Case Study Based On The Palliative Patient Essay

Q1: Complete the following table, describing the needs you would have to consider when planning the different aspects of end of life care for an individual

The aim of a hospice is to improve the quality of life of the dying

Getting prepared for death can be an exhausting experience for the patient and their family. It is very important that the patient not only knows what they want as far as their right to receive or reject treatment and medications or knowing whether they want to receive palliative care at home or in a hospital setting to include the advantages and disadvantages of each. The main focus of this paper is to give the reader an in depth look on how an end of life crisis affects a patient and their family. Ella is a breast cancer patient who just came out of remission and is at the end of her life.

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

This is recognized to be an issue, and throughout the article the authors provided an understanding of how palliative care and end-of-life care are provided too late for a patient and should be provided at an earlier time in order to bring more comfort to the patients. The authors suggest that when and how end-of-life care is provided should be altered, with nursing ethics in mind, so that patients and nurses may feel better about the care they receive. This source will help my research by providing information on how changing the policies of end-of-life care and palliative care can result in the patient feeling a relief from their suffering and ultimately feeling more comfortable. This will also help my argument in how altering the current policies and focusing on providing better end-of-life care can lead to the diminishment of physician-assisted

Hospice patients often receive palliative care to help them cope with the stress, pain, and anxiety that comes with hospice care. Galfin, Watkins, and Harlow (2011) explored the need to train palliative care nurses how to provide not just physical care, but also psychological care. The authors reference previous studies that addressed similar training programs, but point out that many lack an explanation of what the palliative care entails, or statistical evidence to show if guided self-help improved patient’s psychological distress.

In my nursing practice, I frequently care for dying patients. Instead of simply providing medication to ease pain during the dying process, I wanted to learn about ways to enhance the comfort of the dying patients and possibly assist their family during a difficult time. This desire led me to examine the conceptual model of comfort. Through my research of the concept of comfort care at end of life, I discovered Katherine Kolcaba’s theory of comfort. I found her theory to be useful in describing the concept of comfort care and decided to further analyze it for a more thorough understanding of its usefulness and applicability to nursing practice. Nurses are the ones in direct contact with their patients, providing relief from certain discomforts, continuously assessing, monitoring and providing care that will ensure the patient is at ease. According to Kolcaba, “Comfort is the desirable state that nurses would want for their patients.” (Kolcaba, 2003). With its fundamental emphasis on physical, psychospiritual, sociocultural, and environmental aspects of comfort, the Theory of Comfort care will contribute to a proactive and multifaceted approach to care. This paper aims to describe the origin of Comfort Theory, its primary concepts and relational statements, review of the literature, critique describing its strength and limitation as a middle range theory

This study supported the idea of receiving hospice or palliative would be beneficial for patients and primary caregivers which reduce the negative symptoms and have an advantage for receiving hospice or palliative care which also support and be relevant to the thesis that I would like to research on.

This results in the following PICO question: In terminally ill patients, does early admission into a hospice program, versus those who are admitted later, result in more effective pain control at the end of life? The focus of this question is therapy (Sackett, 1997).

Nutrition and adequate hydration are fundamental needs for the body. Most people see the act of eating and drinking as an enjoyable or pleasurable part of life that meets the biological, social, psychological and cultural needs. Loss of appetite and no desire to drink is a natural process for a person in the end stages of life. The simple task of eating and drinking can cause a great deal of discomfort as well as cause a lot of anxiety or stress to the family. As an advocate for the patient in the nursing profession, the cessation of nutrition and fluids to the terminally ill or dying patient is ethically challenging for both nurses and families.

The role of the expert palliative care nurse is complex and unique. The nurse functions as an integral part of a Multidisciplinary team, providing expert skilled assessment and nursing care, supporting the patient and the family to make informed choices thereby encouraging the patient to continue to make autonomous decisions about their care towards the end of their life.

I believe that comfort care should be a “substantive need in all aspects of life” as the author proposes. It is important that all patients are kept comfortable regardless of what they are being treating for. A patient that is kept comfortable is more likely to recover faster and have more motivation to get better and participate in their plan of care. Why should comfort care only be important to the patient’s who are end of life, when all patients can benefit from being kept comfortable. Being kept comfortable is a state of mind that is at ease, and the overall patient is relaxed and pain free. All patients regardless of their illness should not have to suffer from any source of discomfort. Comfort care is often associated with the end of

In 2003, the American Nurses’ Association published a position statement regarding “Pain Management and Control of Distressing Symptoms in Dying Patients.” The organization states:

Care team members need to be aware of this tendency to overestimate survival, to reduce residents’ and families’ potential distress.

Having a dignified approach and respecting elderly patients in a palliative care unit is important because it is enabling them to have control over their care and treatment. This is going to help the patient to feel valued and throughout their last days of life, as they have a choice. (Social care institute for excellence, 2010). By making the patient feel as comfortable and as pain-free as possible, it will help encourage family members to respond in a positive way. This is because they are seeing that their relative is in a comfortable state.