Witt Sherman (1998) suggests that palliative care must be offered to family members of patients with terminal illnesses to address the physical, emotional, and social needs associated with being the caregiver of a person with a terminal illness, stating “the clinician needs to acknowledge the caregivers efforts and assess his or her relationship with the patient and other family members, while encouraging the expression of fears, concerns, loss, and grief. It is important to put the caregiver in touch with respite services before stress, emotional and physical exhaustion, and depression take their toll” (Witt Sherman, 1998). As an intern at a cancer institute, this writer assesses for the mood and needs of patients’ family members by initiating discussions about how they are coping with the patient’s illness. This writer attempts to empower caregivers by asserting the need for self-care at a time when they are devoting most of their time and energy to the family member they are caring for and providing them with the knowledge that the services offered by the Psychosocial Oncology department are available to them, as well as the patient.
Prejudice in End-of-Life Care
There are many factors that may make it difficult for social workers to be unprejudiced when dealing with patients in End-of life care. These factors include their feelings and beliefs regarding death, bias toward curative or comfort care, and their feelings regarding characteristics of each individual they
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
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
Hospice patients often receive palliative care to help them cope with the stress, pain, and anxiety that comes with hospice care. Galfin, Watkins, and Harlow (2011) explored the need to train palliative care nurses how to provide not just physical care, but also psychological care. The authors reference previous studies that addressed similar training programs, but point out that many lack an explanation of what the palliative care entails, or statistical evidence to show if guided self-help improved patient’s psychological distress.
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
Many terminally-ill patients give up hope when treatments are no longer available to help them and hospice care is given to them as an option. However, hospice care has proven itself to provide the best quality care for the last six months of the dying. The purpose of hospice is to provide the best care for terminally-ill patients at the end stage of their lives. Hospice offer services to support too many aspects a patient’s life such as medical, legal, spiritual care. Hospice includes art therapists, music therapists, and certified chaplains on the palliative team.
My perception of palliative and Hospice care has changed slightly when it comes to communication with the family. I walked into the hospice unit mentally preparing myself to talk with patient families about their loved one and the dying process; this was certainly not the case. The family and the patient did not want to be bothered unless comfort interventions needed to be carried out and there was no conversation to be had about the patient and his situation. This shows that each family is different, each patient is different; and we need to respect and accommodate their unique
When it comes to the experience of grief that goes along with a terminal diagnosis or death the focus of care, therapy, and concern is often placed solely on the patient and his or her family and friends, and rightly so (Woolhouse, Brown & Thind, 2012). However, the health care professionals that help to care for these patients and their loved ones are often left in the shadows to cope with the grief that they may be feeling, alone (Woolhouse, Brown & Thind, 2012). Often, their grief is deemed unacceptable by their colleagues and society, and they are certainly not provided with the same level of care as someone who is experiencing real grief, first-hand (Leming & Dickinson, 2016). This paper discusses the differences that health
As people approach the end of their lives, they with their families and their caregivers, face many tasks and decisions. They may be psychological, spiritual, or medical in nature, but all end-of-life choices and medical decisions have complex psychological components, ramifications, and consequences that have a significant impact on the suffering patients and their caregivers.
Family caregivers have the important role in assisting their loved one through their cancer experience. Our society needs to acknowledge informal caregivers as a valuable members of the cancer patients healthcare team. Cancer care is becoming increasingly more complicated and difficult. Numerous caregivers are family members and close friends who tend to be unprepared and untrained for their position as caregiver to a older individuals with cancer.
The three articles were most relevant to the topic and explored the implications that family involvement has during end-of-life in long term care from the family perspective. The three recurrent themes that family involvement has during EOL in long term care are: improved caregiver advocacy and improved quality of end-of-life care for patients achieved through improved communication.
Dying due to an incurable illness can be devastating With responsibility of caretaking falling chiefly on the patient’s family. While dealing with the normal every day activities that families encounter, becoming a primary caregiver to the terminally ill is an emotional as well as financial burden. The ill person usually lives in the house of a family member, which forces the family to witness the person dying every day. Having to watch a person suffer in your own home is depressing to even the strongest of people and knowing there is nothing that can be done to stop their pain makes things that much worse. Studies have shown that people who receive a terminal illness diagnosis become depressed and develop anxiety. Because of the mood disorders that can
The authors MacKinnon, Smith, Henry, Milman, Berish, Farrace, Korner, Chochinov, and Cohen (2016) revealed a receipt of the several financial support for the research, authorship, and/or publication of the article. The Canadian institute of Health Research (CIHR) studentship to the main author: the CIHR/Canadian Cancer Society Stratiegic Training Program in Palliative Care Research and the Family Caregiving at End of Life New Emerging Team (Mackinnon, Smith, Henry, Milman, Berish, Farrace, Cohen, 2016).
The implications of this issue and the challenges it presents for social workers in the palliative care field
For this assignment I attended the Cancer Caregivers Support Group in the clinical center at Froedtert Hospital. The meeting took place on October 22nd 2016 at night 5:30pm to 7:00pm at night. This caregiver group was a group of fifteen to twenty people who specifically were planning on becoming a caregiver for a family member who was battling cancer. The meeting was held in a
Caregivers play an integral role in improving the quality of life for hospice patients. Most of the individuals involved in caring for the terminally ill are family members. However, caring for terminally ill patients can adversely affect the caregiver’s overall health. Gallese, Keysers and Rozzolatti (2004) emphasize that caregivers suffer from worse physical and mental health compared to their non-caregiving counterparts. One of the major causes of poor physical and mental health amongst caregivers entails the high level of stress associated with the care giving role. The caregivers’ stress is caused by a multitude of stressors such as role adjustment, end-of-life decision making and financial strain. Alternatively, stress also arises from the patient’s suffering (Hebert, Arnold & Schultz, 2007).