The End Of Life Care

Q1: Complete the following table, describing the needs you would have to consider when planning the different aspects of end of life care for an individual

When a patient is unable to make decisions for himself or herself, their caregivers and those who know them are appointed to make the decisions based on what the patient would have wanted. This is called surrogate decision making. According to the article Terri Schiavo and End-of-Life Decisions “when surrogate decision makers and caregivers cannot agree upon what that choice would have been, they may turn to the courts to determine either what the now-incapacitated patient would have chosen or who is best suited to choose as the patient would have” (Mathes, 2005)

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.

In reviewing the two studies I found, it is very clear there is a difference in quantitative and qualitative studies. To start, Lee et al. (2017) conducted a qualitative study in which the problem statement recognizes that end of life care (EOLC) in dementia patients is less than optimal when compared to cancer patients. The researchers aimed to determine what service managers and frontline staff at different facilities felt were the key aspects in improving EOLC in dementia patients (Lee et al., 2017). As a result, the researchers purpose was to contribute to the current evidence base on good EOLC and interventions to increase quality of care of end of life dementia patients.

Nurses are healers by nature, and most nurses would by no means ever suggest ending a patient’s life. When a patient is expiring from a terminal, debilitating disease, he/ she may beg for a rapid and painless death. This concern will raise a very complicated moral dilemma for a nurse. This type of situation aids the nurse to second-guess the ethical traditions she has obtained in the nursing profession, leaving us with the uncertainty “what is a nurse’s role in assisted suicide?” (Kozier & Erb, 2010). In spite of this, assisted suicide should not be confused with ethically warranted end-of-life decisions and actions. The case was based on family and the physician’s individual beliefs. According to her husband, Michael Schiavo, Terri did not want to live life in a vegetative state. Her wishes needed to be heard, valued, and fulfilled. Possibly if the healthcare team offered education to the family then the individuals this could have kept their autonomy. Many times all it takes an explanation what the patient is going through and assisting the family with making the best ethical decision for their loved one. Nurses, play a major role in end-of-life care by advocating for patient’s needs and making certain that the quality symptom management and support at the end of life. In the case of Terri, the patient autonomy was taken from them and their wishes were not granted.

My perceptions have changed dramatically since the Clinical 1 rotation. I have noticed that the minute I walk into my patient’s room, I start to collect data. I notice if they are breathing normal, what their skin looks like, what their cognition level is, and what equipment they have in their room. I have started to connect the “puzzle pieces” of the patient’s health, rather than just feeling like I have a bunch of random information. My perception of people has continued to stay the same from Clinical 1. I continue to have an interest in learning about patients and believe that they also have something to teach us. I have learned so much from the patients and it is fun for me to get to know different

Hospice is compassionate care provided to patients facing terminal illness or illness for which there is no cure. These patients are diagnosed with an illness from which they will never recover and usually have a life prognosis of six months or less (Hospice Foundation of America, 2014). The goal of hospice care is improving quality of life and managing the symptoms of disease and the dying process. The care hospice offers is focused on pain management and emotional and spiritual support for both the patient and family (National Hospice and Palliative Care Organization, 2012). Hospice care can be provided in many different settings, often the patient’s own home. Hospice care can also be provided in hospitals, nursing homes, long-term care facilities and free-standing hospice centers and is available to patients of all ages (NHPCO, 2012). A patient receiving care in a hospice program has a team of healthcare individuals that can consist of the patients own physician, nurses, home health aides, clergy, social workers, and speech and physical therapists (NHPCO, 2012). Usually, a care plan is developed by the hospice team and care of the patient is provided by family members with the support of the hospice staff (NHPCO, 2012). Nurses make regular visits to the patient and family and are on call 24/7. Once enrolled in a hospice program hospice covers everything that will be needed to care for you, from medications to manage pain to

In nursing, the goal of care is usually to restore the patient back to the highest level of health possible. In some cases, however, the goals of care change when a curative approach is no longer appropriate. The new goals of care could simply be palliation and pain control rather than a restoration back to full health. This type of care is called palliative care. Palliative care is not the same as end-of-life care, but the two go hand-in-hand at times. The goal of end-of-life care is a “good” death, good being defined by the patient. Palliation is part of that “good” death. Both palliative care and end-of-life

