Comfort Measures Only describes to medical treatment of a dying patient where the natural dying process is allowed to transpire while assuring utmost comfort. It consist of devotion to the psychological and spiritual needs of the client and support for both the dying client and the client’s family. It is not the same as a physician order to withhold emergency resuscitative measures such as Do Not Resuscitate. However making a decision to focus only on comfort is A major changeover point for patients, their loved ones and health care providers all medications and laboratory tests that do not progress comfort are discontinued. All lot of times these patients are left pain medications. Most patients near the end of life are not awake
In my nursing practice I frequently care for long term elderly residents on ventilators and who suffer from stage 3 or 4 pressure ulcers, diabetic, venous ulcers etc. Instead of simply providing pain medications and wound treatment to ease their pain or giving medications to relax them, I wanted to learn ways to enhance the comfort of these residents. This led me to learn more about Katherine Kolcaba’s theory of comfort. I found her theory to be useful in understanding the theory of comfort. Hence as a nurse, it became important for me to analyze, evaluate and research more on its applicability in the world of nursing and also in other health care disciplines.
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
Caring for patients at the end of life is a challenging task that requires not only the consideration of the individual as a whole but also an understanding of the
Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.
Death is one of the most avoided topics because of the finality that comes with it and the fear of the unknown after death. However, there are quite a number of authors such as AtulGawande, Elisabeth Kubler-ross and Ira Byock who have attempted to go ahead and deal with death as a topic and other connected topics.Each of these authors have delved into one of the most revered topics that is death including related topics that come with it such as the dying process itself. Ira Byock’s Dying well: Peace and possibilities at the end of life is a book that looks at the moment prior to death when an individual is terminally sick and is at the point of death. A
Many terminally-ill patients give up hope when treatments are no longer available to help them and hospice care is given to them as an option. However, hospice care has proven itself to provide the best quality care for the last six months of the dying. The purpose of hospice is to provide the best care for terminally-ill patients at the end stage of their lives. Hospice offer services to support too many aspects a patient’s life such as medical, legal, spiritual care. Hospice includes art therapists, music therapists, and certified chaplains on the palliative team.
This article can be used as a way to further support my argument about how most patients don’t utilize all of the benefits that hospice has to offer. There are some cases where people choose not to receive spiritual support due to
The comfort theory is a nursing theory that was first developed in the 1990s by Katharine Kolcaba. The Theory of Comfort considers patients to be individuals, families, institutions, or communities in need of health care (Petiprin, 2015). The environment in which this theory can be applied is in any aspect of the patient, family, or institutional surroundings that can be controlled by a nurse or a patient’s loved one by means to enhance their comfort. Health is considered to be optimal functioning in the patient, as defined by the patient, group, family, or community (Kolcaba, 2005).
Let us first take into consideration and calculate the patient’s pleasure versus pain. With a prognosis of six months, the patient must be in a current state of pain and insecurity emotionally and/or physically. On one hand, there could be a possibility that the patient could experience pain in saying goodbye to loved ones. On the other hand, the pleasure the patient will feel from the security of knowing all pain ceases after death can be noted as a higher pleasure. In addition, the patient will experience happiness knowing their autonomy is the sole administrator of death, thus being able to experience the security of patient autonomy. Consequently, the patient would experience an overall pleasure from the role patient assisted
Hospice psychologist work is to conduct some research to understand the psychological aspects of caring terminally ill patients and their families.
In such situations the treatment provided shall only be that necessary to correct the life- or health-threatening situation. Any further treatment shall be deferred until consent is obtained
Health care practitioners that are licensed using these prescription drugs in ensuring that the injured or sick person receives the most appropriate treatment. The last decade has experienced some significant transformation in the health care, and this can be accorded with the relevant advances that have been gained in the pharmaceutical therapies. As a result, significant advances in how diseases are managed, prevented, or cured have been achieved with reference to the prescription drugs identified (Hamric, Hanson, Tracy, & O'Grady,
Elisabeth Kübler-Ross, (2014), a Swiss-born American psychiatrist, introduced concept of providing psychological counselling to the dying. In her first book, On Death and Dying (published in 1969), she write about the “five stages of grief”, they are denial, anger, bargaining, depression, and acceptance. based on her studies of the feelings of patients facing terminal illness, and have being generalised to other types of negative life changes and losses, such as divorce, loss of property or job, and offered strategies for treating patients and their families as they negotiate these stages.
The study discussed theoretical concepts such as the interrelation of pain in palliative care and the nurses’ perception and orientation to pain throughout the whole article. However, the study did not state any nursing theories and did not mention anything about it being related to the research. Upon reading the whole article, I believe that the concept and approach of this study correlate with Katharine Kolcaba’s theory of comfort. The comfort theory was first developed in the 1990s and clearly defined comfort as an enhanced feeling of a person’s well being, a sense of being strengthened and is definitely individualized and holistic (Krinsky, Murillo, & Johnson, 2014). Kolcaba believes that comfort is what provides the framework and the core
I have always believed that health cannot be optimized through the treatment of disease only. Rather, health should be addressed on a biological, physical, psychological, social, and spiritual continuum. Palliative care addresses an often-overlooked aspect of the patient experience, which is symptom management of their chronic illnesses. Health care professionals tend to treat acute episodes of