Conclusion When it comes to completing an Advance Directive, many factors affect the decision-making process. It can be assumed that ultimately, it is the responsibility of the individual. However the influence of friends, family members, and the health care team are very important in that process as well. Although individual factors, such as gender, culture, and level of education, are evidently huge contributing factors in the percentage of those who have completed or are more likely to have completed an Advanced Directive, I believe awareness and effectiveness of Advance Directives impact an individual’s view of whether they would complete an Advance Directive. In conclusion, despite all of these factors, I believe that Advance Directives …show more content…
Patients are encouraged to attend this workshop with friends and family to start the discussion about Advance Directives. So far, there has been high patient satisfaction and high rates of patients who state they will complete an Advance Directive within the next month. We understand that Advance Directive need time and further discussions to complete, therefore we do not pressure patients to fill it out on the spot. We have also received feedback from my patients that doctors and nurses do not educate or, at the very least, mention Advance Directives to patients unless they are scheduled to undergo some type of invasive procedure. Patients are very appreciative of the Life Care Planning Class. I would like to further our efforts in bringing awareness to Advance Directives by developing a training to help the health care team promote Advance Directives in a similar way we do in our class, but also focus on reminding and emphasizing the patients’ rights and autonomy through their Advance Directives. Even though patients are vulnerable when they are seeking our care in the hospital, we need to respect their rights and health care choices. With these efforts, we are assuring
Wiener, Lori, Elizabeth Ballard, Tara Brennan, Haven Battles, Pedro Martinez, and Maryland Pao. 2008. "How I wish to be remembered: the use of an advance care planning document in adolescent and young adult populations." Journal Of Palliative Medicine 11, no. 10: 1309-1313. MEDLINE with Full Text, EBSCOhost (accessed May 26, 2014).
As we get older and delve into the real world, it is important to start thinking about end-of-life care and advance directives. Although it is something no one wants to imagine, there is an absolute necessity for living wills and a power of attorney. Learning about the Patient Self-Determination Act and the different legal basis in where you live is important because it will help people understand why advance care directives are so important. Although there are several barriers in implementing advance care directives, there are also several actions that healthcare professionals can take to overcome these obstacles. These are also important to know about, especially for someone going into the medical field.
The individual will need to be encouraged to make decisions about the care they receive and the type of life they want to live and also ensure that their families are part of the decision making process.
Consequently, she was left in what most assumed to be a vegetative state for years eventually because her husband continued to advocate for her right to die she was unplugged and died soon after. This case served as a warning for most people who didn’t really consider Advanced Directives before. Are family members sure of what lengths should or shouldn’t be taken worst case scenario. Repeatedly this has proven not to be the case. Death or dying is always a taboo subject however, when high profile cases like this arise people are forced to evaluate their own lives? A study regarding knowledge about advance directives conducted in 2004 suggested that there was a direct correlation between attitudes, financial stability and the number of people who had advanced directives. Surprisingly this same study discovered that doctors or healthcare professions assumed it was the patient’s duty to seek out
In this context, new emphasis is being placed on the rights of patients. Recent federal legislation, for example, requires all health care facilities receiving Medicare or Medicaid monies to inform patients of their right to make medical treatment decisions. This includes the right to specify "advance directives," [1] which state what patients wish to be done in case they are no longer able to communicate adequately.
Hospice focuses on end of life care. When patients are facing terminal illness and have an expected life sentence of days to six months or less of life. Care can take place in different milieu including at home, hospice care center, hospital, and skilled nursing facility. Hospice provides patients and family the tool and resources of how to come to the acceptance of death. The goal of care is to help people who are dying have peace, comfort, and dignity. A team of health care providers and volunteers are responsible for providing care. A primary care doctor and a hospice doctor or medical director will patients care. The patient is allowed to decide who their primary doctor will be while receiving hospice care. It may be a primary care physician or a hospice physician. Nurses provide care at home by vising patient at home or in a hospital setting facility. Nurses are responsible for coordination of the hospice care team. Home health aides provide support for daily and routine care ( dressing, bathing, eating and etc). Spiritual counselors, Chaplains, priests, lay ministers or other spiritual counselors can provide spiritual care and guidance for the entire family. Social workers provide counseling and support. They can also provide referrals to other support systems. Pharmacists provide medication oversight and suggestions regarding the most effective
The first journal article is about advance care planning (ACP) in palliative care. This is of interest due to several clinical experiences and the realization that many families either ignore the patient’s request for end of life (EOL) care or who have no idea of how to plan for EOL care. By reading the research and understanding the methods used, this will allow for insight into how to implement palliative care into clinical practice across different sites. The authors of this original research are Jeanine Blackford PhD, RN, senior lecturer at La Trobe University in Australia, and Annette Street PhD, associate dean of research and professor of cancer and palliative care studies. According to Blackford & Street (2011), this research is important as there are many countries that “report a low percentage of people who have completed an advance care plan” (p. 2022), and ACP is needed upon admission to facilities that offer palliative care. In addition, the purpose of the study is to try and obtain guidance to integrate an ACP model into routine clinical practice in the community. The research question chosen for the analysis of this article is: Is it feasible to implement ACP into routine practice and documentation at multi-site locations in...
