End Of Life Research

A person’s life can end at any age. They can depart quickly or slowly. End of life care, also known as palliative care, is the care of patients that are not only in their final hours or days but the patients with a terminal illness that has become incurable. End of life care takes into mind what the patient desires so it is recommended that they consider an advanced care plan also known as an advance directive and living will. These documents allow the patient to formulate decisions on the future of their care if, at any point, they cannot vocally express themselves.

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

Advanced care planning is critical element in the therapeutic alliance between healthcare team and patient in providing adequate patient-centered care, with the patient a more willing collaborator. This process provides patient, family, and caregiver with realistic expectations about result of treatment and prudent preparation for possible outcomes. Effective advance care planning has been shown to increase satisfaction with care, lower moral distress, lead to healthier bereavement after death, provide timely

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

The topic of end-of-life care may seem daunting and uncomfortable, and yet most individuals do have unique desires and concerns regarding their provision for the future. Providing the opportunity for that communication, the advance directive and POLST forms allow an individual to explicitly state their wishes before the future. Developed to lessen the apprehensions concerning patients undergoing any extensive and unwanted measures to preserve life at any cost, these medical directives lighten the decision-making burden for physicians and families alike and help comply with the patient’s utmost end-of-life wishes.

The importance of end of life issues and decisions are now being discussed at the time of admission to most acute care and long term acute care facilities. More attention is being placed on these specific decisions to ensure that the patient's

Advanced care directives are legal documents provided to physicians and health care workers with an outline containing preferences for the treatment at end of life. Patients often do not discuss their wishes regarding end-of-life care with family members or health care providers prior to the event of a serious illness or traumatic event. Educational interventions focus on raising awareness and providing patients with information on advance care planning.

It is very important that each individual, if possible has a say in his or her own dying and death. Facing death is hard for everyone and there are specific issues to be talked about in advance. A living will or a Physician Order for Life-Sustaining Treatment (POLST) is extremely useful. The POLST is designed for people with serious or life-threatening illnesses. “This is a standardized form that describes a patient’s wishes and is signed by his or her physician, providing both summary of an individual’s advance directive decision and the physician’s order. It can be used to inform emergency personnel about a patient’s wishes for life sustaining procedures, such as CPR. “

Physicians, psychologists, and society can see people or know people who are physical suffering from pain or a terminal disease. For example, someone diagnosed with multiple sclerosis is aware that the disease will take over the body, at some point. That person may want to die because they are scared or depressed that they have this terminal disease, not because of physical excruciating pain. On the other hand, multiple sclerosis may not be an acceptable illness because it is not as severe as prostate cancer. The research found from the questionnaire that revealed the attitudes of U.S oncologists, regarding voluntary euthanasia and physician assisted suicide about whether or not people with prostate cancer should be able to partake in assisted suicide. Why were only people with prostate cancer included in this research study? Further research needs to be done on all aspects of assisted

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.

Advanced directive is a legal documentation that allows individual to spell out their wishes and decisions about end-of-life care ahead of time. It provide direction to their family, friends and health care professionals about the kind of medical care they want if they become unable to make or communicate their decisions. An advance directive includes a living will, power of attorney for health care and do-not-resuscitate order. It is a responsibility of every healthcare professional to inform their patients that they have a right to refuse treatments, including resuscitation, and to appoint a person of their choosing to make health-care decisions for them if they cannot.

With an increasing aging population and growing numbers of individuals with chronic conditions, it is important for individuals to prepare for end-of-life care. An Advance Directive is a defined as a “legal document that provides data to critical care staff about patients’ wishes, especially when critical illness decreases decision-making ability” (McAdam, Stotts, Padilla, and Puntillo, 2005). An Advance Directive also allows for better communication between the patient and doctor, and preserves the autonomy of patients. It may also alleviate one’s family from any possible burden of uncertainty of one’s wishes. It provides guidance, which may avert arguments with family members concerning treatment choices (Cedars Sinai, 2015). The Patient

Setting: The interviews were conducted on palliative care hospital units, and in outpatient clinics, free standing hospice facilities, and home hospice.

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

Upon reflection of the Five Wishes, several thoughts came to mind. First and foremost, having a designated advanced directive is critical. There are countless examples of clinical experiences in with which families were overwhelmed with unexpected end-of-life decisions. As an educated caregiver, we should personally take the necessary steps to assure these tough decisions are known to someone who can facilitate the level of care desired. Such consideration of these elements of care in advance can help to support our loved ones during this emotional time. After review of the five wishes, I recognized that I would not want life-support measures if faced with irreversible deleterious outcomes that resulted from