary disease (COPD), dementia, and emphysema.Once the patient has been diagnosed and chooses hospice care, this can generally take place at home or as in-patient care. Hos pice neither prolongs life nor hastens death, but controls pain and discomfort allowing a person to live as fully and comfortably as possible during life’s final journey (â€Å"Career†). Pain control is one of the central goals of hospice care. Every person facing a serious illness hopes for as little pain as possible. Fortunately, with advances in modern medicine, physical suffering can now be almost entirely manages, and in some cases eliminated. From the legal standpoint, the federal guidelines regulating hospice require the hospice to make every reasonable effort to assure that the patient's pain is controlled (Berry3).Most state laws governing hospice  also make pain control a primary and required component of hospice care. The hospice Interdisciplinary Team and the hospice Registered Nurse case manager are focused on making sure the patient is comfortable. The Attending Physician who orders all medications should be focused on the same goal, and in many cases d oes see to it that the patient is kept comfortable. Unfortunately, for varying reasons, some physicians may not order the needed medications to adequately control the patient's pain (Berry4). In these cases, the hospice staff must intervene to protect the patient and make sure the patient gets what is needed to control pain.The hospice Medical Director, being a physician, has the authority to give medical orders and can intervene to provide the patient with the needed medications. In fact, the hospice Medical Director is required by law to make sure the patient's medical needs are met; these needs include medication for pain (Berry4). When dealing with patients and families in hospice care, the psychological and social needs of both patients and family members must be met in order to improve the quality of life throughout the dying process.Many caregivers and loved ones feel overwhelmed by the fact that end-of-life may be near for someone they love; you have to have realization that the patient is not going to get any better despite your best care. It may bring feelings of frustration, anger, sadness, grief and loss to the family of the patient (â€Å"What†). Ignoring feelings of depression, anxiety, confusion or delirium can be harmful†¦ Expressing can be freeing. 48 children and spousal caregivers of hospice patients and 36 controls were evaluated shortly before deaths of their loved ones and again at 2, 7, and 13 months after their deaths. All subjects were administered the Hamilton Raitina Scale for depression, symptom innovatory and the Texas Revised instrument of Grief (Dutton 30).Caring for a loved one who is nearing death can be important time of growth for caregivers. Experience can bring a deep sense of joy and satisfaction in having helped to make a loved one’s last days happier, and more peaceful. Studies indicate that the majority of patients would like their spiritual issues addressed. Spirituality has to do with respecting the inherent value and dignity of all patients. It is very important for the patients’ beliefs to be known to healthcare workers so the patient is not disrespected in any way by the healthcare worker (Karnes2). Patients tend to become more spiritually connected during end-of-life care because they are  nearing the end of their journey.Families are impacted emotionally and spiritually and will be grieving the loss of their lived one whereas their journey is beginning (Karnes6). When a loved one dies, mourning is an essential step in the healing process for those suffering the pain and confusion of loss (Karnes8). Counselors work with clients to validate the experience of grief, find the strength and coping skills, and eventually regain a sense of hope (Karnes7). While grief is very personal, there are many common experiences that accompany the death of a loved one.Talking with a counselor helps clients learn more about the natural process of grief and identify areas of strength and support, as well as areas of potential growth (Collins). Grief support group sessions provide the opportunity for people to meet others who are experiencing similar losses. Grief that accompanies the death of a loved one often comes in waves-and sometimes those waves arrive in the days and weeks that follow. At other times, it may be months-or even years- before the reality of the loss sinks in (Karnes11).Family members may also be grieving over the fact that financial issues may accompany them after their loved one passes. There is always help for any patient or family member in need. After learning more about Hospice and the care that they provide it’s more of a â€Å"safe haven† and a place of comfort for you or your loved ones that are passing. Many others would personally choose hospice as their end-of-life care.