There are also many types of people who can be a main carer and are able to provide palliative care for dementia patients in the terminal stage, such as physicians, general practitioners, pharmacists, support staff and volunteers (AIHW 2014, p. 44). Nevertheless, the most appropriate and influential carer is the patients’ family members. In order to provide person-centred and palliative care for the patients, their families are essential and can maintain and enhance the patients’ quality life (Small 2007, p. 198). The key element of the provision of person-centred palliative care is decision-making. Due to advance dementia, the capacity of communication of the patients is limited - they cannot convey their needs and participate in decision-making about their care and management. Consequently, their requests and symptoms are often ignored. …show more content…
2014, p. 158; Agar et al. 2015, p. 1). Unfortunately, in addition to poor pain management due to a lack of knowledge of healthcare workers, emotional and spiritual neglect also frequently occur for patients with advanced dementia (Small 2007, p. 197). The effectiveness of family involvement in palliative care for the patients supported by a randomised control trail is that the case conference with their family members is associated with better maintenance of physical and mental health, and decreases in hospitalisations (Mitchell et al. 2008, p. 904). It is clear that the family members are definitely a key carer to provide person-centred care for dementia patients in the terminal phase, so their families have to be involved in the patients’
Even if a person with dementia can no longer make complex decisions, it is likely that they can make more basic decisions. Every effort should be made to get their input wherever possible. Once the person with dementia begins to lose capacity it is important that their carer and/or health care professionals are consulted and involved in decision making. This method is called the multidisciplinary approach. Macmillan Cancer Support (2012) describe a multidisciplinary team (MDT) as a group of doctors and other health professionals with expertise in a specific cancer, who together discuss and manage an individual patient’s care, planning the best treatment for the individual patient.
At the end of life: Many people can die from dementia; however they can also die with another disease which doesn’t relate to their dementia even though they suffer it. Usually, the dementia will be that far advanced towards the end of life the individual may not even know what is happening or may even be too ‘ill’ to understand. However, it is important as a care worker or any professional that is trained in end of life care (palliative care) to ensure the best quality of life until the end. Each individual should be treated equally, yet individually. These individuals must not be overlooked and still have rights as well as everybody else.
The World Health Organization (WHO, 2017) defines palliative care as a care that improves quality of life of patients and families who are facing problems associated with their life-threatening illness. This is by preventing and relieving suffering by the early identification, immaculate assessment, treatment of pain, and other problems like physical, psychosocial and spiritual issues. The goal to palliative care is to not only treat the patient but also provide comfort to both the patient and family members. Therefore the review of these literatures will provide insight on the barriers and specific needs that a patient with dementia may have.
The purpose of this assignment is to demonstrate understanding of long term conditions and palliative care. Nursing care in general entails holistic care and collaborative care of individuals of all ages, families, groups and communities, whether sick or well (Royal College of Nursing, (RCN) 2007). Better management of lifelong conditions has been the priority of the National Health Service since the 1990s. When long term conditions are managed well in the community, patients’ can live a quality life without visiting hospital frequently (RCN, 2011). In Britain, six in ten people are reported to be suffering from long term conditions that currently cannot be cured; and these people are often suffering from more than one condition that makes their care challenging. It is estimated that by 2030 the UK will have double the number of people aged 85 years or over, who are living with one or more long term condition (Department of Health, 2014).
