End of life can be completely difficult to cope with, but is a part of everyday life. End of life pertains to the last days of a patient’s life, which means that end of life requires many important decisions such as medical treatment and knowing when to terminate life support. So planning end of life can be extremely difficult for the patient and their family members. They will have to make the decision on where the patient want to spend their last days, treatments they wish to have and not to mention their goals of care. This topic is truly important because not many individuals realize what comes with dealing with end of life care.
However, when it comes to medical treatments the patient must decide whether or not they would like to continue their current
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What is extremely important is following the doctor’s orders to make the patient as comfortable as possible.
Not to mention, if you have a patient that is on life support and the doctors are unable to help them any longer the family must decide what they are going to do. Therefore, terminating life support can be a difficult decision to make, especially when it’s your loved one. That is why it is important to have an advance directive or living will on file. This will enable the patient to take these difficult decisions off of their family members. It also will ensure that the doctors acknowledge the patient’s wishes.
As a matter of fact, according to research the percentage of advance directives being completed is up to 80%. Where as in the early 2000’s only a staggering 29% of patients had an advance directive. This number is extremely significant because it means that family and loved ones are beginning to understand the importance of having an end of life care plan. Not only that, they are laying a strong foundation for the medical professionals. This will let physicians and nurses know what life saving techniques they can and cannot use according to this
While navigating the abundant and sometimes confusing legal language of advance directives can be time consuming, it would benefit every person to consider their end of life wishes and have some form of written statement available for their doctor and family to understand those wishes. Doing this in advance can prevent emotional anguish, suffering and expensive litigation. In the end, clearly and when possible, written, documentation of a medical directive, a living will, or a chosen health care power of attorney will lessen the burden for the medical professionals and family of a dying or incapacitated person.
Many of his suggestions provided revolve around training doctors to better assist patients in end-of-life care decisions and to ask pertinent questions and have frank discussions on the matter that encompass more than just medical care, which is what much of the literature provides. However, while many of these suggestions can be implemented, one relevant question is whether healthcare providers, when faced with these critical junctures, always have the time to do so, especially if it is a time-sensitive intervention that requires quick thinking. This may be why Gawande advocates for planning beforehand with the family/patient regarding their desires for end-of-life care, so that if this critical juncture is reached, the best decision is made that accords with the wishes of the
We consider the legislation consistent with the principle that "respect for that person [who is capable of participating] mandates that he or she be recognized as the prime decision-maker" in treatment. [2] The patient is a person in relationship, not an isolated individual. Her or his decisions should take others into account and be made in supportive consultation with family members, close friends, pastor, and health care professionals. Christians face end-of-life decisions in all their ambiguity, knowing we are responsible ultimately to God, whose grace comforts, forgives, and frees us in our dilemmas.
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).
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
Through reading the essay-interview, "The Long Goodbye" by Sam Mowe, you become exposed to Katy Butler 's view on medical care and how she feels the decision-making process of end of life events should occur. Katy has experienced the death of her parents in two very different manners and used those struggles to explain her views. She believes that many people are kept alive past the point that they can live a meaningful life. Katy also expresses her opinion that palliative care is a necessity in these end of life situations so that more appropriate decisions can occur when death is near. This article also touches on how Katy Butler feels that with there being so much money in health care, personal care takes a back seat
In every death there is some kind of issue, but recently, ‘pulling the plug’ has become an even worse one. When a loved one dies we all deal with in it different ways, anything to cope with it, but when can we consider it as too far? In my personal opinion, the case of Jahi McMath has gone extremely too far. ‘She was pronounced brain dead on December 9th, 2013 by the coroners office after suffering from rare complications.’ (McCullough, Laurence. Ethicists criticize treatment of teen, Texas patient) Jahi has been placed on a ventilator, but she is a vegetable. Her heart is artificially beating and has also ‘had one tube inserted in her throat and another into her stomach to pump nutrition’ (McCullough, Laurence. Ethicists criticize treatment of teen, Texas patient). I understand that losing your child would be hard and some people just really can’t cope with it, but how can they just stand there and watch their ...
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.
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
In addition, those potentially nearing the end of their life may be asked a DNR, or “Do Not Resuscitate,” Order. This states that in a life-threatening emergency where one is facing possible death, no actions shall be done try and “resuscitate” the individual in an attempt to restore life to the person. However, if a DNR Order is not filled out, actions including CPR, or cardiopulmonary resuscitation, mechanical ventilation, h...
THOMAS, K. and LOBO, B., 2011. Advance care planning in end of life care. Oxford: Oxford University Press.
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...
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...
The subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.