Judge Neil Gorsuch, President Donald Trump’s nominee for the Associate Justice of the U.S Supreme Court, is soon up for a vote to join their rankings. The article proceeds to mention a book that Judge Gorsuch wrote in 2006 and his stand-point on the matter of End-of-Life Care where he is against the idea. The article switches to the perspective of Dan Diaz, the husband of a patient who needed medical aid in dying after being diagnosed with a terminal brain tumor. Diaz says that if Gorsuch would have been in his position at the time of his wife’s situation he would have a different outlook towards medical aid in

The ethical principles for nurses to practice with beneficence and no maleficence. This legal battle between Terri Schiavo’s husband and her family was an ethical debate between continuing artificial life or remove her feeding tube by the request of her husband. Using the theories of utilitarianism and deontology can be applied or considered in making the most ethically correct resolution. The cases are very complex and raise many moral and ethical issues. The cases have brought awareness to society of “the importance of discussing end-of-life issues with family members and underscores how an advance directive, a living will and/or durable power of attorney for health care, are a healthcare proxy clarifies and provides evidence of the wishes of an individual regarding end-of-life decisions. Terri Schiavo should impress upon laypersons and professionals alike the uncertainty of the context in which issues of continuation and termination are argued ethically. Nobody knows what Mrs. Schiavo would have wanted. She left no advance directive and in its absence her husband says one thing and her parents

Terri Schiavo was 26 years old when she collapsed in her home and suffered acute hypoxia for several minutes. Slightly shy of a year after her injury, it was clinically determined that she was in a persistent vegetative state (Perry, Churchill, & Kirshner, 2005). There were no legal documents, such as an advance directive or living will, specifying the wishes for care under such circumstances. Her husband, Michael Schiavo, was designated as her legal guardian. The Schiavo case caught the public’s attention when her husband elected to remove her feeding tube in the mid 1900’s. He understood that there has never been a case of recovery after a year of being in a persistent vegetative state. One of the moral issues surrounding the case centered on the appropriateness of removing the life-sustaining feeding tube or maintaining it. Throughout the case, there has

In my nursing practice, I frequently care for dying patients. Instead of simply providing medication to ease pain during the dying process, I wanted to learn about ways to enhance the comfort of the dying patients and possibly assist their family during a difficult time. This desire led me to examine the conceptual model of comfort. Through my research of the concept of comfort care at end of life, I discovered Katherine Kolcaba’s theory of comfort. I found her theory to be useful in describing the concept of comfort care and decided to further analyze it for a more thorough understanding of its usefulness and applicability to nursing practice. Nurses are the ones in direct contact with their patients, providing relief from certain discomforts, continuously assessing, monitoring and providing care that will ensure the patient is at ease. According to Kolcaba, “Comfort is the desirable state that nurses would want for their patients.” (Kolcaba, 2003). With its fundamental emphasis on physical, psychospiritual, sociocultural, and environmental aspects of comfort, the Theory of Comfort care will contribute to a proactive and multifaceted approach to care. This paper aims to describe the origin of Comfort Theory, its primary concepts and relational statements, review of the literature, critique describing its strength and limitation as a middle range theory

Quality of Life and Functioning for End of Life Care. HAT2 Community Health Nursing. Western Governors University.

They were the subjects of public disputes with family members, court systems, medical professionals, the media, and society at large. Terri Schiavo, Nancy Cruzan and Karen Ann Quinlan; their names are synonymous with permanent vegetative state (PVS). The amazing technological advancements in modern medicine has been credited with keeping persons alive who in times past would have died, therefore this is remarkable for countless families. In the cases of the Quinlan’s, the Cruzan’s and many like them, families members find it unbearable to witness loved ones who linger indefinitely in PVS with little or no chance for recovery. There are many like Terri Schiavo’s parents, who value the lives of their love ones no matter how limited their

Since this is generally a problem for all types of families in every economic class, the most impactful factor regarding the lack of preparation for this issue is probably a lack of intentional and formal education for young people, as well as proper public awareness for young adults to those near retirement.