Quality of Life for the Patient and Family

In this article, Working Together to improve the Patient Experience, author Richard Billingsley(2014) explains how working together amongst providers, the patients, and the patient's family improves the patient experience, thus markedly heightening the quality of care. In this article, he also shares how other organizations have successfully adopted a model to facilitate cultural change within their facilities. This cultural model is referred to as patient family centered care (PFCC), and while it is not a new concept, it's emphasis has gained popularity as insurance companies adjust the criteria that encompasses what constitutes as high quality care.

By being able to identify my own values and beliefs is an important aspect of my continual personal growth. I use them to guide my actions and behaviours throughout my life as well as helping form attitudes towards different things. Some are rally core to me and they define who I am, whilst others change in importance dependant on my needs at any given time.

This gives the implication that values can differ from person to person, so it is therefore important to identify and understand one’s own values in order to work effectively in the field.

Sense of Self- This component focuses on how an individual should recognize one’s self, in terms of attitudes, behaviors, and values.

It describes what is important to the person - what matters to them, from their

It has often been said that what people value can be determined only by what they

The WHOQOL surveys were developed by the World Health Organization (WHO) to assess population groups in a variety of situations in an effort to evaluate quality of life across various cultures (University of Washington, 2016). WHOQOL-OLD is one such measure for older adults, which was created in part because other QOL scales like WHOQOL-100 and WHOQOL-BREF did not address some of the more pertinent issues that individuals face in the latter portion of their lives (University of Washington, 2016). Similar to the other quality of life assessment tools created by WHO, WHOQOL-OLD includes basic, yet important quality of life indicators that touch upon the physical, psychological and environmental states of individuals as well as the quality of

* the importance of being special to someone, being able to express feelings, developing healthy dependence, developing healthy independence;

factors in how one would live his or her life. The only way he can retain his own dignity in

At the same time, we have a need for positive self-regard - to develop a sense of trust in the accuracy and reliability of our own inner experienced, it is on this we must depend if we are to become independent from and able to make good decisions about life and how we are to be in it.

- Allowing others to make their own decision and be responsible for your own behavior and decisions

“Nursing is an art, and if it is to be made an art, requires as exclusive a devotion, as hard a preparation, as any painter’s or sculptor’s work...” (Nightingale, 1868)

A twist on the "patient's perspective" approach is to describe a time when medicine failed to save or heal someone close to you. The purpose of this tactic would not of course be to rail against the medical profession, but rather to show how a disappointing loss inspired you to join the struggle against disease and sickness.

• encourage you to develop self awareness of your own personal values through critical reflection.

The case study based on the palliative patient Mrs. Mavis looks at issues both the family and the patient are dealing with in regards to the end of life treatment Mrs. Mavis is receiving. Mrs. Mavis is a palliative patient, currently unconscious, who is dying and only wants comfort measures within her nursing care. This was made clear through her advanced care directive, which was made weeks before beginning to receive her end of life care. Mrs. Mavis’ comfort measures include pain relief, hygiene and keeping her comfortable. Mrs. Mavis’ family want her to have fluids and medications to help improve her health. They also want oxygen and pain relief to help with her breathing. Issues such as educating and supporting the family, pain management, the effectiveness of having an advanced care directive and pain assessment will be evaluated to determine the best effective interventions for Mrs. Mavis and her families care. Interventions that will be discussed through-out this essay include the use of analgesia medication, the use of subcutaneous injections and syringe drivers, emotional support for the family, effective communication, educating the family on Mrs. Mavis’ wishes and the importance of having an advanced care directive. These interventions will be evaluated to ensure they are the best practice for Mrs. Mavis’ care.