End Of Life Care

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 law effectively covers situations in which a patient can personally consider the effects of terminated treatments, but does not provide for situations in which the patient is incompetent to inform agents of their desires. Conflict occurs when the court requires evidence for consent to end lifesaving medical treatment, which could be otherwise avoided should the Act be amended to accommodate the needs of the patient (for example, conversations held in passing being held as evidence). The Act should be amended to allow families to make the judgment rather than the patient themselves (such as in Re BWV, Ex Parte Gardner (2003) 7 VR 487, 491[19]). Although it is possible to make decisions on a patient’s behalf, clarification by the Victorian state is needed. The legislation fails to make distinctions between the patient’s desires and what is in their best

A patient barrier might include having limited knowledge surrounding life-support systems and treatment options, thereby hindering their ability to fully comprehend or demand certain interventions. Good counseling is therefore essential to overcoming this barrier in implementing the patient’s true and best wishes (Kroning, 2014, p. 222). Another barrier in implementing advance directives concerns the role and influence of family members and the patient. There may be discordance between the desires of the patient and family, which can result in serious debate and tension if not addressed and taken into consideration. Physicians still may have reservations, as certain demands made by the patient may raise ethical concerns in the future, if the provider feels the interventions being done are no longer medically appropriate.

In reviewing the two studies I found, it is very clear there is a difference in quantitative and qualitative studies. To start, Lee et al. (2017) conducted a qualitative study in which the problem statement recognizes that end of life care (EOLC) in dementia patients is less than optimal when compared to cancer patients. The researchers aimed to determine what service managers and frontline staff at different facilities felt were the key aspects in improving EOLC in dementia patients (Lee et al., 2017). As a result, the researchers purpose was to contribute to the current evidence base on good EOLC and interventions to increase quality of care of end of life dementia patients.

My perceptions have changed dramatically since the Clinical 1 rotation. I have noticed that the minute I walk into my patient’s room, I start to collect data. I notice if they are breathing normal, what their skin looks like, what their cognition level is, and what equipment they have in their room. I have started to connect the “puzzle pieces” of the patient’s health, rather than just feeling like I have a bunch of random information. My perception of people has continued to stay the same from Clinical 1. I continue to have an interest in learning about patients and believe that they also have something to teach us. I have learned so much from the patients and it is fun for me to get to know different

In nursing, the goal of care is usually to restore the patient back to the highest level of health possible. In some cases, however, the goals of care change when a curative approach is no longer appropriate. The new goals of care could simply be palliation and pain control rather than a restoration back to full health. This type of care is called palliative care. Palliative care is not the same as end-of-life care, but the two go hand-in-hand at times. The goal of end-of-life care is a “good” death, good being defined by the patient. Palliation is part of that “good” death. Both palliative care and end-of-life

CNA Code of Ethics for Registered Nurses (2008) provides guidance in dealing with cases like this by explaining the core nursing values and responsibilities involved which are: a) providing safe, compassionate, competent and ethical care; b) promoting health and well-being; c) promoting and respecting informed decision-making, and d) Preserving dignity; e) maintaining confidentiality, f) promoting justice and g) being accountable. The first nursing value is always expected to be upheld in any case because it is their duty to provide care using appropriate safety precautions and preventing/minimizing all forms of violence (CNA, 2008). The collaboration of the nurses between the physician and Mr. C’s family has been evident since then. This therefore calls Mr. C’s nurses to be more compassionate about his situation and try to recognize where he is coming from as they build a trust-worthy relationship before judging him or jumping into conclusions like he does not want to live anymore. Even if he decides to withdraw from these potentially life-sustaining treatments, health care providers are still obliged to give him the care he need the best way they can up until the end of his life. The second nursing value, just like the first one, still calls nurses to still aim to promote or at least maintain Mr. C’s health and well-being to the highest possible level regardless of the path he had chosen for his life. This can be achieved by continuing to collaborate well with other

Judge Neil Gorsuch, President Donald Trump’s nominee for the Associate Justice of the U.S Supreme Court, is soon up for a vote to join their rankings. The article proceeds to mention a book that Judge Gorsuch wrote in 2006 and his stand-point on the matter of End-of-Life Care where he is against the idea. The article switches to the perspective of Dan Diaz, the husband of a patient who needed medical aid in dying after being diagnosed with a terminal brain tumor. Diaz says that if Gorsuch would have been in his position at the time of his wife’s situation he would have a different outlook towards medical aid in

“The final moments of one’s life are difficult for everyone involved-the patient, loved ones, and even the healthcare provider” (Klein, 2005). If a patient’s final wishes regarding his/her care are undefined or not clear, then the situation could be worse or uncomfortable. During what should be a time of caring, mourning and supporting one another can quickly become overshadowed by ethical and legal battles. However, this can be prevented and avoided by the execution of advanced directives.

There are occasions when medicine is not your friend and the effects of the treatment will only prolong the suffering of the patient. Healthcare professionals must be objective and ask will the end result be changed. We must know when it is appropriate to discuss end of life options and when it is not. According to Adams (2015), most desire to die at home, but less than half are allowed to do so (p. 13). Our responsibility is to allow the client to make an educated decision about all the available service and treatments.

There are some ethical dilemmas evident in this scenario, starting with an End of life dilemma, refusal of care and informed consent.“End of

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

n the case of 64 year old Mr. Jackson there are many important facts that should be assessed for the decision making process. Some of the most important facts include, he had advanced dementia, cancer and a tumor that could not be cured. Mr. Jackson also had a stroke that caused him to be non-communicative. It is also important to note that Mr. Jackson had no living will or treatment preferences for his family and health care providers to use to help make decisions. Other important clinical information is that Mr. Jackson’s doctors say he needs artificial hydration to survive several more weeks and a feeding tube which could give him from 4 to 6 months survival rate. These medical facts are very important in the decision making process but

In the medical field today, whenever a procedure is going to be done on a patient, informed consent must be given to the doctor from the patient prior the procedure taking place. Informed consent is the approval given by the patient to the doctor for treatment. In the case being discussed today, an 80 year old patient, with a history of congestive heart failure, is in the doctor's office complaining of chest pains. After an examination, the doctor believes the best course of treatment would be to have a surgical procedure, in an attempt to save the patients life. During the examination however, the patient expresses the wish to just be able to die. There is no Living will or Do Not Resuscitate (DNR) on file. The patient’s wife is

As an administrator I would need to take into consideration the patient’s autonomy, autonomy is recognizing an individual’s right to make his/her own decisions about what is best for them regarding their health care (Pozgar, 2012). The patient’s rights always should be considered before any decisions are made by any other family members. In this scenario it is clear that the patient is unable to make any decisions, the patient has suffered a serious brain damage, and although it is not complete brain death, we must determine how to proceed.