Palliative 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

Palliative care is a holistic approach to support a patients symptoms who have an advanced progressive condition. Healthcare professional’s objectives are for the patient and families to have the best quality of life throughout their illness, this also involves psychological, social and spiritual support (NCPC, 2015).

Hospice exists in the hope and belief that, through proper care and the encouragement of a caring and sensitive team, patients and their families may be free to achieve some level of mental and spiritual preparation for death that is comfortable to them. The goal is to help

The first half of this clinical placement, I was on a palliative ward. While others might find it difficult caring for patients at the end stage of life or in great deal of pain, I find that it gives me a great deal of satisfaction that I was able to provide care for these client in my own unexperienced way of palliative care. Being a patient myself of a very serious illness in the past, the goal of a palliative care team which is to provide quality of life during these difficult stages of the client, hits close to my heart. I might consider working in the palliative care unit in the future.

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.

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

The present-day misconception of palliative care possibly comes from the circumstance that palliative care was used interchangeably with hospice care until the 1980s. (Clark & Seymour, 1999). Clark and Seymour (1999) extensively write on the beginnings and evolution of palliative care. They describe the progression of palliative care as a whole and explain the movement from palliative starting out as supplemental care to terminal patients to the concept division of palliative and hospice care. They describe the differences in each and explain why palliative is its own concept that differentiates from hospice care. In 2002, the World Health Organization defined palliative care as “an approach” that increases the quality of life of

Palliative care is a relatively new concept. Palliative care programs have become more numerous and better utilized since 2000 and continue to grow. It is now accepted that the palliative care model is appropriate for patients with life-limiting illnesses. Chan et al. (2013) stated that the ultimate goal of palliative care is to relieve suffering and to maximize the quality of life for dying patients and their families, regardless of the stage of illness or the need for other medical treatments (p. 133). As life-expectancy increases, there is a growing need for these services. People are living longer with chronic diseases and palliative care services can provide an extra layer of support to patients and their families. Evidence has shown that 13% - 36% of hospital inpatients qualify for palliative care services (Robinson, Gott, & Ingleton, 2014).

You have made excellent points. I do not believe that health care professionals neglect to treat patients in palliative care in the correct settings. The care one receives is based on what type of locations they are in. Hospitals and hospice centers often have employees with higher education levels and an increased passion for their job. I believe that health care providers want to ensure that one is comfortable at the end of life. I have visited Alive Hospice here in Nashville and was able to see the the great amount of care they provided to their patients. I have attached a link to their website below. I am curious to know your opinion on why you think one would not receive adequate care at the end-of-life phase.

Regardless of the benefits of palliative care, many problems remain in the execution of palliative care which is often referred late in the course of one’s illness. Despite the many barriers identified, education that is supported by evidence remains the key to rendering the effectiveness with better outcomes predicted for the patients, love one, and healthcare treatment

Clinicians sometimes underestimate the impact on patient’s sense of self and spiritual aspects that chronic progressive diseases like heart failure can have. As a palliative care provider, it is important to enquire about the patient’s spiritual and existential concerns, and to address their sense of spiritual well-being. Patients with symptomatic heart failure and advanced cancer may have similar needs for palliative care when comparing symptom burden, depression and spiritual well-being27. Interventions such as dignity therapy and meaning-centered psychotherapy have been tested in those with advanced cancer to enhance spiritual well-being and these could be applied and evaluated in patients with advanced heart failure and other chronic diseases. Supportive communication has been effective in Mr AM’s case which had helped reduce his emotional distress.

The senior population will always have a great abundance in society. They are highly aware that death would be right around the corner, especially if they are terminally ill or disabled. It is the time for them to have conversations with their doctors about the different options that will highly impact their remaining life. The high costs of the many services affect the patient’s decision on how they should be treated as to why Medicare and private insurance is an important factor and issue. Older patients want to live out their life, but they cannot do that if these services are limited. Seniors often take the surgical path in order for them to improve their state. They do not really consider the option of palliative care. It’s a great

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

This critique reviewed a quantitative study based upon palliative care and how it met emotional or spiritual needs of the families of patients with serious illnesses. The critique used eight criteria to analyze the quantitative study. The criteria include the identification of the problem, the determination of the purpose of the study, the review of the literature, the selection of the sample size and the research design, methods for collecting the data, the analysis of the data, study findings as well as the utilization of study findings.