Congestive heart failure (CHF) is a debilitating chronic illness that requires a lot of daily management. As a result, it impacts not only the patient, but the patient’s family. The effects of heart failure can leave patients fighting to retain a quality of life and trying to prevent further complications. As the patient struggles to live with a chronic illness, the family is taxed with balancing the patient’s needs with the needs of the entire family (Kaakinen, Coehlo, Steele, Tabacco, & Harmon Hanson, 2015). This task is especially challenging in heart failure due to the debilitating effects it has on the ill family member. In this paper I will discuss several ways the family nurse can provide intervention to guide and support the patient …show more content…
Self-management is both a process and outcome of nursing care that includes self-efficacy, self-monitoring of the illness, and management of systems either by the patient or a person he or she directs (Kaakinen, Coehlo, Steele, Tabacco, & Harmon Hanson, 2015). One of the most important challenges in heart failure patients’ is self-care compliance to a low-sodium diet (Shahriari, Ahmad, Babaee, Mehroli, & Sadeghi, 2013). Since diet occurs at home family members can play an important role with encouraging compliance to diet restrictions. As a family nurse, I would initiate a nurse-led family conference to address this self-care compliance, information would be shared on the benefits of a low-sodium diet and the risks to a heart failure patient if ignored. Furthermore, education would be provided in regards to reading food labels, tips for eating in restaurants, and discussing the American Heart Association’s guidelines for a low-sodium diet. Self-care is a non-pharmacological intervention that can improve clinical outcomes in patients with …show more content…
At some point, patients and their families will be forced with the decision as to whether or not to continue aggressive treatment. Palliative care focuses on improving the quality of life, and supports the patient’s and the family’s needs. It takes a holistic approach that can start at the time of diagnosis and extend to bereavement (Kaakinen, Coehlo, Steele, Tabacco, & Harmon Hanson, 2015). It is important to provide well-being and dignity for a patient with congestive heart failure, as well as maintaining effective communication with healthcare professionals, and offering emotional and spiritual support for the patient and family; palliative care provides this type of intervention. Being secure with my own attitudes towards death and dying, I would talk to the patient and family about developing advance directives. I would explain the benefits of having advance directives in place, and the peace-of-mind it can provide the patient and the family. Being a family nurse I realize palliative care involves an interprofessional team approach, I would facilitate an intervention that works conjointly with the patient and family. Given the physical, psychological and financial burdens of heart failure, palliative care needs to be an integral part of the care plan for heart failure
Using nursing strategies that are unique for each family based on their individual genetic and genomic variations is fairly new in the area of nursing (Munro, 2014) and interventions for this family should be tailored to helping them keep up on current information about heart disease, diabetes, and cancer, which are the main medical issues in their family medical history, and having a plan that ensures they continue getting regular health checkups.
Jeon, Y., Kraus, S. G., Jowsey, T., & Glasgow, N. J. (2010). The experience of living with chronic heart failure: a narrative review of qualitative studies. BMC Health Services Research. doi:10.1186/1472-6963-10-77
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.
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).
Participant 4 stated, “I think just basically being there for the family as well…I think even just a cup of tea can go a long way with any family (McCallum & McConigley, 2013). Another theory that intertwines with Watson’s is Barbara Dossey’s Theory of Integral Nursing. Dossey articulates, “Healing is not predictable, it is not synonymous with curing but the potential for healing is always present even until one’s last breath,” (Parker and Smith, 2015, p. 212). Dossey believes that integral nursing is a comprehensive way to organize different situations in fours perspectives (nurse, health, person and environment) of reality with the nurse as an instrument in the healing process by bringing his or her whole self into a relationship with another whole self. In the HDU, the RN’s interacted with each patient while providing high quality care to create a healing environment for the patient and family even when their prognosis was otherwise. Patient 3 specified that “We still have to provide care...and make the family feel that they are comfortable and looked after” (McCallum & McConigley, 2013). These theories ultimately show the importance of a nurse through the aspects of caring to create and maintain a healing environment that is not only beneficial to the patient but to their loved ones as
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.
Patients under the care of advanced nursing professionals who were advised to take an proactive role in the development of management plan under the supervision of their nurse practioners and medical doctors. were more effective in their compliance than those While no significant differences were in the outcomes that included A1C and the levels of triglyceride, there were notable increases in patients who comply with activities related to caring for self and willingness to make healthy lifestyle changes in the areas of increased physical activity and nutritional intake.
Also, the whole family needs to come to term with the health condition, make change in priorities and schedule, and keep the family. For example, it can be much more stressful for a young or a newly married couple because they may have more experience to overcome life's difficulties. As a result, as with individual maturation, family development can be delayed or even revert to a previous level of functioning (Hockenberry, p 762.) Therefore, health care providers need to apply family development theory while planning care for a child and family with chronic health condition. Indeed, family centered care should be a part of that intervention. Parents and family members have huge and comprehensive caregiving responsibilities for their chronically ill child at home or at hospital. Moreover, the main goal taking care of chronic ill child is to “minimize the progression of the disease and maximize the child’s physical, cognitive, psychological potential” (Hockenberry, p 763). Therefore, it is essential to family being part of the child care to give highest quality of care. On the other hand, we are as a part of the health care provider need to give attention to all
Including family members in the care of the patient helps them cope better with the patient’s illness and helps them plan ongoing care when the patient goes home. Gaining both the trust of the patient and family can help the health care team get any details that may have been missed on admission, such as medications the patient takes, or special diet, or spiritual needs. Also, the family may provide pertinent information that the patient may not have divulged to the nurse. Encouraging the patient and family to voice their concerns will help implement a safe plan of action.
Moving forward, people should be able to be put out of their misery of their terminal illness. This is something that without a doubt will tear a person to shreds. This type of news, “can trigger feelings of depression, in both patient and loved one. These feelings can be severe or mild and can often be just one of the stages that a person goes through when learning of catastrophic news” (Terminal Illness). Some terminal illnesses this time is also very stressful with decisions that one can make. Although depending on what the patient has, the illness can be brutal and
...concerns appropriate interventions were assigned to each one. For the priority concern of the family’s ability to cope and their risk of depression commendation and interventative questioning were the chosen interventions. For the priority concern of Gilberts care giver burnout and risk for compassion fatigue commendation and encouraging respite were chosen. The Grape family is a fitting example of the complex difficulties a family can have when they are faced with the difficulty of dealing with a chronic illness and tragedy. This paper demonstrates the importance of assessing and creating interventions for a family in a way which includes every member of the family not only the ones with complications. Raising the question should patients who are suffering from chronic illnesses better off to be treated as an individual or as a member of a functional family unit?
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
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 context of chronic illness: a family health promoting process. Journal of Nursing and Healthcare of Chronis Illness 3, (3), 283-92.
In health care, there are many different approaches throughout the field of nursing. When considering the field of family nursing, there are four different approaches to caring for patients. This paper will discuss the different approaches along with a scenario that covers that approach. The approaches that will be discussed include family as a context, family as a client, family as a system, and family as a component to society. Each of these scenarios are approach differently within the field of nursing.