After taking this palliative care class, my views on this valuable topic greatly increased, expanding my nursing practice to better serve my patients. Palliative care service serve as such an underutilized resource to patients. Palliative care holistically cares for the patients by attempting to relieve suffering and promote comfort for patients by addressing their physical, psychosocial, and spiritual symptoms and needs. This is accomplished by emphasizing a large focus on working prophylactically to prevent and treat symptoms of those with terminal or serious, life-threatening illnesses. In addition, palliative care strives to have those difficult conversations with patients on end-of-life care and wishes to align plans of care with the patient’s …show more content…
These conversations allow us as healthcare professionals to align patients’ goals of cares involving decisions on quality of life versus quantity of life and plan medical interventions accordingly based on their medical preferences. I believe far too often it is a conversation that is put off by patients, families, and health care providers alike until it is a “better” time or when it is dire to have the conversation as death proves to be imminent for the patient. A survey from the Conversation Project reported that 90% of people surveyed think that talking with their loved ones about end-of-life-care is important, yet only 27% of them have actually done it (“The Conversation Project”, 2018, p. 2). This goes to show how much room for improvement there is for us to advocate for our patients and explain the importance of having advanced directives. The lack of patients actually having advanced directives filed and documented may be partially to blame on providers being caught up in the other time-consuming tasks, hoping another provider addresses this problem, or just a general lack of knowledge on how to initiate such a difficult conversation, especially with a relatively healthy individual where death seems far off. A shift in the paradigm needs to occur where end-of-life care preference discussion occur …show more content…
This course provided me with numerous valuable resources to aid me to serve as an advocate for my patients by initiating valuable end-of-life-conversations with my future patients, such as the Five Wishes or the Conversation Project. The Conversation Project serves as one valuable resource that served as a guide to lead patients through initiating end-of-life preference conversations, allowing patient to understand how to appoint a health care proxy and assist patients through the required legal documents. The Five Wishes is a living will that allows a person to discuss personal and spiritual desires for end-of-life care as well as his or her medical wishes. I believe it is important to adapt this holistic approach to my own practice when caring for patients, keeping in mind that I am treating more than a disease, but rather a person with psychosocial and spiritual needs that also need to be
When needing to use the advance care directive, it is important that the individual’s wishes be carried out by their proxy and their physicians, no matter what their own personal beliefs are. The last action that should be taken when considering end-of-life care is that is should be reassessed periodically. This is important because an individual may change their mind about what kind of care they would want to receive as they get older.
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...
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).
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
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.
It is found that nurses report that their most uncomfortable situations come with prolonging the dying process and some struggle with ethical issues by doing so (Seal, 2007). Studies have shown that implementation of the RPC program and educating nurses have increased the nurses’ confidence in discussing end-of-life plans (Austin, 2006). With confidence, the nurse is able to ask the right questions of the patient and make sure that the patient’s wishes are upheld in the manner that they had wanted, such as to not resuscitate or to make sure their spiritual leader is present when passing (Austin,
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.
“Persons intentionally choose to become nurses to help patients meet their health needs,” even when the patient is actively dying. (Wu & Volker, 2012) Hospice nursing and palliative care nursing are both considered end of life care. However, hospice nursing is typically given to patients with a terminal illness and who have less than six months to live. Palliative care is typically given to patients with a life threatening illness, and is used to increase the patient’s quality of life. Choosing a nursing career in either hospice or palliative care can be extremely difficult, but will provide an opportunity for great personal growth. At times, an end-of-life caregiver may feel responsible for their patient’s death, or they may feel isolated due to a lack of support. Nurses new to this field should “feel that their unit acknowledges death as a difficult event and that discussion of death is acceptable in the workplace.” (Lewis, 2013) The most rewarding, and also most difficult, part of being a hospice or palliative care nurse is the ability to be a part of your patient and their family’s life, including their loss, grief, and death. (Wu & Volker, 2012)
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...
The political economy of kinship in Paleolithic societies are different than the political economy in today’s society. This is because of three distinct differences on how things in the kinships are dealt with. They are how we deal Power or who is king of the castle. Marriage Customs such as divorce and when it is ok to get married. The last is child-bearing like how the child was raised and what children did growing up. Nisa is a !Kung woman in Paleolithic society that I will use to compare here political economy of kinship to mine.
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.
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).