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End of life care strategies and summary of development essay
Reflection on end of life care
Reflection on end of life care
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TAKING SERIOUSLY ILL PATIENTS SERIOUSLY: ETHICS AND POLICY DIMENSIONS OF THE CHORONIC DISEASE/ END OF LIFE CARE CONTINUUM
The article written by Nancy Berlinger and Michael K Gusmano encompass the definition of chronic disease with different perspectives and ethical issues and policy dimensions in these diseases especially focusing on end of life care. The difference between life threatening diseases and chronic diseases and has been mentioned in perspective of media coverage to attract patients to the health care organizations, illustrating heroic measures taken to cure a disease and success story.
The definition of chronic disease in health policy literature is “Conditions that last a year or more and require ongoing medical attention and/or
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Duration, progression with terminal prognosis, curability, treatability with burden and benefits of treatment and provision of palliative treatment towards the end of life with informed decision making involving patient, all have their importance. Chronicity and stability of the disease also have its implications both professionally and ethically.
Chronic disease management and end of life care shows practice variation and structural inequities in even developed worlds. The acute hospitalize care, nursing home care or caregivers at home all depend on the chronicity, progression and palliative care require by the patient.
Integration of palliative care in health care system to relief pain and suffering is important. Even in US the facility of hospice care is underutilized because of many factors. Having said that, first obligation of health care professionals is to relief suffering of chronically ill and terminal stage disease patient. Research based knowledge must be imparted to health care professionals in this regard. Establishment of institutions who care for these patients, invest in training of their staff, self identify the goals of palliative care, and promote ethical reflection is need of
Gawande’s book is very pertinent to the present day and has by many accounts sparked a national discussion on end-of-life care and how we treat our elderly. With elderly people accounting for a greater proportion of the American populace and as people start living even longer than they do now, end-of-life care will become and remain a major issue faced by doctors, patients, their families, and the healthcare system. Additionally, with our greater focus on improving patient outcomes while getting the most value for our healthcare dollars, end-of-life care is a major area that healthcare systems and hospitals will focus on, as it accounts for a large portion of their budget. As a response to the need to take care of our aging population, hospice care and palliative medicine are some of the newer specialties in the medical field that have been increasing in popularity and more research needs to be focused in these areas to better understand how to improve patient outcomes.
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
Dealing with death on a regular basis can take a toll on a person. Being a hospice nurse will never be easy and is certainly not for the faint of heart. A hospice nurse watches patient’s health decline, often times very rapidly, and many times sit by the patient’s side as they pass away. It can be exhausting both emotionally and physically. You need to have a big heart and a strong will to help those in need for the occupation. Sara Schmidt certainly never saw herself in the profession, but discovered that she has a true love for helping people.
Nurses take an active role in advocacy and policy development regarding assisted death and other end of life choices. Through the help of advance care planning, nurses has helped patient think about what gives their life a meaning, learn about medical procedure offered at end-of-life care, help them communicate about their future health care wishes, choosing a person who would speak for them when they cannot speak for themselves and recording goals and wishes. The role of the nurse in end-of-life care is very crucial, they might be getting more queries on physician-assisted death. So, it is significant for nurses to understand the law and professional standard for better continuity of care and also to protect themselves against potential
The Public Health Imperative measures the quality of life of an individual during times of severe chronic illness. This health imperative is characterized by: the potential to prevent suffering caused by the illness, major impact, and high burden. In the recent past is has become evident that care for older people, who have potential to become terminally ill, must be focused on. The types of patients may also lose the capability to make some of their most important decisions which include actions made by health professionals that are related to their end of life situation. Luckily actions were made to identify certain priorities pertaining to the public health and end of life issues. These priorities were established by the National Association of Chronic Disease Directors and the Healthy Aging Program at the Centers for Disease Control and Prevention. These end of life health priorities which address short-term, medium-term and long-term needs are also called advanced care planning. It can be concluded that communication between professionals and among families about the patient can enhance the effectiveness of advanced care planning.
Even though many dispute over the value and usefulness of treatment and care of terminally ill patients, the debate for the most useful care and pain reliever for these patients is the question that most patients, and their families, have to ask themselves daily. Wesley J. Smith suggests that Hospice care for patients with such a horrible illness is a beneficial program and that many patients need to utilize it. Smith also recommends that a valuable care option would be to “allow the terminally ill to enter hospice care without having to give up life-extending or curative treatments”. (Smith 3) With this statement, Smith demonstrates a way that these ill patients can be provided with treatment and also care for the patient’s quality of life.
Euthanasia is one of the most complicated issues in the medical field due to the debate of whether or not it is morally right. Today, the lives of many patients can be saved with the latest discoveries in medicine and technology. But we are still unable to find cures to all illnesses, and patients have to go through extremely painful treatments only to live a little bit longer. These patients struggle with physical and psychological pain. Dr. Martin Luther King Jr. discusses the topic of just and unjust laws in his “Letter from Birmingham Jail” which brings into question whether it is just to kill a patient who is suffering or unjust to take that person’s life even if that person is suffering. In my opinion people should have the right, with certain restrictions, to end their lives in the way they see fit if they are suffering from endless pain.
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...
A long-term health condition can also be referred to as a ‘chronic illness’ and it can be used to define recurring conditions such as asthma, arthritis, and diabetes.
The purpose of this essay is to analyse various theories on ageing, death, dying, and end of life issues from different perspectives such as: biophysiological theories, psychosocial theories; and taking in consideration the cultural, historical, and religious implications around the aforementioned life stages. One will also discuss important issues relevant to social work practice such as dignity, autonomy, and their relationship with the concept of a successful ageing and a good death. One considers these areas important since they upheld anti-discriminatory practice and may perhaps promote the development of personalised care pathways, as well as fair and justifiable social policies.
Palliative care involves the holistic care to maintain and improve the quality of life of the patient and family during hospitalisation until the terminal stage. Palliation of care refers to the multidisciplinary approach of providing comfort and support for the terminally ill patient and family, thus has an important role in maintaining and improving the quality of life of the whole family. Chronic illness such as cancer gives a physiologic and emotional burden for the patient and family. Education and counselling of the possible options as well as treatments for pain and other symptoms that could help alleviate anxiety, suffering and discomfort. Palliative care provides assistance for the family as a channel for communication between the
... that the nurse or family can do. The goal for palliative care is to make the patient’s passing as comfortable and relaxing, as possible. Medication management should be provided for every patient that is having pain to allow for a more comforting, pain-free, and peaceful death.
The subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.
Euthanasia is ending the life of a person deliberately to relieve their pain. It usually happens when a person is terminally ill or is suffering from a lot of pain and there is no other option to relieve the pain.
Death is something that causes fear in many peoples lives. People will typically try to avoid the conversation of death at all cost. The word itself tends to freak people out. The thought of death is far beyond any living person’s grasp. When people that are living think about the concept of death, their minds go to many different places. Death is a thing that causes pain in peoples lives, but can also be a blessing.