With the rates of chronic and terminal illnesses on the rise throughout the world, it becomes important to recognize and help the families going through these unfortunate events. Not only do these ailments affect the patient, they also take a toll on the families as well. They experience the burden of being a caregiver, both socially and financially. They encounter the many differences in the behavior of the patient, which sometimes can be extreme. The family also takes into consideration the fact that their loved one may not survive their illness, and must be able to carry out the desired wishes of the patient. A great example of how these factors are demonstrated can be seen in the film, “My Sister’s Keeper.” In the film we meet Kate Fitzgerald. …show more content…
We discussed two different forms of carrying out the desires of the ill patient in lecture and in the short film “Facing Death.” The first was a living will. A living will states what is to be done as far as medical interventions to keep the patient alive or not, and the criteria for being taken off of life support. This allows a legal agent to be in place so that there are no questions regarding what is to be done to the patient if they cannot make decisions for them-self. The second was a health care proxy, who is a person that the patient trusts to make decisions about treatment and medications when the patient is unable to. “My Sister’s Keeper” is a poor example of this. Although Kate had her younger sister, Anna Fitzgerald, set out to become medically emancipated from their parents so that she did not have to donate her kidney to Kate, her wishes were never communicated with a legal agent, a health care proxy, in a living will, or even mentioned to medical staff. This returns back to good communication between Kate and her doctor, as well as her …show more content…
This is how the patient functions in daily domains, including: physical, psychological, and social domains. Physically we look at how the patient feels about them-self within a “sense of self” domain. This includes body image, being able to achieve both social and private selves, and having a sense of identity. Oftentimes leukemia patients experience hair loss and rashes due to various treatment options. These factors can impede on how the individual reaches developmental milestones. For Kate Fitzgerald this includes having her first boyfriend, going to prom, experimenting sexually, and even being able to have relationships with friends where she can go out with them. Most importantly in adolescent cancer patients, a sense of identity is a vital attribute to grasp. In Kate’s situation it is evident that her sense of identity is lacking. She was diagnosed with leukemia at age five and only knew life that was filled with treatments and surgeries. She viewed herself as “sick Kate” who was always trying to get better, not an adolescent girl discovering who she was and who she wanted to become. These factors can have an impact on the psychological domain of the patient. Collectively when they are unable to experience these things due to cancer it is not uncommon for them to present signs and symptoms of depression, denial, or anxiety. In the film there is a scene where Kate has been lying in bed for days
Care in of the patient in context of family stems from a theory developed by Von Bertalanffy which asserts the relationships between family members are so intertwined that changes in one member can affect other family members (Potts & Mandleco, 2012, p. 62.). The theory further establishes the needs
Increasingly, people know from their own experience some painful dilemmas involving elderly or handicapped individuals who are in pain. While the achievements of modern medicine have been used to prolong and enhance life for many, they have also helped create an often dreaded context for dying. Costly technology may keep persons alive, but frequently these persons are cut off from meaningful relationships with others and exist with little or no hope for recovery. Many fearfully imagine a situation at the end of their lives where they or their trusted ones will have no say in decisions about their treatment.
A living will is a type of advanced health care directive, which states an individual’s wishes for health care treatment when he/she is terminally ill. Living wills are often applied to end-of-life decision making when patients are no longer deemed competent to direct care for themselves. The form of living wills can vary widely. But, most address whether or not to use life-prolong medical treatment such as CPR, respirators, and artificial nutrition and hydration. These documents can also contain information about the importance of quality of life for patients and can name a healthcare proxy to make medical decisions in their place. Having a living will allows individuals to state their
Nurses are both blessed and cursed to be with patients from the very first moments of life until their final breath. With those last breaths, each patient leaves someone behind. How do nurses handle the loss and grief that comes along with patients dying? How do they help the families and loved ones of deceased patients? Each person, no matter their background, must grieve the death of a loved one, but there is no right way to grieve and no two people will have the same reaction to death. It is the duty of nurses to respect the wishes and grieving process of each and every culture; of each and every individual (Verosky, 2006). This paper will address J. William Worden’s four tasks of mourning as well as the nursing implications involved – both when taking care of patients’ families and when coping with the loss of patients themselves.
People with cancer often begin to define themselves based on their experience with their illness, this self-definition through one’s cancer is one that the characters fear in John Green’s The Fault in Our Stars. The novel shows how the characters strive to discover their identities, but despite that are still identified by their illness. The novel also makes the argument that young people with cancer are not any more virtuous or different than other kids rather, they are just normal kids living with an illness. Augustus wants to be remembered and also be more than just a boy who battled cancer, but despite his efforts is still identified by his illness.
One of the greatest dangers facing chronic and terminally ill patients is the grey area regarding PAS. In the Netherlands, there are strict criteria for the practice of PAS. Despite such stringencies, the Council on Ethical and Judicial Affairs (1992) found 28% of the PAS cases in the Netherlands did not meet the criteria. The evidence suggests some of the patient’s lives may have ended prematurely or involuntarily. This problem can be addressed via advance directives. These directives would be written by competent individuals explaining their decision to be aided in dying when they are no longer capable of making medical decisions. These interpretations are largely defined by ones morals, understanding of ethics, individual attitudes, religious and cultural values.
One of the many concerns is allowing incompetent individuals making this irreversible decision, which is why, “all have agreed that this end-of-life option should apply on to competent individual’s”(113). In addition, people opposed to this method argue that patients demanding this process are suffering from depression and not able to make decisions; yet, Rosenfled explains that practitioners most ensure that patients who consent to this medical intervention do it voluntarily, knowingly and
Wittenberg, E., Saada, A., & Prosser, L. (2013). How illness affects family members: A qualitative interview survey. The Patient: Patient-Centered Outcomes Research, 6(4), 257-268. doi:10.1007/s40271-013-0030-3
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...
...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?
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.
Hospitals have been mandated to honor their patient’s decision ever since 1991, when Congress passed the Patient Self- Determination Act Law. Forty-nine states with the exception of my home state of Missouri gave permission for the next of kin to make decisions for incoherent relatives. Missouri also has an extra requirement for their Living Will Statute and that is any form...
Death is a personal experience and to ensure loved one’s wishes, there has to be the ‘what if’ conversation. It is natural to talk about the possible end with loved ones after marriage and having children. Living wills are obtained and do not resuscitate orders, thoughts of a possible guardian for the children, life insurance, appointing a health care agent, and any other loose ends that will ensure the well being of the family. A health care agent is someone who the patient designates to make medical decisions, if decisions cannot be made generally. The chosen agent should be a person who knows the wishes on the extent of medical care treatment wanted. The appointed health care agent should be someone who is not afraid to ask questions of the healthcare professionals to get information needed to make decisions and be assertive to ensure that wishes are respected. (Healthcare Agents, n.d.).
The end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
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.