Palliative Treatment Of Palliative Care

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.

Over the past five weeks, I have learned what palliative care really is all about. I found that there were areas that really changed my perspective as well, about what palliative care is. Some of these include, but are not limited to, when palliative care is used, how difficult is can be to get patients the pain management they need, as well as how many different complimentary therapies are available to patients.

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

In almost every case of a terminal disease, pain is intolerable and seeing someone in such agony is heartbreaking. For example, Brittany Maynard, a 29 year old brain cancer patient who had to move to Oregon so she can avail of the Death with Dignity act. “Maynard knew that her form of brain cancer would be excruciating. She would endure swelling of the brain that would very likely cause seizures, painful headaches and the gradual loss of bodily function. Doctors know that for about 5 percent of the population, no amount of morphine can block the agonizing pain the terminally ill endure” (EDITORIAL: Dying with dignity). Palliative care can often be provided for the dying patients and alleviating pain to provide comfort for the dying has always been the priority. “Palliative care focuses on relieving the symptoms, particularly the pain, of incurable illness.” (Palliative Care) But, in relieving pain through the prescribed medications there are also side effects that are caused by the prescribed pain suppressors and two examples will be lethargy and it compromises breathing. In most cases the effectivity of the pain medication may no longer alleviate the pain. If a patient will be in such agony for the remaining days or weeks the quality of life is no longer present. The agony of pain prevents a patient from performing even just the bodily functions.

Pain is one of the most common and feared complications of cancer. It is exacerbated by stress, anxiety, fatigue, and malaise which accompany advanced cancer. Pain is generally absent in the early stages of cancer, but it is a significant factor as the illness progresses to advanced stages. Cancer-associated pain can arise from a variety of direct and indirect mechanisms including direct pressure, obstruction, and invasion of a sensitive structure, stretching of visceral surfaces, tissue destruction, infection, and inflammation (McCance 2010). Pain is generally accepted as whatever the patient says it is, wherever the patient says it is. Treatment of pain and its associated symptoms is a primary responsibility of the healthcare team. Treatment modalities for pain include the use of opioid analgesics, patient-controlled analgesia, psychological interventions, and preventing recurrence of pain. Reinforcing the reporting of pain by the patient is important, as is a respect for the social and cultural differences with respect to pain perception.

A woman is thrashing in bed and crying from the pain her illness is causing her to feel. Her family rushes to find a nurse nearby to administer pain relieving medication. A nurse comes by to give palliative care to the woman that’s in agony. However, the strongest medication that’s at hand cannot relieve the pain without overdosing the patient. The terminally ill patient now has to live with intractable pain for the remaining days of her life. Physician Assisted Death is sometimes necessary in case state-of-the-art palliative care no longer works on the cancer patient. Terminal patients should have the option to control the circumstances surrounding their inevitable deaths with Physician Assisted Death to treat the pain.

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.

One of the key aspects of palliative care and sometimes the key aspect in the physician-assisted suicide debate is physical independence and pain management. “Since interest in physician-assisted suicide and euthanasia resurfaced in the late 20th century, pain and physical disability have been perhaps the most frequently cited justifications for legalization of assisted suicide” (Rosenfeld 95). This concept actually leads into the discussion of quality of life. The Encyclopedia of Bioethics states that “quality of life is one of the most important but controversial issues in clinical ethics” (1388). It also cites that quality of life is used to guide medical decisions as to whether or not medical treatment should be withdrawn from a patient. Advances in medicine have made it possible for lives that would have been lost in years past can now be extended. The definition of quality of life lends itself to ambiguity and thus it takes on different meanings depending on the individual and their circumstances. If an individual was an avid cross-country runner and got diagnosis that they had a condition which would cause paralysis or if they were in an accident, would they be able to argue that their quality of life had been changed. They would go from being able to run long distances and taking care of their own needs

Suffering is a constant companion of humans today; people experience it every day, whether it be emotional or physical, internal or external. Living with a terminal illness is also living with suffering, both because of the physical pain that is felt, and also the emotional blows the patient experiences every day. A terminally ill patient has a monumental part of their life taken from them. Few aspects of life still remain in their control, because of doctors, family members, and the illness itself. However, there is a practice that places a final decision, the right to choose the circumstances of death, with the patient. Physician-assisted suicide (PAS), or physician

An ethical dilemma is a difficult situation that usually involves a conflict between moral obligations, in which to obey one would result in disobeying another (Murphy, 1997). Sedation is an ethical dilemma in palliative care because on one side it helps to relieve suffering for patients who are terminally ill and almost at the end of their lives. However, at the same time, sedation is making the patient deprived of certain bioethical principles such as autonomy, the main issue with palliative sedation is that it prohibits the patient from changing his or her decision, once sedation is commenced and informed consent also becomes complex (Cooney, 2005). The writer is in the favour of palliative sedation because it is an effective symptom controlled strategy for the patients who are nearly at the end of their lives. Moreover, it is believed that by providing sedation to a patient induce unconsciousness, which makes the patient completely unaware of the external world and tend to reduce the suffering by considering ethical and moral principles. However, some people think palliative sedation as euthanasia, which cause death because of making the patient deprive of nutrition and hydration while giving sedation. Ethical principles are going to be discussed in this essay such as autonomy, beneficence, non- maleficence and justice. Moreover, this essay also going to put light on current research

The main ethical issues in “The Sea Inside,” are the right to autonomy/self determination and quality vs. quantity of life. The movie mainly focuses on Roman’s journey of 30 years through the legal system in Spain fighting for his right to end his life. Roman believes his life is not worth living any more. His quality of life, from his perspective is but a shadow of what it used to be before the accident. In the movie Roman has a debate with a quadriplegic priest who comes to convince him that euthanasia is wrong.

With major advancement in medical treatments, it is now possible to keep a patient alive, which would not have been possible in former times. This has made end of life issue one of the most controversial issues in healthcare. Medical improvements have set the stage for ethical and legal controversies about not only the patient’s rights but also the family’s rights and the medical profession’s proper role. It is critical that any decision made in such situation is ethical and legal to preserve the rights of the patient and also protect the healthcare institution involved. It is very important when making decisions to discontinue treatments to make sure all other alternatives have been explored.

Freedom, independence and self-autonomy are fundamental rights of a human, This directly pertains to the central notion of an individual's right to live and right to die. A terminally ill patient should not suffer through excruciating pain and discomfort but rather embrace a timely and dignified death, this is implicit in the concept of liberty and self-determination. Despite rapid advancement in medical technology and modern palliative care, some patients suffer from incurable terminal diseases which inflicts destructive pain upon the patient both physically and mentally. They are unable to seek the compassionate relief of pain and suffering that they wish to

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.

Most adults diagnosed with cancer undergo years of treatment in attempts to cure that cancer. However, sometimes these treatments may not work, or the cancer is found too late in a patient to be stopped, and a patient’s cancer can be determined terminal, which means that the cancer can not be cured and will lead to death. If cancer is determined terminal, end-of-life care can be administered patients to control lasting pains, including shortness of breath, nausea, and constipation. However, this treatment does not cure the cancer, and will not prevent death in a terminally ill cancer patient. In some cases, patients decide that receiving end-of-life treatment is not worth it if the treatment does not prevent death. Terminally ill cancer patients may also continue to experience unbearable suffering, despite end-of-life treatments, as it is not always effective. These factors may push some terminally ill cancer patients to request to be actively euthanized. Active euthanasia is the merciful ending of a patient’s life through a single act, such as an injection. Terminally ill cancer patients should have the right to determine if they are actively euthanized. However, only patients who consider their suffering unbearable should have the right to be euthanized.