One of the greatest dangers facing chronic and terminally ill patients is the grey area regarding PAS. In the Netherlands, there are strict criteria for the practice of PAS. Despite such stringencies, the Council on Ethical and Judicial Affairs (1992) found 28% of the PAS cases in the Netherlands did not meet the criteria. The evidence suggests some of the patient’s lives may have ended prematurely or involuntarily. This problem can be addressed via advance directives. These directives would be written by competent individuals explaining their decision to be aided in dying when they are no longer capable of making medical decisions. These interpretations are largely defined by ones morals, understanding of ethics, individual attitudes, religious and cultural values.
In an interview with a staff nurse (S.N), the main problem within patient communication included lack of patient’s (and family) involvement/willingness in planning cares. The staff nurse emphasized how “Patients often feel overwhelmed and do not want to participate. But, it is important for patients to be involved in their care for better outcomes” (S.N., personal communication, February 5, 2014). The staff nurse’s statement is supported by Evans (2013) whom remarked “better-informed patients avoid unnecessary care and frustration”.
I understand how you feel and why you blame yourself for what you termed “helped her with her request” to facilitate her wishes to set things in place. However, you did not make the decision for your aunt; she exercised her right of autonomy to decide for herself. Also, your aunt still had the use of her faculties; that is one of the key factors that should exonerate you from any guilt. What a coincidence, just this week we discussed in my other class the topics on Advance Directive and Power of Attorney. In our hospital, all patients are asked if they have an Advance Directive, and if they do, the hospital has the moral responsibility to honor whatever was stipulated in the directive. Also, there is no need for the service
While navigating the abundant and sometimes confusing legal language of advance directives can be time consuming, it would benefit every person to consider their end of life wishes and have some form of written statement available for their doctor and family to understand those wishes. Doing this in advance can prevent emotional anguish, suffering and expensive litigation. In the end, clearly and when possible, written, documentation of a medical directive, a living will, or a chosen health care power of attorney will lessen the burden for the medical professionals and family of a dying or incapacitated person.
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
THOMAS, K. and LOBO, B., 2011. Advance care planning in end of life care. Oxford: Oxford University Press.
Informed consent is a very serious decision a patient has to make when it comes to their health and consenting to procedures that are believed to cure or treat their current health status. It is important to address the effectiveness of the role a physician play in the informed consent process assuring that the patient has given truly informed consent and what safeguards can be put in place to assure the patient is exercising informed consent. Informed consent is based on the fact that the person consenting is a rational individual that is aware of the action to which he/she is consenting. Allen and McNamara (2011) notes that "On the standard understanding, the important elements of informed consent are the provision of information, the voluntariness of the choice and the competence of the chooser to make the choice— so the potential research participant should be provided with information relevant to the decision to participate, they should be able to choose freely about their participation and they should be competent to decide.
“Western culture, Western civilization (the modern culture of western Europe and North America)” (Princeton University). The definition of western culture is broad and can be applied to many different aspects of life. In the world of health care, western culture prevails when discussing end of life situations. The main focus of western communication in these situations is keeping trust between patients directly and communicating the situation with them in a clear but respectful manner (Hawryluck). According to the National Health Service in the United Kingdom most health and social care staff have received some basic, generic communication skills training for end of life communication. However seeing as end of life situations are one of the most intense and demanding situation of a health care professionals career to deal with, “most believe they would benefit from further training to address the challenging demands of conversations with people approaching the end of life” (NHS). One of the major factors in these discussions is the age of the patient in question. Since it’s not usual for a family member to die before they are old and considered elderly, different situations are in need of different responses. Especially in the case of a child, teenage, or any other death for people under the age of 60. The dialogue between the patient and doctor or any other health care official is greatly influenced if the patient is a minor or an adult. Conversation structure and even the person the professional is likely to have a conversation with might change. In the western world society tends to be split up into 3 major age groups; children and young adults (under 18 years of age), adults (19-60 years of age)...