End Of Life Care Essay

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).

Our end of life care is offered by a multi-discipline team that supports patients and manages illnesses. Throughout the process, our team provides the emotional, physical and spiritual support that patients need to feel comfortable. Our services include medical social services, supportive nursing care, bereavement support, volunteer support, medical equipment, pain management and respite care.

Palliative care is a relatively new concept. Palliative care programs have become more numerous and better utilized since 2000 and continue to grow. It is now accepted that the palliative care model is appropriate for patients with life-limiting illnesses. Chan et al. (2013) stated that the ultimate goal of palliative care is to relieve suffering and to maximize the quality of life for dying patients and their families, regardless of the stage of illness or the need for other medical treatments (p. 133). As life-expectancy increases, there is a growing need for these services. People are living longer with chronic diseases and palliative care services can provide an extra layer of support to patients and their families. Evidence has shown that 13% - 36% of hospital inpatients qualify for palliative care services (Robinson, Gott, & Ingleton, 2014).

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.

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

Palliative care is a relatively new concept, stemming from the hospice movement of the 1960s. This type of care focuses on the quality of life of its patients at any time in their treatment process. Palliative care is a concept that is often used synonymously with hospice care. Although it can be congregated with hospice care, they are not the same thing. Thus, it can easily be misunderstood. Sherner (2015) explains that both clinicians and people alternate palliative care and hospice. Unfortunately, she says, these people believe that palliative care implies the patient is refusing curative care. The purpose of this analysis is to explore the concept, clarify the meaning, and differentiate the concept of palliative care.

Palliative Care for Children: Enhancing the Quality of Life for a Child with a Life-Threatening Illness

Nurses: Assist the patients and families to cope with the end-of-life process such as assessing and

The World Health Organisation (2010) defines palliative care as: An approach that improves the quality of life of patients and their families facing problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. It is also our duty to support John and his wife`s in their decision for John to die at home, Department of health (2008) patients should have a choice over the care they receive and where.

Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illness. It focuses on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.Palliative care is provided by a specially-trained team of doctors, nurses, social workers and other specialists who work together with a patient’s doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.

Hospice is compassionate care provided to patients facing terminal illness or illness for which there is no cure. These patients are diagnosed with an illness from which they will never recover and usually have a life prognosis of six months or less (Hospice Foundation of America, 2014). The goal of hospice care is improving quality of life and managing the symptoms of disease and the dying process. The care hospice offers is focused on pain management and emotional and spiritual support for both the patient and family (National Hospice and Palliative Care Organization, 2012). Hospice care can be provided in many different settings, often the patient’s own home. Hospice care can also be provided in hospitals, nursing homes, long-term care facilities and free-standing hospice centers and is available to patients of all ages (NHPCO, 2012). A patient receiving care in a hospice program has a team of healthcare individuals that can consist of the patients own physician, nurses, home health aides, clergy, social workers, and speech and physical therapists (NHPCO, 2012). Usually, a care plan is developed by the hospice team and care of the patient is provided by family members with the support of the hospice staff (NHPCO, 2012). Nurses make regular visits to the patient and family and are on call 24/7. Once enrolled in a hospice program hospice covers everything that will be needed to care for you, from medications to manage pain to

Nurses also provide end of life, and post mortem care. When a patient dies, the nurse often grieves alongside the family and helps to provide them with emotional support (Hecktman, 2012). Although the prognoses of childhood cancer have improved drastically over the last 30 years, many children still succumb to the disease. Nurses are the ones who provide constant bedside care, and often “must confront the limits of what medicine can do for people” (Schuster, 2013). This can prove to be difficult and bring on feelings of hopelessness and as though they are not helping their patients at all. Patients can leave lasting impacts on the nursing staff, and when multiple children die while in their care, the nurse may begin to experience cumulative loss. Childhood cancer is the leading cause of non-accidental death for children in Canada, and therefore, pediatric oncology nurses are often exposed to death on a routine basis, with little time to grieve between the deaths. It is imperative that nurses are aware of their stressors and how they respond to stress in order to effectively care for their patients.

A survey was conducted in 2000 on more than 9,000 patients discharged from more than 2,000 hospices on the services they received (Carlson, 2007). It revealed that 22% of them received five major palliative care services, which varied among the hospices. These palliative care services were nursing care, physician care, medication management, psychological care, and caregiver support. Approximately 14% of the hospices provided all five services and 33% provided only one or two services. Only 59% of these patients received medication management services. These included administering medication, dispensing correct dosages, and setting and following dosage schedule.

Before I started this class I thought palliative care was only used as end of life care, or for when a curative treatment was unavailable or had failed. As we learned about the different models of care, and how they have changed over the years, it became evident that the use of palliative care has changed drastically over the past several decades. In the 1800s to 1900s, palliative care was only used once the patient had reached the dying stage, and only included the patient in this care, not their families1. Before taking this course, this is what I thought of palliative care as well. Since the late 1900s though, palliative care has been used in a more proactive approach. From the moment an individual receives a life threatening illness, palliative care begins. This includes caring for the family of the patient as well. This care increases as the patient’s illness progresses, and even continues for the family after the death of the patient. Learning this has really made an impact on how I would like to work as a

It is important to remember that care of the patient does not end when the patient dies. After the death there is still work to be done in the form of comforting the bereaved family members. It has been reported that some