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

Communication is the foundation of interdisciplinary patient care for those working with hospice and palliative care populations (Wittenberg-Lyles, Oliver, Demiris, Petty, & Day, 2008). Shared communication between the nurse, patient, and caregiver is fundamental in decreasing caregiver stress and improving both the bereavement process experienced by the family as well as the symptom management issues experienced by the patient (Ellington, Reblin, Clayton, Berry, & Mooney, 2012). Two types of shared communication methods often found in hospice include face-to-face verbal and non-verbal communication.

For this study patient families were randomly assigned to the intervention or control group. In the control group the interactions between the family and ICU staff, including the end-of-life conference, occurred according to the usual practices and policies in the hospital; whereas in the intervention group, the research study was conducted according to specific guidelines. A bereavement information leaflet was given to each surrogate decision maker. In this research, the independent variable can be the type of family conference received by the surrogates and the dependent variables were the level of stress, anxiety, and depression levels indicated in the 90-day follow-up interview.

My perception of palliative and Hospice care has changed slightly when it comes to communication with the family. I walked into the hospice unit mentally preparing myself to talk with patient families about their loved one and the dying process; this was certainly not the case. The family and the patient did not want to be bothered unless comfort interventions needed to be carried out and there was no conversation to be had about the patient and his situation. This shows that each family is different, each patient is different; and we need to respect and accommodate their unique

According to Forbes (2014), transparency of care through communication, including patients ' opinions of care, improves patient outcomes. To improve the overall coordination of care requires thoroughly communicating to families. Inform families and patients on what to expect when dying in an easily understood way will ultimately improve the care and result in a positive outcome.

The significance of addressing psychosocial concerns with dying patients is essential to assure a peaceful closure in end-of-life care. The social worker's role is to provide competent, psychosocial intervention with patients and families.

The setting in which a patient prefers end of life care is a specific choice that is left to the patient and/or their family to decide as well as the decision to pursue hospice care via a physician’s referral. Many people think that hospice is a certain place, however, hospice care can be provided in hospice care facilities, some hospitals, as well as at home. The decision between hospice care provided at home versus hospice care in the hospital setting is a difficult decision to make at the time of tragedy. However, seeking these services early will help the family be able to receive more available care and support (Nemours Foundation, n.d).

Facing the end of life is frightening for many people, especially if it is unexpected or sudden. For the majority of people, however, death is not instantaneous and can be slow and painful. For patients in this situation, an alternative to receiving palliative care and extraordinary measures to prolong life is the use of hospice care. Hospice care has been constructed to provide supportive care in the final phases of terminal illnesses and centers on the comfort and quality of the life of the patient, rather than curative measures. An important feature of this type of care is that the patients are most often cared for in their own homes, offering a familiar and comfortable environment. The care

providers to help enhance their communication with aboriginal patients at the end of life. The

When a person is healthy, he or she should be able to manage any social, physical, or mental challenges that come his or her way. A healthy person therefore is seen as one who should be able to perform their daily assignments, having access to their social services like vocation efficiently without any form of complication (Gentry et al. 2010 p.103). In case where a person’s ability to carry out the functions mentioned above expected of a healthy person, the person could be deemed unhealthy and might require the services of a caregiver for him or her to be able to accomplish some of his or her daily activities.

The use of advance directives varies amongst various ethnicities, with approximately 9% of South Asian Hindu elders residing in the United States have completed one – compared to the national average for completion rate of 15-20% within the United States (Deshpande et al., 2005). Based on the limited literature available regarding end of life care practices amongst this community, the reasons for why South Asian end of life practices are molded in a particular way revolves around religious values, strong filial obligations, and disregard for individual autonomy (Deshpande et al., 2005). Many researchers believe the choices surrounding the decision making process at the end of life may be tied to culture and ethnicity, as opposed

I have chosen to write about one of my service users who i was extremely close to and who has a special place in my heart, I had nursed Mrs Mc for 4years before her passing. Mrs Mc was an elderly lady who was 79yrs old when she passed away and sadly she had Korsakoffs which is a brain disorder associated with heavy alcohol consumption, people with this experience short term memory loss it is also knowing as “alcohol related dementia”.

34 Participants in the study were nurses and from the collective 58 health professionals participates only 10 of them were from an acute hospital setting. Therefore the finding of this paper can’t conclude that it only focused on acute hospitals, this questions the validity of the paper, as the paper's title suggests that it only focused on acute hospital settings only, so the results from this study can’t be generalized to other acute hospital settings. As Gardiner (2011) highlighted it’s important for nurses to be able to reflect on the patient’s needs and have a less task oriented focus. The cultural setting of an acute hospital is fixated on finding a cure for the patient, as reported by Gott et al (2013) nurses feel they are failing their patients if there is no cure for their illness. There is a need introduce the hospice philosophy into acute-care settings in hospitals. McCourt et al (2013); Gott et al (2013). Gardiner et al, (2011) found that nurses focused on curative treatments within hospitals due to the nature of the setting. However, Gardiner et al (2011) also highlighted that nursing staff's attitude towards the end of life/palliative could be seen as a barrier in the care provided. Johansson and Lindahl (2012) established that nurses find it difficult to talk about death and they feel they do not know what to do. Vanderpool (2015) states that a key part of the nurse’s role is having the correct knowledge and understanding, and providing the right information to support the patient/family in their decision- making. NHS England (2014) highlighted that the most reported complaint was poor communication with patient and family from nurses. Insufficient knowledge of palliative care among nurses is well documented and is considered one of the main obstacles to providing high-quality palliative care services. Gott et al

Taking care of a senior loved one with a terminal condition is highly emotional. Despite the challenges of talking about the end, there are many topics that must be addressed. Among them is financial planning.

Usually either patients or families have the legal rights to determine what medical course to take with the patient when it comes to the diagnosis of death, in this case the family's conflict needs be considered. The healthcare staff involved in the patient’s care must communicate with the family members during this difficult time. If the patient is determined to be dead, the family will need support from the health care staff that has been involved in the patients care, all available hospital resources, including medical, nursing, social work, ethics, and pastoral care will be a good resource for the family members. Lawyers will usually advise health care staff to work with the family in the most compassionate way possible, the lawyers should be there to help with any conflict between the family members, and this will also help the organization against any future malpractice suits against the health care staff and organization.