Hospice is giving dignity, support and love to end of life patients. Hospice works with the patient’s pain to give the patient comfort, not to hurry death or hasten the dying process, but to relieve symptoms that are sometimes associated with grief and dying. In my experience, I have witness the positive effects associated with comfort care for both patients and love ones. Dying patients grieve for various reasons. Sometimes it is mentally, physically, emotional or psychological and it affects their love ones as well as their level of comfort. Our promise to every patient we take care of is “To provide exceptional care, to guide the patient and their family on their journey, and to respect their choices. Their comfort, needs and wishes come first. They can count on us when and where they need us” (Hospice and Palliative Care, 2013). …show more content…
In my field of work, I have to make ethical decisions on a regular basis under the supervision of nurses and doctors but this particular time it involved the stopping of liquids and food to the patient. The patient was still alert and able to sit, talk and even walk for brief periods. A swallowing test revealed that this patient was not able to safely ingest by mouth liquids or food so I was to do mouth care only with a fairly dry sponge swab. This was the patient’s only means of mouth stimulation. Some family members felt for whatever reason that this was wrong to do no matter what. How can we stave someone to death? That was a distorted view of hospice and defeated the whole purpose of our mission. Yet they were entitled to their
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
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.
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...
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 workers, likely more than any other group of care providers, deal with the desperation that many individuals feel when they accept the fact that their illness is likely to be the cause of their death. In that process, hospice staff deal not only with the physical pain of the illness, but also the emotional pain of facing leaving one's family, the social pain of enduring what may be considered indignities, and the spiritual pain associated with one's cultural and personal beliefs about life after death. Through an interdisciplinary approach that is unique to hospice care, patients who elect hospice receive treatment for all their concerns. Hospice caregivers have discovered three central reasons a terminally ill person may want to discuss suicide.
The hospice aide’s job duties varies depending on the patient. If the hospice patient is in good condition, the job duties are very similar to that of the nursing home CNA. The hospice aide’s main goal is to maintain the patient’s dignity while providing the most comforting care possible. Many hospice patients are referring to as being on “comfort cares” – meaning if they don’t want to eat, they aren’t forced to. The hospice aide’s job is a hard one, as any CNA’s is, but perhaps more so, as they lose their patients at a higher
Hospice always patient and families the automaty to decide a choice of end of life care. It allows who prefer to end life in their homes, pain free, surrounded by family and loved ones: Hospice works to make this happen. The focus in on caring, not curing. Hospice utilizes an interdisciplinary team of healthcare professionals and trained volunteers that address symptom control, pain management, and emotional and spiritual support expressly tailored to the patient's needs and wishes. Hospice is not “giving up,” nor is it a form of euthanasia or physician assisted
Vendlinski, S. & Kolcaba, K. (1997). Comfort care: A framework for hospice nursing. American Journal of Hospice and Palliative Care, 14(6), 271-6.
This can be seen in the case study as ethical and legal arise in resuscitation settings, as every situation will have its differences it is essential that the paramedic has knowledge in the areas of health ethics and laws relating to providing health care. The laws can be interpreted differently and direction by state guidelines may be required. Paramedics face ethical decisions that they will be required to interpret themselves and act in a way that they believe is right. Obstacles arise such as families’ wishes for the patients’ outcome, communicating with the key stakeholders is imperative in making informed and good health practice decision. It could be argued that the paramedics in the case study acted in the best interest of the patient as there was no formal directive and they did not have enough information regarding the patients’ wishes in relation to the current situation. More consultation with the key stakeholders may have provided a better approach in reducing the stress and understanding of why the resuscitation was happening. Overall, ethically it could be argued that commencing resuscitation and terminating once appropriate information was available is the right thing to do for the
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...
After reading the different stories in the book “Final Gifts”, I believe I have a better understanding of the nurse’s role in caring for the needs of the dying patient and how their families need to be guided through this experience. The different stories in this book provide insight into the experiences of the dying as well as how their loved ones cope with their loss. The authors Maggie Callahan and Patrician Kelly, experienced hospice nurses who have extensive exposure to dying patients and their families, through their shared stories, paint a picture of what the dying want. To many, death is a difficult concept.
Some feel that a terminally ill patient should have a legal right to control the manner in which they die. Physicians and nurses have fought for the right to aid a patient in their death. Many families of the terminally ill have exhausted all of their funds caring for a dying patient and would prefer the option of assisted suicide to bankruptcy. While there are many strong opposing viewpoints, one of the strongest is that the terminally ill patient has the right to die in a humane, dignified manner. However, dignity in dying is not necessarily assured when a trusted doctor, whose professional ethics are to promote and maintain life, injects a terminally ill patient with a lethal dose of morphine.
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.
Another huge ethical topic is the patient’s right to choose autonomy in the refusal of life-saving medicine or treatment. This issue affects a nurse’s standards of care and code of ethics. “The nurse owes the patient a duty of care and must act in accordance with this duty at all times, by respecting and supporting the patient’s right to accept or decline treatment” (Volinsky). In order for a patient to be able make these types of decisions they must first be deemed competent. While the choice of patient’s to refuse life-saving treatment may go against nursing ethical codes and beliefs to attempt and coerce them to get treatment is trespass and would conclude in legal action. “….then refusal of these interventions may be regarded as inappropriate, but in the case of a patient with capacity, the patient must have the ultimate authority to decide” (Volinsky). While my values of the worth of life and importance of action may be different than others, as a nurse I have to learn to set that aside and follow all codes of ethics whether I have a dilemma with them or not. Sometimes with ethics there is no right or wrong, but as a nurse we have to figure out where to draw the line in some cases.