IToday in the 21st century the options for end of life care is innumerable; nursing homes, hospices, outpatient nurses, live-in aides, family support, etc. are just a few of the possible choices. Techniques and approaches regarding end of life are similar: there is surgical care; there is palliative care, living wills, euthanasia, artificial organs/replacement, “full code” as opposed to “DNR” in hospitals, etc. While some argue that more options can be overwhelming, the quality of life and end of life solutions are undisputedly better than before in American history. (1) Until the mid 1900’s, end of life could be summarized succinctly: if you were rich and merely elderly rather than infirm, you had the means to hire attendants and …show more content…
To gain access to these care facilities, one needed vouchers of good character and large sums of money. (3)
Conditions were even worse in the past: folk stories and fairy tales often include the elderly and infirm in their stories, always in terrible conditions: in Beauty and the Beast an “old hag” is homeless, ugly, and completely impoverished. In the Water of Life, the youngest son and protagonist is aided by a handicapped dwarf, also ugly and impoverished (save for good advice and a kind heart). One of the evils that Pandora released was “old age.” The quality of being elderly itself was akin to being diseased with the uniform wish to have a speedy and peaceful death. (4) Today life has changed drastically: in 2004, approximately 16,000 nursing homes were in operation, and although better rich than poor, America is progressing so that all citizens will have access to healthcare. Social security, pensions, etc. came into being in the mid 1900’s; end of life is no longer a certain mark of suffering and call for early death, but rather a series of lifestyle choices of: “How can I best enjoy the golden years of life,” a paraphrased popular saying which well sums up the change in end of life decisions (which have even now become a golden prospect). (5) The advances in technology have allowed “end of life” to become an extended, and often ambiguously defined time period. Although most humans certainly die before 100 years, the end
This is why treating the person with dignity and respect is vital in end of life care in case of an individual with dementia.
The aim of a hospice is to improve the quality of life of the dying
Back in twentieth century, a tiny fragment of mere 5% population was comprised of people aged 65 and above. A little spike in this segment was observed during the period of 1950s-1960s; however, that spike was not significant and restricted to 8% of entire population (Chart 1.1). Many factors were responsible for the small proportion of senior population, the most prominent one though, low life expectancy, high fertility/birth rates and limitation of health services.
Berger (2008) state that late adulthood, which begins at age 65, is the final stage of the life span development process that culminates through the death of an individual. During the course of the twentieth century the notion of late adulthood changed significantly (Kowalski & Westen, 2009). The average person’s life expectancy increased probably by 30 years. This changed the proportion of North Americans over 65 years from 1900s one in 30 to a projection by the year 2040 that it will be one in five. This drastically changed the perceptions of late adulthood (Kowalski & Westen, 2009). For example,
Next, we will discuss the biblical, theological, and cultural perspectives on the end of life issues. “There is a time for everything, and a season for every activity under the heavens: a time to be born and a time to die, a time to plant and a time to uproot, a time to weep and a time to laugh, a time to mourn and a time to dance.” When God created everything, he advised us about our time on earth before we inherit the promises in our heavenly home. “Our days may come to seventy years, or eighty, if our strength endures; yet the best of them are trouble and sorrow, for they quickly pass, and we fly away.” In today society, many people are dying at a young age for various reasons. One barrier is the change in our dietary. The older generations grew most of their own food. With my generation and afterwards, farm life decrease and more fast food chains increase. Farmers are now using more chemical to make the food grow faster to meet the need of the fast food chains. Also, there has been more man-made food and concepts. These options have impact life leading to more clog arteries, digestive issues, cancer, heart-attack, and others. Another barrier has been increase number in gang related death, suicide attempts and death, and being murder. “While most pastors, theologians and ethicists agreed that it was permissible to
Last year 23 September 2012. I had a resident called “Mrs X” she was a 72year-old widowed living at ---, a Nursing Care Home. She’s not a religious type of person as she was Atheist. She has lived in the home for the past two years, and during that time I was assigned as her key worker. Mrs X had One Son and 3 grand daughters they are all regular visitors to the home. She has recently been diagnosed with renal failure, and her life expectancy is only a couple of months without dialysis. In the past Mrs X has made it clear that when her “time comes” she wants to be able to stay at Belmont House, and “go quietly”. She has stated that she does not want any treatment that will prolong her life. This means
Understand the requirements of legislation and agreed ways of working to protect the rights of individuals at end of life;
With major advancement in medical treatments, it is now possible to keep a patient alive, which would not have been possible in former times. This has made end of life issue one of the most controversial issues in healthcare. Medical improvements have set the stage for ethical and legal controversies about not only the patient’s rights but also the family’s rights and the medical profession’s proper role. It is critical that any decision made in such situation is ethical and legal to preserve the rights of the patient and also protect the healthcare institution involved. It is very important when making decisions to discontinue treatments to make sure all other alternatives have been explored.
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.
Quality of Life and Functioning for End of Life Care. HAT2 Community Health Nursing. Western Governors University.
Modern medicine affords us the ability to prolong life; however, is that always the right thing to do? This is a question that palliative care patients, families, and their healthcare teams must ask themselves. Every patient is unique and they have differing medical presentations, belief systems, customs, cultural traditions, and ethical principles which influence their opinion regarding end-of-life options.
Care team members need to be aware of this tendency to overestimate survival, to reduce residents’ and families’ potential distress.
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
Today we are face with death in a different setting then our ancestors, instead of dying at a younger age and dying in our home with our families, people are now dying at a hospital or in a medical setting. We are living longer because of the advances in medicine, this is causing us to develop diseases that our ancestors never had to face. Our ancestors did not live long enough to develop some of the diseases we face today. As Jones (2011) provides, “we don’t just die of different diseases then our ancestors, we also die in different circumstances” (p. 302). The changes in circumstances have caused us to reevaluate what is believed to be ethical when faced with dying. There are many medical options a terminal ill or elderly patient that is dying can choose from, however there is great debate whether some of these options are ethical.
Death is considered a dreaded word. Death is the final stage of an individual’s existence. Death is a word that makes people uncomfortable. The word death is something no one desire to think about, prepare for or discuss. But death is inescapable, unavoidable, and inevitable all humankind will experience death as part of their destiny. Therefore, each has the responsibility of addressing the issues that maybe related to a decline in their physical and mental function status, which render them incapable of making their life decisions.