Palliative Care : An Area Of Care

I first heard about hospice from a co-worker a few years ago when that co-worker was preparing to check her mother in hospice and she was in her forties. As she discussed with me her mother had a drug addiction problem her entire life. At that time I had never heard about hospice and I became interested in learning more about it. “Hospice is a special concept of care designed to provide comfort and support to patients and their families. Patients are referred to hospice when life expectancy is approximately six months or less. Hospice care can continue longer than six months if

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.

Before I started this class I thought palliative care was only used as end of life care, or for when a curative treatment was unavailable or had failed. As we learned about the different models of care, and how they have changed over the years, it became evident that the use of palliative care has changed drastically over the past several decades. In the 1800s to 1900s, palliative care was only used once the patient had reached the dying stage, and only included the patient in this care, not their families1. Before taking this course, this is what I thought of palliative care as well. Since the late 1900s though, palliative care has been used in a more proactive approach. From the moment an individual receives a life threatening illness, palliative care begins. This includes caring for the family of the patient as well. This care increases as the patient’s illness progresses, and even continues for the family after the death of the patient. Learning this has really made an impact on how I would like to work as a

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

Pediatric palliative care is both philosophy and an organized process to help care for children with life threatening conditions. Treating pain and difficult symptoms with psychosocial and spiritual care. The people involved in the treatment care is the family members, and a transdisciplinary 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

When I was fourteen, I went to South Korea and visited my grandmother who was diagnosed with Alzheimer’s. She was staying with one of my aunts in an apartment complex that restricted many of her daily activities and years later, her dementia progressed and passed away. Within the short time I spent with her, it was difficult for me to help her with her daily activities while maintaining her dignity. Therefore, when reflecting her death, I wondered about the type of care my grandmother had received. My potential learner gains from reviewing the literatures on this topic are how to successfully give a patient with dementia complete palliative care.

Nurses also provide end of life, and post mortem care. When a patient dies, the nurse often grieves alongside the family and helps to provide them with emotional support (Hecktman, 2012). Although the prognoses of childhood cancer have improved drastically over the last 30 years, many children still succumb to the disease. Nurses are the ones who provide constant bedside care, and often “must confront the limits of what medicine can do for people” (Schuster, 2013). This can prove to be difficult and bring on feelings of hopelessness and as though they are not helping their patients at all. Patients can leave lasting impacts on the nursing staff, and when multiple children die while in their care, the nurse may begin to experience cumulative loss. Childhood cancer is the leading cause of non-accidental death for children in Canada, and therefore, pediatric oncology nurses are often exposed to death on a routine basis, with little time to grieve between the deaths. It is imperative that nurses are aware of their stressors and how they respond to stress in order to effectively care for their patients.

There is a time to be born, and a time to die. As frightening as it is, we will all die someday. Some will die at birth, some in a tragic accident, and others from a natural cause. The average person will live a full life, and die in old age. Cancers and other deadly diseases are becoming more prominent in our culture, the demand for end of life care is becoming substantial. Hospice nurses provide near death care, and attend to the emotional, physical, mental, and spiritual needs of the terminally ill patient. Hospice nursing would not be the perfect job for all nurses, it takes a nurse with a special heart, and calling to specialize in the hospice field.

Palliative Care for Children: Enhancing the Quality of Life for a Child with a Life-Threatening Illness

I don't know if I am in a right knowledge, but I think that many people are skeptical and somewhat hesitant when it comes to speaking about the end of life. But, being in a medical field since I came out of high school, I have always been passionate of caring geriatric population and I think one of the important innovative health care delivery model that incorporates interdisciplinary care delivery team is either palliative or hospice care. Hospice care is not only a type of care but a philosophy of care that focuses on comfort for the patient and family at the end of life. It includes management of physical emotional, and spiritual needs. Care is provided by a team that includes a physician, nurse practitioner, nurse, social worker, nursing

Two popular forms of EOLC are palliative care and hospice. Palliative care, focuses simply on relieving suffering, providing psychosocial support, and closure near the end of life (Lo, Quill, & Tulsky, 1999). While palliative care focuses primarily on relief and support, hospice care enrollment is a form of comprehensive care provided to individuals who suffer from serious and/or progressive illnesses. This type of care allows the patients and their families to enjoy life to the fullest by providing pain and symptom control. EOLC differs from curative care because patient treatment begins with curative care that may or may not transition to EOLC. For most children diagnosed with cancer, the primary goal of treatment is achieving a cure. Curative care is defined as care that tends to eradicate the disease and promote patient recovery. Palliative care and curative care may be integrated to improve mental and physical

Identifying the need for pediatric palliative care has been a challenge for medical practitioners. According to (William T. Basco, 2008) a study surveying physicians and nurses at one West Coast academic medical center in the United States showed that the most commonly reported barrier to optimal end-of-life care was uncertainty about the prognosis of the child, considered significant in 54.6% of the sample.

I have always believed that health cannot be optimized through the treatment of disease only. Rather, health should be addressed on a biological, physical, psychological, social, and spiritual continuum. Palliative care addresses an often-overlooked aspect of the patient experience, which is symptom management of their chronic illnesses. Health care professionals tend to treat acute episodes of

2. Carr, D. B., Fischer, D. S. & Markman, M. (1994). Cancer: when to focus on palliation. Patient Care, 28, (3), 123–126.