Nursing Paper: Gerontological and Geriatric Nursing

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

Many people have many different definitions of a family. Some include family as the people they live with, some include their entire extended family, and some include friends, neighbors, coaches, and teachers. According to the Vanier Institute (2013), a family is “a combination of two or more persons who are bound together over time by ties of mutual consent, birth, and/or adoption” (para. 2). Whichever way you look at it, families often play a major role in life. It only makes sense that when a person begins to go through a drastic change in life such as illness, the family will be involved. This is why it is important that nurses learn how to provide suitable client and family centered care. They can do this by following the four

Including the client as an expert member of the team creates an enhanced quality of care (Coad, Patel & Murray, 2014). In pediatrics, parents are often at the center of the child’s care. When asked to define what made the client care experience positive, parents stated that sensitivity, empathy and honesty were key factors (Coad, Patel & Murray, 2014). Working in healthcare, nurses can become desensitized to difficult experiences because they deal with them daily. Integrating the client and family as part of the healthcare team, allows the nurse to see the patient and family as a people first. By avoiding using illness as context, and instead using person as context, care will be more holistic (Coad, Patel & Murray, 2014). A family-focused approach helps to ensure that the whole family feels a part of the experience and is valued. In the case of bereavement, family centered care is particularly important. If the family is not included in the care from the start, it can provide barriers for grieving and impact how the family deals with loss (Jones, Contro & Koch, 2014). Nurses have an opportunity to help support the family through the grief process (Jones, Contro & Koch, 2014). Families have a significant impact on how the client heals, so by caring for the family’s needs, the nurse is indirectly caring for the patient. It is in the client’s best interest for the care to be holistic for the patient as well as the family (Jones, Contro & Koch, 2014). All

Depending on the patient's level of self-care, the nurse must work with the family to enhance such self-care. The family may view an elderly, disabled, or otherwise incapacitated patient as a child and unable to adequately perform tasks of self-care. According to Orem,

These potential psychosocial issues relevant to Jenny, create different nursing care interventions also relevant to Jenny. Education and emotional support for the patient and family is a necessary role for nurses to paediatric patients with cancer and chronic illnesses (Kieran, Meyler & Guerin 2010, p.16). It is important that nurses involve the appropriate health professional through referrals for social workers, psychologists, psychiatrists and more (Kieran, Meyler & Guerin 2010, p.16). When caring for Jenny, nurses and health professionals need to consider that the legal age for consent to medical treatment is sixteen (reference) and Jenny is nine. Therefore, her parents need to be involved and addressed in every decision throughout Jenny’s care. Family centered care is the dominant type of nursing care for children with cancer as it

The World Health Organisation (2010) defines palliative care as: An approach that improves the quality of life of patients and their families facing problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. It is also our duty to support John and his wife`s in their decision for John to die at home, Department of health (2008) patients should have a choice over the care they receive and where.

Family as system is the third approach which focuses the whole family as the client pg (10). The way the families interact with each other will have influence on the nursing intervention (pg 10). There was a female patient that was diagnosed with terminal cancer in her mid-thirties. She was married with two children. When her two teenaged children found out the cancer was terminal, they broke into tears. The husband was in denial. He could not come to terms with the fact that his young wife had a couple months to live. I had to wait on the family interactions before deciding which nursing intervention to choose. I played the councelor role to the family so they can express their feelings. The husband was able to accept her diagnosis and he was her caregiver at home during her last couple of months.

Within the dementia care environment, it is my experience that it is often unclear to nursing staff as to appropriate assessment and management of pain for clients in the palliative stage of their illness.

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).

Nursing has evolved in many ways over the years, in particular is the Florence Nightingale foundation of caring for the whole family and not just the patient. The following case study of Omid 's story: The Power of Family-Centered Care highlights the positive and negative aspects of their family’s healthcare experiences , and models of family nursing and concepts of family-centred care. By comparing the theories and models to what is currently put into practice by today’s nurses and healthcare providers a better outcome for this family is idealized.

Palliative care, somewhat similar to Hospice care, focuses on relieving or preventing suffering from a life altering illness. The goal for both Palliative and Hospice care is to provide the best possible quality of life to

Think back to when you were a child and you became ill. All you wanted was the protection and guidance of your mother to take care of you. If you had older siblings, maybe they were the ones that helped make you feel better. Even as we grow older, we rely on our family for support when we are not well. When a family member is ill, it is not just that one person that suffers. When an illness strikes a family member, it oftentimes includes the whole family to deal with the illness also. There are different approaches that a nurse can utilize when dealing with family nursing. Approaches include family as context, as a client, system and a component of society. In this paper, I will discuss where and how these approaches are utilized.

In any practice of care, nurses must be able to provide care that is holistic and centred to the individual client. According to the World Health Organisation (WHO), to care for a patient ‘holistically’ is to look beyond their illness or disability and care for them as individuals considering not just physical but also their mental, emotional and spiritual well-being (ref). Whilst, person-centred care is to deliver care moulded to the patients’ personal preferences, treating them with value and respect, ensuring that the care provided is appropriate for their needs (Goodrich and Cornwall, 2008).

However, often the nurse will find herself dealing with difficult family dynamics with family members having differing expectations of the type of care that the patient should be receiving, staff conflict over treatment methods or strategies and high workloads. These issues can only compound the stresses on the Palliative Care Nurse and to cope

“Family-centered care” is a term heard often in healthcare settings and in nursing practice. Family-centered care has been recognized as being an integral part to patient health, satisfaction and health care quality (Kuo, et al, 2012). Family-centered care is implemented with the goal to increase partnerships between, families, patients and providers; and has been prioritized as a core-concept of quality healthcare (Gallo, Hill, Hoagwood & Olin, 2016) Many professionals, however, would be hard-pressed to state what the term “family-centered care” actually means and how it applies to nursing practice. They would be at a loss for how to implement family-centered care and what is absolutely necessary to have in order for family-centered care to be successful. Advanced practice nurses are faced with the challenge of adhering to family-centered care in their practice. Illness, both chronic and acute, and health does not just affect the patient involved in care. Illness and health affect the patient, their children, their spouses, their parents, their brothers, their sisters, their grandparents and anyone else involved in their life. Research by Davidson (2009) supports the idea that the perceived effectiveness of communication between healthcare providers and the patient’s family is related to the overall satisfaction of care. Advance