End Of Life Communication

This author’s personal perceptions concerning patients facing a lingering terminal illness, have been shaped by over 20 years of critical care nursing experience. Facing death and illness on a daily basis requires self-examination and a high degree of comfort with one’s own mortality, limits and values. Constant exposure to the fragility of life forces respect for the whole person and the people who love them. A general approach to patients who are actively dying is to allow them to define what they want and need during this time. The nurse’s role

Integrating spiritual and religious dimensions of clients ' lives into their treatment requires consummate professionalism and the highest quality of knowledge, skills, and attitudes. Psychologists

The Faith, Importance and influence, Community, and Address in Care (FICA) Spiritual History Tool provides a way for “the clinician to efficiently integrate open-ended questions into a standard medical history and can be used by any health care professional” (Borneman, Ferrell, & Puchalski, 2010). The FICA tool explores the presence of faith, the importance of spirituality, the influence a person’s spirituality has on their health care decisions, the involvement in a spiritual community, and the interventions to address spiritual needs (Borneman et al., 2010).

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.

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

Key people could be family, doctors, carers, religious leaders etc. Each may own distinctive role to play in order for the choices and preferences of the individual to be respected and carried out. [ Every person’s end-of-life trajectory is different and needs differ in intensity and quality over time. End-of-life care must adapt to the varying and changing needs of the individual over time and that it cannot be limited to certain settings or services. The provision of good

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.

For health care providers to deliver the best holistic care that patients deserve, a thorough spiritual assessment must be included during their care. With more research showing a relationship between supporting a patient’s spirituality with their health and ability to cope with illness, it is now a requirement of organizations to include a spiritual assessment to maintain accreditation with The Joint Commission. The minimum required of a spiritual assessment by The Joint Commission is to determine the patient’s religion and

Family conferences are key to providing patients a peaceful death. The focus will be outlined according to the patient’s individual needs as appropriate. Areas of discussion will be transparent view of prognosis, setting realistic goals of care, appropriate treatment options for symptom management, relief of discomfort and suffering, timing and sequence of withdrawal of treatment as appropriate, access to the family to their loved one and preparation for the sights and sounds of death (Holtschneider, M.E., 2004)

“Spiritual assessments are one of many ways the religion and spirituality are present in modern healthcare” (Cadge & Bandini, 2015, p. 431). From a personal perspective, the best way a healthcare professional can address the spiritual and religious needs of a patient when a life-threatening situation appears, is to first perform a spiritual assessment to the patient upon admission, second after being properly informed about the patient preferences, look for the proper spiritual services that best fulfill the patient’s needs and offer those available services to the patient. When treating patients, medical professionals need to be supportive throughout the patient’s course, listen to the patient’s needs and concerns, offer the available spiritual services, and be mindful of the patient’s spiritual history (Puchalski, 2001, p. 4). For some patients, spirituality is necessary to cope with life threatening situations and is the moral duty of healthcare professionals to help patients to accept their illness and find peace with their life’s.

Spirituality is a delicate topic, and some may not be open to talking about their beliefs. Spirituality is generally understood to be an essential aspect of being human (Lyndo-Lam, 2012). Assessing the spiritual needs of patients is a key component in the nursing process. A compassionate and thoughtful nurse can make a patient feel more secure, making it easier for him to express his spirituality. The participation of both patient and health care provider is vital in promoting spiritual health. The main focus of a spiritual assessment is to gather information regarding the patient’s spiritual needs in order incorporate them into the plan of care, so as to treat

Our society finds it difficult to talk about dying and euphemisms are the norm. It is typical for both doctors and patients to be hesitant to initiate a discussion on dying. Focus instead is often more often placed on interventions and actions for managing symptoms. This avoidance can leave patients and their families unprepared for the inevitable death. (Schapira, 2010) It also often results in requests for therapies which may be excessive, costly and even painful in the hopes for a cure. One study demonstrates that when patients are aware that they are terminally ill, the majority are able to reach a state of peacefulness and also exhibit lower levels of distress. (Ray, Block, Friedlander, Zhang, Maciejewski & Prigerson, 2006) It is also important that family members are willing to discuss end-of-life options with their loved ones. According to elderly patients, they are most often the ones who initiate these conversations with their

Communication as to end-of-life care within a critical care setting is discussed within this paper. Also examined will be the unexpected stress of a critically ill patient, the emotional impact the family must burden, and the utilization a family care conference to facilitate proper communication. Additionally, the first-hand experience of withdrawal of care that this author experienced during clinical is reviewed.

When thinking about end of life care the research must encompass levels that are substantial for the entire family as a whole. The purpose of this study is to examine if counselors-in-training (CIT) are receiving proper teaching on the topic of discussing or integrating spirituality into practice. The research will help counselors, supervisors, and trainees who work in palliative/hospice care or areas that are more likely to experience secondhand trauma and compassion fatigue.