Focusing on dementia, it is not constantly possible to involve the dementia sufferers in the decision making course of their care without encouragement and assistance by
Sampson, E. L. (2010). Palliative care for people with dementia. British medical bulletin, 96(1), 159-174. doi:10.1093/bmb/ldq024
What was once believed to be a form of neglect has resulted in a change in practice with the idea that doing less is more. Culture is an important factor in how care is rendered and thus, the limitations of palliative and hospice care lie within the desires of the family and patients. A thorough understanding of our surrounding demographics helps to ensure a seamless approach to providing care without bias or imposition of ones beliefs. However, just as with all things, providing care for the sick and comforting the dying should be rendered in moderation as to prevent the effects of burn out. Likewise, the same effects occur in the caregivers who sacrifice their responsibilities in order to care for their love ones. Finally, and with some closing thoughts, the writer wishes to express with gratitude the benefit of having taken this course to better understand oneself and others in the realm of healthcare. The lessons learned throughout have expanded this writer's knowledge and understanding of the human desire to make a connection through communication, emotion, compassion, and spiritually - the platform from which this writer wishes to continue seeking further knowledge and
Researchers said that patients with advanced dementia are at risk for undertreatment of pain and being treated with burdensome and nonbeneficial interventions, such as being attached to a feeding tube in their last moments of life. The study followed 323 patients in 22 different nursing homes for 18 months. All of the patients were diagnosed with advanced dementia. By the end of the study, more than half, at 54.8%, of the patients being observed had died. Out of those who had passed away, about 40% of the patients were hospitalized, were attached to a feeding tube or experienced some type of “burdensome intervention” during a few months before their death. Patients were less likely to undergo “burdensome interventions” and were more likely to have palliative care in their final moments alive when caretakers were aware of the poor prognosis and expected clinical complications when dealing with advanced dementia. Researchers said that recognition for advanced dementia as a terminal illness will provide an alteration to the care process towards advanced dementia by improving comfort rather than focusing on extending the patient’s life; a better
Palliative care approach is stated in the 2016 Australia ‘Clinical practice guidelines and principles of care for people with dementia’ which can promote quality and care consistency (Durepos rt al., 2017 Dyer et al., 2016) An Australian systematic review found person centred palliative approach can improve the quality of life for people with dementia and their family, reduce an individual symptoms, lessen caregiver burden, safeguard that treatment decisions are well informed and in the framework of the individual and family needs and goals (Hines et al., 2010; Mitchell., 2017)
BWV who was a 69-year-old woman resided in a nursing home in Victoria. She suffered from a progressive and fatal dementia, probably Pick’s Disease. Although she was ambulant, she was not able to communicate properly with anyone apart from her husband; therefore, her husband agreed to use artificial feeding via percutaneous gastrostomy (PEG) tube insert into her body. Subsequently, her condition became to persistent vegetation and she stayed approximately three years in hospital before her husband to request artifical feeding cease. However, BWV’s husband was not sure whether it would be lawful or not to withdraw the PEG tube from her body in Victoria; hence, he sought for assistance from the Public Advocate Victoria (PAV) who was
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
Several ethical considerations of death and dying issues such as those addressed by hospice and palliative care services based on the right to die pain-free and with dignity often starts with communicating barriers, poor symptoms management and shared decision-making concerns. (Weisman, 1972). Ethical consideration can often be balanced by creating the best possible care while involving all participants, hospice and palliative care patients that are involved in the sick persons care including: family members, the patients and the caregiver all, should sympathetically work together to acknowledge and communicate end-of-life experience. According to Blendon, Szalay, & Knox, but the dying person must make decision unless they are incompetent. “Palliative care
The provision of palliative care services needs to improve. The RACF in Australia, for example, should be able to deliver the person-centred care approach that consumers with end-of-life dementia require. Behavioural and psychological symptoms of dementia should be considered as a priority to enable proper management and care for consumers in the end-stage of the disease. RACF organisations need to focus on appropriately training staff in palliative care, advance care planning, and the effects the burden of dementia has on the consumer such as pain and distress. Moreover, it is important that staff have good communication with the family about the consumer's advance care plan and wishes and that these preferences are documented when the consumer
Ever wonder where you left your keys or found yourself in a room without remembering why you ended up there? Imagine going through this several times throughout the day. Dementia is in my parental grandmother’s medical history. Dementia is a decline in mental ability severe enough to interfere with daily life (Alzheimer’s Association, 2016). My grandmother is dealing with changes in mood as well as personality, memory loss and difficulty completing family tasks that disrupts her daily life due to Dementia. In this essay I describe how grandmother came to be diagnosed with Dementia; how my family has dealt with my grandmother’s cognitive decline; and what this disease has taught me about my grandmother, about my family and myself.
Having a dignified approach and respecting elderly patients in a palliative care unit is important because it is enabling them to have control over their care and treatment. This is going to help the patient to feel valued and throughout their last days of life, as they have a choice. (Social care institute for excellence, 2010). By making the patient feel as comfortable and as pain-free as possible, it will help encourage family members to respond in a positive way. This is because they are seeing that their relative is in a comfortable state.