Suffering : The Biopsychosocial Model Of Health Care

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

1.1 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.

Caring for patients at the end of life is a challenging task that requires not only the consideration of the individual as a whole but also an understanding of the

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.

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

Nurses: Assist the patients and families to cope with the end-of-life process such as assessing and

Suffering at the end of life stems from multiple sources, including unyielding pain, depression, loss of personal identity, loss of control and dignity, fear of death, and/or fear of being a burden on others (AAHPM, 2007). The overwhelming symptoms lead many terminally ill patients to ask their doctors to help them die (Gorman, 2015). According to Dr. R. Sean Morrison, professor of geriatrics and palliative care medicine at Mt. Sinai’s Icahn School of Medicine in New York, “their choice shouldn’t be an assisted death or living with intractable suffering” (as cited in Gorman, 2015). The American Academy of Hospice and Palliative Medicine (AAHPM) (2007) strongly recommends that medical practitioners

Let us first take into consideration and calculate the patient’s pleasure versus pain. With a prognosis of six months, the patient must be in a current state of pain and insecurity emotionally and/or physically. On one hand, there could be a possibility that the patient could experience pain in saying goodbye to loved ones. On the other hand, the pleasure the patient will feel from the security of knowing all pain ceases after death can be noted as a higher pleasure. In addition, the patient will experience happiness knowing their autonomy is the sole administrator of death, thus being able to experience the security of patient autonomy. Consequently, the patient would experience an overall pleasure from the role patient assisted

This is recognized to be an issue, and throughout the article the authors provided an understanding of how palliative care and end-of-life care are provided too late for a patient and should be provided at an earlier time in order to bring more comfort to the patients. The authors suggest that when and how end-of-life care is provided should be altered, with nursing ethics in mind, so that patients and nurses may feel better about the care they receive. This source will help my research by providing information on how changing the policies of end-of-life care and palliative care can result in the patient feeling a relief from their suffering and ultimately feeling more comfortable. This will also help my argument in how altering the current policies and focusing on providing better end-of-life care can lead to the diminishment of physician-assisted

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

Dr. Ira Byock’s latest book, The Best Care Possible: A Physician’s Quest to transform Care Through the End of Life, is a remarkable book written from a personal perspective as one of the foremost palliative-care physicians in the country. Dr. Byock shares stories of his experience with patients in his clinical experience to illustrate how end-of-life care affects each person. He explains what palliative care really is and how to make humane choices in a world obsessed with conquering death. Byock presents an agenda for end-of-life care that stresses compassion, dignity, and each patient being viewed as a unique case with the opportunity to partake in shared decisions amongst a team of professionals and family members. Dr. Byock is an advocate of dying well in a society marked by a fear of death; his highly personal account provides thought-provoking vignettes of how people struggle to make the right decisions in the winter of their lives. Byock urges society to embrace the reality of death and transform the medical community into an environment that will allow patients to live the last of their days in comfort with dignity and peace. This book is a vitally important piece of literature for everyone to devour with fervor. Everyone needs to understand the inevitability of death and the environment end-of-life care can present in what will be the final moments of life.

The good that came out of the situation was that the care plan for the last days of life had been met. The patients and the family's psychological, social and spiritual needs had been addressed, and the patient was comfortable and free from pain (Kemp 1999). The care that was carried out protected the patients' dignity and respected him as a human being, with his family being involved as much as possible with his care.

Elizabeth Kübler-Ross was a Swiss-born psychiatrist who spent two years of her professional career gathering information from terminally ill patients to create the premise for On Death and Dying. “It is not meant to be a textbook on how to manage dying patients, nor is it intended as a complete study of the psychology of dying.” (Kübler-Ross, 1969). This book was written as a call-to-action; to raise awareness of the voice of the dying. Not only is there stigma surrounding the topic, but also numerous misconceptions concerning the emotional journey of the terminally ill. The Kübler-Ross Model creates a framework for those interacting with dying persons, to help caretakers better understand the transitions that are taking place, resulting in higher-quality care. This model is comprised of five stages, which can be experienced in a variety of combinations. Prior to the first stage, the patient must be delivered the news of their illness or the severity of their illness, which usually results in shock. Denial is the first stage noted by Kübler-Ross. Denial and isolation are normal responses to overwhelming emotions and serve as a temporary response until the individual is ready to accept reality. Although this defense mechanism is normative, it is important to note that it isn’t necessarily healthy, and that some never move past this stage. As reality sets in, pain beings to emerge and manifests itself in the next stage: anger. Rationality takes a

Many nurses are regularly confronted with the hopelessness and exhaustion of patients and their families making it difficult for them to find balance between the preservation of life and the enablement of a dignified death. Nurses must acknowledge their own feelings of sorrow, fear, dismay and helplessness and recognize the impact of these emotions in clinical decision making. These distressing pressures may cause a nurse to contemplate intentionally assist in ending a patient's life as a humane and compassionate answer, however; the conventional goals and standards of the nursing profession mitigate against it.

Our society finds it difficult to talk about dying and euphemisms are the norm. It is typical for both doctors and patients to be hesitant to initiate a discussion on dying. Focus instead is often more often placed on interventions and actions for managing symptoms. This avoidance can leave patients and their families unprepared for the inevitable death. (Schapira, 2010) It also often results in requests for therapies which may be excessive, costly and even painful in the hopes for a cure. One study demonstrates that when patients are aware that they are terminally ill, the majority are able to reach a state of peacefulness and also exhibit lower levels of distress. (Ray, Block, Friedlander, Zhang, Maciejewski & Prigerson, 2006) It is also important that family members are willing to discuss end-of-life options with their loved ones. According to elderly patients, they are most often the ones who initiate these conversations with their