The Issue Of Palliative 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

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.

Key people could be family, doctors, carers, religious leaders etc. Each may own distinctive role to play in order for the choices and preferences of the individual to be respected and carried out. [ Every person’s end-of-life trajectory is different and needs differ in intensity and quality over time. End-of-life care must adapt to the varying and changing needs of the individual over time and that it cannot be limited to certain settings or services. The provision of good

Over the past five weeks, I have learned what palliative care really is all about. I found that there were areas that really changed my perspective as well, about what palliative care is. Some of these include, but are not limited to, when palliative care is used, how difficult is can be to get patients the pain management they need, as well as how many different complimentary therapies are available to patients.

Hospice is a philosophy of care. It treats the person rather than the disease and focuses on quality of life. It surrounds the patient and family with a team consisting of professionals who not only address physical distress, but emotional and spiritual issues as well. Hospice care is patient-centered because the needs of the patient and family drive the activities of the hospice team.

This essay discusses the core principles of long-term conditions and management. Government guidelines and standards are also discussed in relation to how these will impact the care of the patients who are experiencing long term conditions. The reports, guidelines and plans that play an important role in directing the current nursing system today, are discussed with regard to the management of chronic conditions and lastly, palliative care and outcomes from the publication “Together for Health – Delivering End of Life Care” (2013)

When I was fourteen, I went to South Korea and visited my grandmother who was diagnosed with Alzheimer’s. She was staying with one of my aunts in an apartment complex that restricted many of her daily activities and years later, her dementia progressed and passed away. Within the short time I spent with her, it was difficult for me to help her with her daily activities while maintaining her dignity. Therefore, when reflecting her death, I wondered about the type of care my grandmother had received. My potential learner gains from reviewing the literatures on this topic are how to successfully give a patient with dementia complete palliative care.

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.

There are occasions when medicine is not your friend and the effects of the treatment will only prolong the suffering of the patient. Healthcare professionals must be objective and ask will the end result be changed. We must know when it is appropriate to discuss end of life options and when it is not. According to Adams (2015), most desire to die at home, but less than half are allowed to do so (p. 13). Our responsibility is to allow the client to make an educated decision about all the available service and treatments.

Furthermore, these presumptions were not entirely correct. Although, my patients were in their late 70s, with limited mobility, reduced cognizance, and from lower socioeconomical class backgrounds, I did not contemplate the actual humanistic qualities of my patients. I completely neglected to acknowledge the unique lives I was about to enter. Alternatively, looking back with some disappointment, I was not able to conduct a deep, meaningful conversation about the implications of death. I predicted I would discuss different views of death and dying, but this subject is much more personal than I imagined. In conjunction, I did not encounter a bitter attitude from my patients, as I predicted. However, both my patients’ conditions determined their willingness to engage upon each visit. Sometimes patients were too tired to hold a conversation, often overwhelmed by questions about their lives. During one visit I asked my patient about his hobbies when he was younger. He proceeded to discuss the wonderful recreational vehicle cross-country trips he and his wife would take. This led to sorrow about the loss of his wife, dog, and inability to conduct the trips in the future. Aside from the unpredictable interactions themselves, I did not forecast how my patient’s conditions would dictate our visits together.

(Schapira, 2010) It is important for patients to have all the facts in order to accept and prepare for death. Another area not always communicated well has to do with advance care planning. Many patients do not learn about options or talk about end of life issues until it is very late. Studies have shown that younger doctors are more likely to initiate conversations about end of life care options. (Pahwa, Babu & Bhatnagar, 2005)

Palliative care also referred to as end-of life care (Mosca, Blazer, Wheeler and Abernethy, 2011), is a clinical issue which focuses on treating symptoms, relieving suffering, and providing support to the patient and their family (Hauser et al., 2011). Castro (2015) further defines palliative care as providing comfort through pain relief, attaining a high quality of life and preserving the self-respect and self-confidence of a patient (p. 13). Palliative amputation is a type of surgery described as a component within palliative care that is vital to managing incurable diseases, through preventing and minimising painful symptoms (Mosca, Blazer, Wheeler and Abernethy, 2011). Merimsky, Kollender, Inbar, Chaitchik and Meller (1997) report that palliative amputation is now considered a rare procedure, as it has been replaced with less invasive approaches, including limb-sparing surgery (p. 151). Cancer patients are often the subject of research regarding palliative care, due to the need to be treated with care rather than curative intent (Schofield, Carey, Wein, Love and Nehill, 2006). This paper will address the bioethical principles of autonomy, justice and beneficence in respect to palliative amputation. Despite the focus on cancer patients the principles can be generalised to most palliative patients. Furthermore, the contrasting opinions of whether palliative amputation should be used as a palliative care treatment is also discussed.

I have been a registered nurse at UCLA for 18 months. One particular issue that has captured my attention is the utilization of palliative care in health care. Because nurses are generally at the bedside all the time, they have an important role to play in voicing the importance of its utilization and implementation in the patient’s care.

It is a truth well acknowledged that there will come a time when every doctor will have to face the death of their patient. Whether their patient was much loved, tolerated or was barely known does not matter, but how the doctor or medical student deal with their passing is important. Yet death is a natural process and something that doctors and medical students are expected to struggle through and learn from. Depending on their speciality and experiences doctors experience a variety of different emotions, difficulties and strategies to cope with death of patients and these will discussed.

Care team members need to be aware of this tendency to overestimate survival, to reduce residents’ and families’ potential distress.