Terminal Illnesses

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

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 process of deciding when a terminally ill patient should die lies within the patient, family members, and the

illnesses, and their loved ones are often reduced to helpless observers. Terminally ill patients are

The importance of end of life issues and decisions are now being discussed at the time of admission to most acute care and long term acute care facilities. More attention is being placed on these specific decisions to ensure that the patient's

Nearly 70% of Americans will die in a hospital or care-facility, while this 70% would prefer to pass away in their own home. Most people with chronic diseases wish to avoid hospitalization during the end of their life (pbs.org).Vivian Bearing from the play, Wit by Margaret Edson, is diagnosed with stage 4 terminal cancer and is then immediately hospitalized. There, she is put into an intensive treatment program where it caused great physical and emotional pain to her. The more time that passed, the greater the decrease in Dr. Bearing’s quality of life. Being sick like this had caused Dr. Bearing to lose her independence, a quality she had greatly valued. She was forced to accept the loss of her self-reliance, and even worse, the fact that she was going to die. Often times the most difficult part of having a terminal illness is losing self-defining qualities along with coping with the weight of the looming fate. As shown in the play Wit, the diagnosis of a terminal illness often has devastating effects on one’s mental health, quality of life and independence, along with the struggle of accepting death. By understanding these conditions one can better prepare for the inevitable, while medical professionals can provide more appropriate support and care.

The second part relates to terminally ill and chronically ill patients, two notably different circumstances. In one case, prescription of deadly drugs occurs because a life of any quality is not worth living if it is sufficiently short. In the other case, it occurs because a life of any length is not worth living if it is of sufficiently low quality. Its important to note, before investigating distinctions, that arguments related to double-effect or intention do not apply insofar as the prescription is explicitly intended to be lethal. On one hand, the terminal nature of the patient means that if life discourages them, then they may lack motivation to live in a worthwhile way. At the same time, a chronically ill person will continue to have

The current health situation should be explained in a non-technical way so the patient (if possible) family, and or valid surrogate can understand every aspect. The physician should also help them understand when there is no hope for recovery. Most often the organs are no longer functioning, or there is little to no brain activity; at this point suffering potentially outweighs the probability of recovery. Medical teams most often realize that the focus should be on comfort, rather than extending a dying life. This decision comes with a great deal of uncertainty, and will always be hard, no matter what age of the patient, or the circumstances. Kathryn Kosh, MD explains that, “Ready access to advanced modern technology has changed death from an event to a process… Defying death requires payment [in the form of] pain and discomfort or in an unacceptable decline in the quality of life.” Often times physicians will not prescribe treatment in the first place knowing that this option will not benefit the patient, prolong suffering; and will likely end in termination anyway. Therefore, allowing the nature of the illness or injury to take its own course of action. Another point of interest regarding this topic is that medical teams realize in most cases, that providing an ethical and dignified death can be just as rewarding as administering aggressive measures to save a

This paper explores the meaning as well as the different aspects of “Chronic Illness.” These information about the concept is illustrated through an art piece, such that “Chronic Illness” is symbolized as a multi-coloured circle. Throughout the paper, the image is broken down into three parts to analyze and explain how each detail truly symbolizes the concept.

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

As we all know, chronic illness is the number one health care problem in the United States; however, it is important to be aware of the capability of acute illness.Frequently, acute illnesses happen only in one part of the body and respond to treatment. Nevertheless, chronic illnesses are long- term conditions that usually involve multiple system, and there is no guarantee of a future where the condition will be cured completely. The similarity of these two type of illnesses have is that they both cope with any health problem depending of the severity of the condition. The biggest difference is that chronic illness usually requirement more treatment and care in order to maintain the homeostasis (Murrow & Oglesby, 1996).

Usually either patients or families have the legal rights to determine what medical course to take with the patient when it comes to the diagnosis of death, in this case the family's conflict needs be considered. The healthcare staff involved in the patient’s care must communicate with the family members during this difficult time. If the patient is determined to be dead, the family will need support from the health care staff that has been involved in the patients care, all available hospital resources, including medical, nursing, social work, ethics, and pastoral care will be a good resource for the family members. Lawyers will usually advise health care staff to work with the family in the most compassionate way possible, the lawyers should be there to help with any conflict between the family members, and this will also help the organization against any future malpractice suits against the health care staff and organization.