Introduction Death is a normal part of life, however it is usually regarded as being an illness. Consequently, many individuals pass away in hospitals, lonely and painfully.1 Palliative care mainly aims on the prediction, prevention, identification, and treatment of symptoms that are encountered by patients with serious illnesses and to help the patients and their relatives to carry out medically important decisions. Ultimately, the aim of palliative care is to enhance the quality of life, despite the diagnosis (Rome, Luminais, Bourgeois & Blais, 2011).
The definition and principles of palliative care The World Health Organization (WHO) states that palliative care is a means of improving the quality of life of the patients and the relatives
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It is important for relatives to be nearby and attentive during an individual's final days (Bernstrom, 2017). The second principle is that death is not postponed or hastened. Rather, the aim of palliative care is to provide comfort and enhance the quality of the individual's life in order for the patient to enjoy time with relatives in a home-like setting (Amber city hospice, 2017). Thirdly, relief is provided for pain and other symptoms. An important part in palliative care is pain management and symptom control in order to enhance the quality of care for patients, their relatives, and the healthcare system. Pain management is holistic, cantered on the patient, inclusive, and multidimensional. Therefore, it does not only address the physical aspect, but also the psychological, social, and spiritual aspects. The model of ‘total pain’ which Saunders stated, best describes the multidimensional nature of pain management . The pain that the patient is suffering from is not only physical but involves the psychological, social and spiritual aspects. This leads to the fourth principle where the psychological, psychosocial and spiritual aspects …show more content…
This includes practical support that help the physical and functional aspects, psychosocial support and spiritual support. The seventh principle, suggests a team approach needs to be used in order to bring forth the needs of the patient and his or her family, this includes bereavement counselling, if suggested. In addition, another principle states that palliative care will improve the quality of life, and could have affect on the course of illness in a positive way. Research done on patients who received palliative care showed that quality of life was enhanced. It showed that patients were less likely to be depressed and had less symptom burden. In addition the patients felt that they are more in control of themselves, were more capable of avoiding risks that are related to treatment and hospitalization and have reduced expenses with enhanced use of the health care resources. The benefits were also seen in the patients families as palliative care demonstrated a greater contentment with the high quality of care and notice to the needs of the caregiver. In fact, in a study conducted on patients with non–small cell lung cancer showed that the patients that were given palliative care had enhanced survival rates when there was a comparison with other patients that were just given standard treatment (McAteer &
End of life pain management is an important function of hospice organizations. Families and patients alike are comforted by the fact that, at the end, there are resources which allow for a comfortable death. Much of the quality of hospice care is determined by patient family members. In 2005, the Brown Medical school conducted research with regard to t...
Palliative care is medical or comfort care that reduces the severity of a disease or slows its progress, but does not provide a cure (Dreeben, 2007). Different people have different needs when life is ending. Working with the incurable may sound depressing but death is a certainty and what we do each day for these patients as physical therapist assistants, matters. Providing care effectively and appropriately has a huge impact on the patient, therefore acquiring the ability to comfort and care for a patient at such a critical stage in life, is an amazin...
...red theory to show the relationship of theory to the practice of palliative care in the clinical setting, it is uncertain if this shared theory will improve palliative care practices and nursing competence in caring for the palliative and chronically ill patient. By writing objectively, this article provides valuable information and brings attention to the need for developing indicators to test the shared theory and brings a call to action for education and nursing competence to enhance the quality of life for both nurses and palliative care patients.
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.
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
Palliative care is an essential to the creation of a health and wellbeing continuum for Australians living with a chronic illness. It is an approach of care that seeks to improve the life of patients and family experiencing the effects of chronic illness. Palliative care centres on the relief of the symptoms and effects of disease and incorporate the physical, psychological and social dimensions of a person at the end of life. A recent focus for the delivery of palliative care by nurses to Indigenous communities is the consideration that culture can create barriers to the provision of appropriate and beneficial care for the dying or deceased person. This essay explores the palliative nurse caring for Indigenous communities and the need to consider
Palliative care - treatment that helps to comfort patients, while slowing the progress of a disease.
PAD is the most debated moral issue, where the stances taken by various stakeholders are either for or against the issue. Since, Nurses put the patients’ decision first, most nurses advocate for the legalization of the PAD. Despite, Palliative care aims to relieve suffering and improve the quality of living and dying, most patients with a progressive life-threatening illness wish to end their life with some medical help. This desire needs to be respected, for patients deserve the peace of mind and improved quality of life that comes with knowing that a peaceful and dignified PAD will be an available choice, when the suffering becomes intolerable (BCCLA, 2015). In situation where legislation restricts the client to resort to PAD, people find different ways to end their life to eliminate the unbearable suffering, even if that means choosing a violent and risky death. Therefore, it is arguable that if these kind of violent methods are acts of desperation, then why not consider a peaceful method of ending life through medical help? Accepting PAD does not necessarily encourage suicide or
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.
When you think of home care for a loved one, you want comfort and convenience with quality of life. A misconception of palliative care is that it is equivalent to hospice care, which concentrates on end of life. However, palliative care is now being offered to patients whether it begins early at diagnosis or throughout ongoing treatment. It is no longer limited to medical settings as more health care agencies are now offering it in home care. Think of palliative care as “comfort” care during any stage of illness.
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...
Pain is neither objective nor seen or felt by anybody other than the person that is experiencing it. Pain is subjective, therefore there is no way to distinguish whether or not someone is hurting and the only and best measurement of pain is that what the patient says it is. In settings such as end of life care, patients present with many different disease processes and ultimately are there because they have an average of six months to live. Along with this stage in their lives, palliative care patients can encounter a myriad of symptoms, which can result in these patients experiencing tremendous physical and psychological suffering (Creedon & O’Regan, 2010, p. [ 257]). For patients requiring palliative care, pain is the most incapacitating of symptoms and in return unrelieved pain is the primary symptom that is feared most by these patients. So why has pain management not become the top priority when it comes to end of life care, considering this area is growing at an extraordinary rate as a result of an increasingly ageing population?
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
Comfort measures are crucial for the dying patient and their loved ones. Comfort measures, not only, include pain management but also massage, music, position changes, and heat, which are all just as important. Palliative care is an extremely important aspect of nursing. Palliative care “focuses more broadly on improving life and providing comfort to people of all ages with serious, chronic, and life-threatening illnesses” (http://www.WebMD.com). The ultimate goal of comfort measures and palliative care is to ensure that the patient has a more relaxed and peaceful death (End of Life care: An Ethical Overview, 16). Other important aspects of palliative care consists of hygiene measures, which includes keeping the patient dry and clean, offering food and fluids often, and keeping the patient, along with the family, as comfortable as possible. Some try to argue that drugs, like Morphine, should not be given to the dying because it speeds up the dying process, but I believe that their death is inevitable and it is best to make the patient as comfortable as possible. For many families, the thought of losing their family member is too much to handle but with pain management, at least, the patient gets to die a relatively pain-free death. This can be comforting for the family. Although, there are pain medications that can suppress the respiratory and cardiovascular system, the patient, typically, has a much more peaceful death, as opposed to not having any sort of drug.
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.