Significance. Canada’S Population Is Rapidly Aging And

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

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

Each human being will reach a stage in life where death and separation are inevitable. Consequently, it is important for each individual to be able to foresee what the future will behold especially when death can occur unexpectedly or subsequently after chronic illnesses. The British Columbia Ministry of Health (2013) states that developing an advance directive ensures that families, and members of the interdisciplinary team acknowledge the individual’s own health care decisions, and carry their own wishes in an event where the individual may be deemed incapable (p. 3). Furthermore, it gives the individual the autonomy to make decisions in advance for themselves for situations such as an irreversible coma due to decrease oxygen perfusion to

For this study patient families were randomly assigned to the intervention or control group. In the control group the interactions between the family and ICU staff, including the end-of-life conference, occurred according to the usual practices and policies in the hospital; whereas in the intervention group, the research study was conducted according to specific guidelines. A bereavement information leaflet was given to each surrogate decision maker. In this research, the independent variable can be the type of family conference received by the surrogates and the dependent variables were the level of stress, anxiety, and depression levels indicated in the 90-day follow-up interview.

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

.“As medical technology continues to advance and health care choices become more complicated, the preservation of end-of-life autonomy is an increasingly important issue faced by various client populations.” (Galambos, 1998).

Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.

A patient barrier might include having limited knowledge surrounding life-support systems and treatment options, thereby hindering their ability to fully comprehend or demand certain interventions. Good counseling is therefore essential to overcoming this barrier in implementing the patient’s true and best wishes (Kroning, 2014, p. 222). Another barrier in implementing advance directives concerns the role and influence of family members and the patient. There may be discordance between the desires of the patient and family, which can result in serious debate and tension if not addressed and taken into consideration. Physicians still may have reservations, as certain demands made by the patient may raise ethical concerns in the future, if the provider feels the interventions being done are no longer medically appropriate.

Death is an experience that we will all have to encounter at some stage in life, but for those with elderly parents or relatives, the experience becomes more real. “The experience of dying not only affects the person who is dying but also caregivers, family members, and friends who are left behind” (Osterbur, 2015, p. 102 ) and I can associate with that. My maternal grandmother suffered a major stroke and was later diagnosed with Alzheimer’s disease.  She died in the hospital 2 years ago. Unfortunately, she was not a recipient of hospice care and the task of caring for her was done at home with the help of a hired aide and family members. Novak (2012), explains that many are faced with the dilemma of institutional death or at home and the decision to prolong care or end treatment can be burdensome (p. 411). It was an uphill battle and emotionally draining for my mom and

The beginning of life is celebrated. Books and resources are shared among friends and family in preparation for becoming a new parent. So, what happens as one approaches the end of life? Unfortunately, the same care and sharing rarely occurs in those circumstances and many face the prospect of dying unprepared. Though most people state they would prefer to die at home, this is often not where death occurs. Many Americans spend their last days attached to medical apparatus that keeps the body alive, but it does not allow for communication with family and often requires heavy sedation. Additionally, this level of treatment comes at a high price. As a society, we must become as comfortable in addressing the end of life process as we

My perception of palliative and Hospice care has changed slightly when it comes to communication with the family. I walked into the hospice unit mentally preparing myself to talk with patient families about their loved one and the dying process; this was certainly not the case. The family and the patient did not want to be bothered unless comfort interventions needed to be carried out and there was no conversation to be had about the patient and his situation. This shows that each family is different, each patient is different; and we need to respect and accommodate their unique

There is diversity among all Canadian, hence there is differences among the aging population. Not all seniors are aging well and have the appropriate programs and services to meet their needs. Some seniors are victims of abuse and some are living in isolation and poverty. Some seniors suffer from chronic illness and other socio-economic factors limit the amount of money they can put away for retirement. Hence these middle and low income elderly retirees will have to depend mainly on the pension plan that is offered between the age of 60- 65. The age of 60-65 is regarded in Canada as the age of retirement. This paper will focus mainly on the disadvantaged older populations. The disadvantaged older populations are those who are currently

According to Forbes (2014), transparency of care through communication, including patients ' opinions of care, improves patient outcomes. To improve the overall coordination of care requires thoroughly communicating to families. Inform families and patients on what to expect when dying in an easily understood way will ultimately improve the care and result in a positive outcome.

With an increasing aging population and growing numbers of individuals with chronic conditions, it is important for individuals to prepare for end-of-life care. An Advance Directive is a defined as a “legal document that provides data to critical care staff about patients’ wishes, especially when critical illness decreases decision-making ability” (McAdam, Stotts, Padilla, and Puntillo, 2005). An Advance Directive also allows for better communication between the patient and doctor, and preserves the autonomy of patients. It may also alleviate one’s family from any possible burden of uncertainty of one’s wishes. It provides guidance, which may avert arguments with family members concerning treatment choices (Cedars Sinai, 2015). The Patient

3) What limitations did the authors face in data collection? How could these have been lessened or minimized? A limitation of the study is that the protocol as funded did not involve auditing the behaviors of caregivers to determine whether their symptom management changed and whether any changes that were made were appropriate and effective. Patients who were admitted to the hospice often were too ill to participate in the study, and despite careful screening, those who did participate were likely to die before all data were collected. Starting the study with patients just prior to their hospice admission could minimize the loss of patients during the data collection. Questioning the caregivers about their symptom management strategies at the initial interview and during follow ups can lessen the chance that caregivers changed their symptom management strategies unknowingly to the researchers.