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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 …show more content…
According to Haley and Daley (2013), cancer as the main cause of the terminal illness in the paediatric age. For the recent years, the survival rates of children with cancer have increased significantly with 7 out of 10 recovers (Selwood, Langford, & Wright, 2012). Haley & Daley (2013) also mentioned that parents act as the decision-makers and as the primary carer, moreover, physical and psychosocial developmental factors of the child affects the perception of death as temporary and the capability to communicate and make their own decisions. Moreover, parents make the decision for the child as for legal matters, but the child needs encouragement to actively participate and to develop the sense of authority. Children may have a different idea of pain and illness, for instance, they may think that they did something wrong that is why they are suffering. Children may refuse or not participate properly in any treatment without the supervision of the primary carer. Providing the child and family with health education during palliation as well as helping them to the transition to adulthood is an important task for the nurse. Derby, Tickoo, and Saldivar (2014) mentioned that the major difference of between old and younger adults is the need for extensive support of the family. Decision-making for older people might include the patient’s family, surrogates and Advanced Care Planning (ACP) at the time they are not able to make their own decision. Derby et al., (2014) stated that “ACP prepares for lack of capacity in decision-making and relieves the burden of decision-making on others” and surrogate decision-maker “is a person whom the patient designates to make decisions if/when he or she is unable to do so”. Older patients need a representative, mostly an elderly act as a primary carer to make the decision for them or someone who will make
End of Life Care involves choices such as hospice some instances, if that is what the patient chooses. Hospice involves that of palliative care, where health care professionals instead of treating the illness treat the patient they help to keep them comfortable and eliminate pain (Allender, Rector & Warner 2010). The choice of a patient’s end of life care is often considered after the diagnosis of a terminal illness, and the patient is able to decide how they would like to spend the rest of their days. Adolescence is characterized by a time of growing and finding ones self, which makes the debate about whether or not an adolescent should be able to make a decision about their own health care.
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...
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).
The first journal article is about advance care planning (ACP) in palliative care. This is of interest due to several clinical experiences and the realization that many families either ignore the patient’s request for end of life (EOL) care or who have no idea of how to plan for EOL care. By reading the research and understanding the methods used, this will allow for insight into how to implement palliative care into clinical practice across different sites. The authors of this original research are Jeanine Blackford PhD, RN, senior lecturer at La Trobe University in Australia, and Annette Street PhD, associate dean of research and professor of cancer and palliative care studies. According to Blackford & Street (2011), this research is important as there are many countries that “report a low percentage of people who have completed an advance care plan” (p. 2022), and ACP is needed upon admission to facilities that offer palliative care.
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
PAD is the most debated moral issue, where the stances taken by various stakeholders are either for or against the issue. Since, Nurses put the patients’ decision first, most nurses advocate for the legalization of the PAD. Despite, Palliative care aims to relieve suffering and improve the quality of living and dying, most patients with a progressive life-threatening illness wish to end their life with some medical help. This desire needs to be respected, for patients deserve the peace of mind and improved quality of life that comes with knowing that a peaceful and dignified PAD will be an available choice, when the suffering becomes intolerable (BCCLA, 2015). In situation where legislation restricts the client to resort to PAD, people find different ways to end their life to eliminate the unbearable suffering, even if that means choosing a violent and risky death. Therefore, it is arguable that if these kind of violent methods are acts of desperation, then why not consider a peaceful method of ending life through medical help? Accepting PAD does not necessarily encourage suicide or
Palliative care is an essential to the creation of a health and wellbeing continuum for Australians living with a chronic illness. It is an approach of care that seeks to improve the life of patients and family experiencing the effects of chronic illness. Palliative care centres on the relief of the symptoms and effects of disease and incorporate the physical, psychological and social dimensions of a person at the end of life. A recent focus for the delivery of palliative care by nurses to Indigenous communities is the consideration that culture can create barriers to the provision of appropriate and beneficial care for the dying or deceased person. This essay explores the palliative nurse caring for Indigenous communities and the need to consider
Palliative care - treatment that helps to comfort patients, while slowing the progress of a disease.
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.
The individual will need to be encouraged to make decisions about the care they receive and the type of life they want to live and also ensure that their families are part of the decision making process.
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...
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
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...
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 ...