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The importance of pain management in palliative care nursing easy
Principles of palliative care
The importance of pain management in palliative care nursing easy
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Hospice is place that provides support and care for persons with incurable disease such that, patients are at the last phase of the disease. Hospices care provide provides pain-free support to their patient and making patient comfortable and maintaining the quality of the remaining life because they recognizes dying as part of the normal process of living. The focus of hospice is care and cure of patient. According to the National Hospice and Palliative Care Organization (NHPCO), hospice support patient with their needs; spiritual, emotional and physical needs so that patients/clients will be comfort. Hospice specialized in pain and symptoms management as well as support services proving counseling and education. Hospice is not a place patient receive hospice care the home (Corr, Vol 17, NO 1). Care is open to people of all ages including children but many times, it elderly people who have being diagnose by physician with terminal illness and have approximately six months to leave. Medications and customary equipment’s such as commode, wheelchair etc. are also covered by hospice (NHPCO, 2012).
The history and name hospice got its name from hospitality. In 1967, Dr. Cecily Saunders evented the first hospice was which was used for people who were terminally ill. However, the Hasting center Report, shows that in 1973, hospice emerges in the United State, and was used as a concept of care and not a place of care. Hospice upholds life and neither speeds nor postpones death. They offer palliative care to people with end of stage of life regardless of their age, gender, nationality, race, sexual orientation, etc. Hospice believes that proper care to the community will help patients and their families to be mentally and spiritually prepared for the death of their love ones. They provide 24/7 care in either home or facility base setting. The care of hospice is for patients who have chronic illness and have six month or less to live (NHPCO, 2012). Opiates mediation is used to treat pain. Hospice offer palliative care service to their patients to improve the quality of life. The primary goal is to control patient’s pain, symptoms management, and improve the quality of life (NHPCO, 2012). Hospice also provides bereavement services for families who have lost their love one. This is to help the family to cope with death. The bereavement services last for about a year or thirteen months after patients die. Families are offered individual counseling or support group (NHPCO, 2012).
Final Gifts, written by hospice care workers, Maggie Callanan and Patricia Kelly, includes various stories detailing each of their life changing experiences that they encountered with their patients. Hospice care allows the patient to feel comfortable in their final days or months before they move on to their next life. This book contains the information considered necessary to understand and deal with the awareness, needs, and interactions of those who are dying. Not only are there stories told throughout the book, there are also tips for one to help cope with knowing someone is dying and how to make their death a peaceful experience for everyone involved. It is important that everyone involved is at as much peace as the person dying in the
God tells his children, “He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away” (Revelation). Death is one of the most frightening and confusing times a person can go through. Watching a loved one pass away is also one of the hardest trials a person can experience. Many people assume that death is a time of pain and the only thing that they can do is mourn and watch their loved one fade away from the earth. This is wrong. There are ways that people can turn a bad situation to good. Dying doesn’t have to be painful and full of suffering. The County Hospice staff makes sure of this. The Hospice staff not only takes care of passing patients physically, but they also take care of the patients emotionally and spiritually. Hospice staff also plays a key role in helping families during the grieving process.
The change which is outlined in this paper relates to how early referral of terminally ill patients into a hospice program results in better patient outcomes, in particular, with regard to pain management. PICO format question will be used , along with a supportive body of evidence regarding the fact that early onset into a hospice program is helpful with providing end of life pain control. Hospice programs available, and options associated with them will be discussed as well as common concerns associated with early admission to hospice. The methods used for payment of hospice, and how one qualifies for entrance into a hospice program will be explored. A literature search will be performed and its results detailed within the body of this paper. Recent publications on the subject matter and associated issues such as moral and ethical questions as well as the change question will be discussed. Planning, implementing and evaluation of the change proposed will be explored within this paper.
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.
Being in hospice care is a better alternative than being stuck in the hospital to try to avoid the unavoidable. Common misconceptions about Hospice could include that hospice makes life more miserable; however, a physician expressed his findings in Hospice,“You can only fail a patient if you fail to understand and respond to their needs. We may not be able to cure all of our patients, but if we can make them comfortable in the last moments of their lives, we will not have failed them”..Hospice care gradually emerged in the 1970s, when groups like the National Hospice Organization were formed “in response to the unmet needs of dying patients and their families for whom traditional medical care was no longer effective.”Herbert Hendin, an executive director of the American Suicide Foundations illustrates a story of a young man diagnosed with acute myelocytic leukemia and was expected to have only a few months before he died. He persistently asked the doctor to assist him, but he eventually accepted the medical treatment. His doctor told him he can use his time wisely to become close to his family. Two days before he died, Tim talked about what he would have missed without the opportunity for a
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
Death comes to all in the end, shrouded in mystery, occasionally bringing with it pain, and while some may welcome its finality, others may fight it with every ounce of their strength. Humans have throughout the centuries created death rituals to bring them peace and healing after the death of a loved one.
Hospice Care refers to the focus on quality of care and life rather than treatment and curative options for someone and their disease. This type of care includes not only the patient, but also their family and physician. Dame Cicely Saunders states, “You matter because of who you are. You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but also to live until you die.” With this quote, Saunders reflects what Hospice believes in and their commitment, or duty, for the patient. Patients who are terminally ill can be considered as patients with cancer, diabetes, and many more diseases. Very few cancer patients have a type of cancer that has a known cure, and unlike those patients many other cancer patients possess a type of cancer that is curable today. Terminally ill patients have to choose between continuing treatment or being provided with Hospice Care. Both hope and Hospice means that the patient can have both the benefit from treatments, which give them hope that the disease could be cured or at least reduce the symptoms, and Hospice Care, which provides the patients with relieve of pain and
“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)
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...
Should opting out of life be an option for those who are sick or hurt people? With euthanasia, that is something now available for terminally ill patients. “The definition of euthanasia is the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma, or the intentional termination of life or the intentional interruption of procedures intended to prolong life by a physician” (Oxford Illustrated Companion to Medicine). Other names it is known by is mercy killing, or assisted suicide. It is also referred to as quietus, meaning death or something that causes death, but is very rarely called that (Funk & Wagnalls New World Encyclopedia). Euthanasia is illegal in most countries and almost every state
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
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). Palliative care is not the same as hospice, since it is not only for the dying. According ...
Research on Pediatric Palliative Care The pediatric nurse that participates in palliative care for a child has an important role in their coping and healing process based on their excessive interaction with the child and their family, and their job description to manage the child’s pain. It is hard for a child to accept or realize the situation of having a terminal or ongoing illness when admitted into palliative care. A nurse needs to realize and discover the psychological and holistic needs of the child inorder to prevent safer digression in their health and improve their stay in palliative care. The main goal that a registered nurse that is working in a palliative care unit/setting, is to provide the best best care and also proved physical,