Hospice And Palliative Care: A Case Study

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

.“As medical technology continues to advance and health care choices become more complicated, the preservation of end-of-life autonomy is an increasingly important issue faced by various client populations.” (Galambos, 1998).

The purpose of this paper is to examine communication strategies related to palliative and end-of-life care with a focus on Aboriginal clients. Firstly, I will explain the role of cultural competence in the nursing care of an Aboriginal client. Secondly, I will argue the cultural challenges a nurse may face when caring and communicating with Aboriginal clients receiving palliative end-of-life care. Thirdly, I will present solutions to the aforementioned communicative challenges. Lastly, I will discuss the impact I believe this experience may have on my future practice.

The process of deciding when a terminally ill patient should die lies within the patient, family members, and the

According to Allen et al. (2012), “millions of people with chronic illnesses endure unrelieved pain, uncontrolled physical symptoms and unresolved psychosocial or spiritual problems.” This issue occurs because palliative care is often considered a form of end-of-life care. Palliative care is a treatment that can be used for patients who suffer from chronic illnesses and diseases while receiving curative treatment. (Horowitz, Grambling & Quill, 2014) purposely states the misconceptions of palliative care and advocated for seriously ill patients that education must bring under control the misconceptions. Some patients do not receive appropriate symptom management because the palliative care treatment needed is often confused with end-of-life care. However, end-of-life care attempts to relieve pain and suffering when a disease is no longer responsive to curative treatment. Pain and suffering could ultimately be controlled or even eliminated through the proper utilization of palliative care. Patients who are not referred to palliative care in a timely manner is more likely to have poor quality of life, uncontrolled symptom management and increased amounts of visits to the emergency room during the disease process. Patients with life limiting illnesses bear the burden of increased discomfort and increased suffering. Nurses experience clinical practice issues and difficulties in the clinical setting during the delivery of comfort and symptom management. These issues

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

Due to it’s uncomfortable and sad nature, the Death with Dignity act has become very controversial. With the U.S population nearly split evenly on this topic, with 47% of the population in support of it and 49% in opposition to it, there have been many pros and cons discussed for these acts (Lipka). Many supporting the Death with Dignity act believe it is the patient 's right to decide to die. Others opposing counter this with the fact that premature death is unnatural and immoral in their eyes. People also argue that the Death with Dignity act allows the patients have a more peaceful more controlled death giving them and their families more closure as they reach their end. Opposers believe that palliative care is the answer to a more peaceful end. Some in support believe that people

An ethical dilemma is a difficult situation that usually involves a conflict between moral obligations, in which to obey one would result in disobeying another (Murphy, 1997). Sedation is an ethical dilemma in palliative care because on one side it helps to relieve suffering for patients who are terminally ill and almost at the end of their lives. However, at the same time, sedation is making the patient deprived of certain bioethical principles such as autonomy, the main issue with palliative sedation is that it prohibits the patient from changing his or her decision, once sedation is commenced and informed consent also becomes complex (Cooney, 2005). The writer is in the favour of palliative sedation because it is an effective symptom controlled strategy for the patients who are nearly at the end of their lives. Moreover, it is believed that by providing sedation to a patient induce unconsciousness, which makes the patient completely unaware of the external world and tend to reduce the suffering by considering ethical and moral principles. However, some people think palliative sedation as euthanasia, which cause death because of making the patient deprive of nutrition and hydration while giving sedation. Ethical principles are going to be discussed in this essay such as autonomy, beneficence, non- maleficence and justice. Moreover, this essay also going to put light on current research

ed. For the immense number of ill patients, the solution to their suffering is predominately quality sedative care, of which I ardently encourage. Though there are ill patients who seek sedative care, there is a significant amount of terminally ill patients for whom palliative care is not the solution and who suffer tremendously until they die. These are the type of patients who wish to end their suffering by making the decision to end their lives with the assistance of doctors. This also allows them to end their lives with dignity, and place of their choice. The only way to prevent suffering of this amount is to revise the law so patients are allowed to lawfully receive assistance to peacefully pass away.

It should be clarified that when inevitable death is imminent, it is legitimate to refuse or limit forms of treatment that would only secure a precarious and burdensome prolongation of life, for as long as basic humane, compassionate care is not interrupted. Physicians are not obligated to and should not offer useless or futile treatments, even in the name of patient automony. Despite this, physicians still seek to obtain patient and proxy consent before writing a Do Not Resuscitate (DNR) order. Reasons for this include fear of legal repercussions, limited physician patient relationship, time constraints, hospital culture, guilt, grief and concerns about family reaction. Some data show that physicians, tend to avoid end of life discussions due in part to their own discomfort with death and dying. Agreement to DNR status does not preclude supportive measures that keep patients free from pain and suffering as possible. Acceptable clinical practice on withdrawing or withholding treatment is based on an understanding of the medical, ethical, cultural, and religious issues of each patient. There is a need to individualize care option discussions to illness status, and patient and family preferences, beliefs, values, and

In end-of-life scenarios, where the patient may not be able to communicate their wishes, decisions must be made either by the healthcare professional(s) or family member(s). However, who gets to decide or where the line should be drawn are not always clear. Consequently, not all decisions may be ethically permissible. To illustrate, I will discuss a scenario in which physicians and family are not in agreement. Upon proving a brief summary and explaining the ethical dilemma, I will provide moral reasons for two ethically permissible choices from which, by referencing the principle of autonomy and Utilitarianism, will determine which course of action ought to be carried out.

make sure the client has the capacity and knowledge to obtain the necessary skills to move forward without me, if I should have to terminate our final session early. My second job mainly pertains to the clients who have been in the hospice program for more than 6moths, such as clients who have congestive heart failure.

The family that was seeking assistance encompasses the father, Craig, Mother Jane and two daughters, Jenny and Debra. The family is having problems focusing on their father’s health. Starting with the Father Craig is currently suffering from end stage lung cancer for the past three years he recently lost his job too. His relationship with his wife is stressful and he doesn’t communicate always. Some of his strengths are that he was a good provider for the family holding an engineering position at Honeywell. He also has a good relationship with both of his daughters. The mother, Jane is looking for educational materials to help her cope with her husband’s cancer. Jane seems motivated in asking for help with some emotional problems she is

Previously, HIV was considered a disease associated with young persons. However, in present day, it is recognized as the disease that affects people of all ages. Individual aged 50 and older has many of the same HIV risk factors as a younger individual. There is an increase in the number of patients aged 50 and over who are living with HIV. This increase in the population is due to the increase in life expectancy of people with HIV and new cases in older people. To manage this increasing population a holistic care is needed.

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.