Introduction. Nurses Play A Key Role In End Of Life Care.

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

Caring Hospice is a company that will provide nursing care to patients that are terminally ill. The ultimate goal is to insure the patient is kept as comfortable as possible while maintaining dignity during the dying process. This company will send registered nurses to the patient’s home for routine physical assessments, medication teaching and administration, education about terminal diseases and the dying process. The nursing staff will also create and maintain appropriate plans of care for the multi-disciplinary team to provide holistic care to the patient.

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

A survey was conducted in 2000 on more than 9,000 patients discharged from more than 2,000 hospices on the services they received (Carlson, 2007). It revealed that 22% of them received five major palliative care services, which varied among the hospices. These palliative care services were nursing care, physician care, medication management, psychological care, and caregiver support. Approximately 14% of the hospices provided all five services and 33% provided only one or two services. Only 59% of these patients received medication management services. These included administering medication, dispensing correct dosages, and setting and following dosage schedule.

Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.

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.

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

This might be one reason why some patients choose conventional treatment instead of choosing a hospice program, there is many other factors that may contribute to this decision such as; financial status. This research will help give nurses a stronger knowledge base of characteristics and advantage of hospice care. In addition, nurses will be able to explain the advantages of Hospice programs to more of their patients, thus, they will be able to educate and encourage more families to choose hospice care. Not only will it help the patient live out a comfortable life it will also help the caregivers with

Despite significant advances in the multidisciplinary approach of palliative care and the growing body of evidence-based practice, a multitude of variables continue to interfere with excellence in end-of-life care for everyone (Anonymous, 2007). Because of this the primary nurse must be diligent in administering the proper medications to allow the patient to have minimal pain or suffering and provide emotional support and reassurance to family members, and possibly fellow staff members

End of life issues involving education on palliative care and hospice; are these issues important to you and your loved ones? The purpose of this paper is to discuss end of life care and how the legislative process affects this important topic. As the American population keeps growing, so does the amount of an aging population. Is the amount of training and education in nursing school sufficient for palliative care and hospice? Do we need to provide more training to the medical field to help support the growing need for end of life care? At some point in our careers we might be faced with helping someone in their final days. Being educated and having the ability to provide appropriate care is part of our scope of practice. (American Nurses Association, 2010, pp.1-2)

Hospice and palliative care are still new concepts to many that come into the facility. While the process and the goals of palliative and hospice care can be described to the patients and family members, the terminology and interpretation may be challenged by their previous beliefs and ideologies. However, after careful counseling and education, many family members agree to undergo hospice or palliative care at the appropriate time. Considering that five years ago, hospice utilization in the workplace was scarce in comparison to today where there is an entire unit devoted to promoting palliative and hospice care, it can be said that these new forms of care are becoming accepted practices with favorable

Nurses are a respected part of our community. They’re trained and educated to help heal, teach, and offer supportive care. Nurses can specialize in different areas, one would be the hospice field. Hospice patients typically have six months or less to live. Hospice will normally be provided in the patient’s home; however, the patient may also receive hospice care in the hospital, nursing care facility, or a family member’s home (“Home Health Care And Hospice Nursing”). According to Lauren Douglas, RN, while providing care in the home, the nurse must come prepared, and be expected to professionally and efficiently give outstanding care (Douglas). Hospice nurses often provide, teach, and monitor wound care, provide blood draws, as well as administer, and organize medications. Some hospice nurses will provide chemo-therapy and

Kolcaba defines comfort care for nursing as a “philosophy of health care that focuses on addressing physical, psychospiritual, sociocultural, and environmental comfort needs of patients (kolcaba, 2003, p. 252). With regards to end of life, the national cancer institute defines comfort care as care give to improve the quality of life of patient who has a serious or life threatening disease. Practicing in the area of hospice, I am often faced with caring for patients at end of life. I believe the best way to assist a patient with truly living until their death is to fully understands what comfort care is and to incorporate that understanding into my own practice.

I have been a registered nurse at UCLA for 18 months. One particular issue that has captured my attention is the utilization of palliative care in health care. Because nurses are generally at the bedside all the time, they have an important role to play in voicing the importance of its utilization and implementation in the patient’s care.

The concept of hospice care in the United States has continued to evolve over the past three decades. Initially met with great skepticism and mistrust by the general population and the medical community, hospice services and care are now considered a valuable resource and venue of care for those suffering from a terminal illness and for their families. The choice of hospice services and the approach of palliation of symptoms, comfort care, and the end of life can be difficult for a patient and family. The many issues that surround the concept of hospice care may cause the patient and family feelings of great sadness, grief, anticipatory grief, anger, defeat, loss, and many other complicated and gut wrenching thoughts and emotions (Chi Ho Chan & Fong Tin, 2012). With the support of the hospice care providers the patient and family have the opportunity to spend quality time together and share their thoughts, concerns, reflect on the past, and most importantly to communicate final good-bye’s and potentially seek closure to any remaining unresolved issues.