The age expectancy continues to increase in society. More people are live very far into old age; this is why the number of elderly people continues to rise. Disease patterns are changing continually. Chronic disease is often the cause of death, over those that are caused by acute illness. The population that requires care is becoming much older. High quality care is necessary for end of life. Older people have more complex problems and disabilities (Ebersole, Hess, Touhy, Jett, & Luggen, 2008). The care provided for these older adults require an established partnership between the nurse and the patient.
People that have serious illnesses often receive palliative care by special medical personnel. No matter the diagnosis, the focus on providing relief from the pain, stress, and the symptoms of their disease (Kapo, Morrison, & Liao, 2007). The goal for the family and the patient is improve the quality of life.
The medical personnel that comprise a palliative care team are doctors, nurses and any other specialist that is involved in the patient’s care. These extra specialists are those that are needed for an extra level of support for the patient’s diagnosed disease process. Certain disease processes require care from a specialized area, such as, an endocrinologist or a respiratory therapist. Massage therapists, pharmacists, nutritionists, chaplains and others may also be part of the team (Shawler, 2011). All of these people contribute to the care of the elderly and can make their life comfortable even with chronic illness.
The needs of the patient and the family are met by the care team. The care team will spend as much time as possible with the elderly patients that require palliative care. The point of palliative care is to ha...
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... for the older adult. J Palliat Med, 10(1), 185-209.
Rajmohan, J. & Suresh-Kumar, K. (2013). Psychiatric morbidity, pain perception, and functional status of chronic pain patients in palliative care. Indian Journal Of Palliative Care, 19(3), 146-151. doi:10.4103/0973-1075.121527
Shawler, C. (2011). Palliative and end-of-life care: Using a standardized patient family for gerontological nurse practitioner students. Nursing Education Perspectives, 32(3), 168-172. doi:10.5480/1536-5026-32.3.168
Skilbeck, J. (2013). Caring for frail older people: are we ready for the challenge?. International Journal of Palliative Nursing, 19(12), 575.
Vassal, P., Le Coz, P., Herve, C., Matillon, Y., & Chapuis, F. (2009). Is the principle of equal access for all applied in practice to palliative care for the elderly?. Journal Of Palliative Medicine, 12(12), 1089. doi:10.1089/jpm.2009.0224
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...
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).
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
Houde, S., & Melillo, K. (2009). Caring for an aging population. Journal Of Gerontological Nursing, 35(12), 9-13. doi:10.3928/00989134-20091103-04
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...
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.
There are changes in the demographic as the population grows older, the number of older adult’s increases and thus, there is an increase of proportion of patients that are older adults for nurses to take care of (Wells, Y., Foreman, P., Gething, L., & Petralia, W., 2004). The nurses are there to assist and support the older adults in achieving wellness within their situation through empowering the clients (Touhy, et al (2012). Caring for older adults is important as there is an increase in population with deteriorating health. When caring for a client it is important to incorporate Jean Watson’s caring theories and Carative Factors to help influence and support the care. She encourages nurses to co-participate within the caring process by establishing unity and trust between the nurse and client. First, this paper will explain a situation in where I cared for an older adult and it will then introduce Jean Watson’s lower order needs, specifically the need for activity and how it relates to the older adult I cared for. Lastly, this paper will explain the nursing interventions I implemented to meet the lower order need, with a discussion of Carative Factor #4 relating to the client.
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.
Candidate Handbook. (2013). National Board for Certificate for hospice and palliative care nurses. Retrieved November 23, 2013, from http://www.nbchpn.org/
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...
Puckett , P., Hinds, P., & Milligan, M. M. (1996). Who supports you when your patient dies?. RN, 59(10), 48-50, 52-3. doi: 1996037794
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.