The Management Of Nutrition And Hydration

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

A survey was conducted in 2000 on more than 9,000 patients discharged from more than 2,000 hospices on the services they received (Carlson, 2007). It revealed that 22% of them received five major palliative care services, which varied among the hospices. These palliative care services were nursing care, physician care, medication management, psychological care, and caregiver support. Approximately 14% of the hospices provided all five services and 33% provided only one or two services. Only 59% of these patients received medication management services. These included administering medication, dispensing correct dosages, and setting and following dosage schedule.

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

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.

Before I started this class I thought palliative care was only used as end of life care, or for when a curative treatment was unavailable or had failed. As we learned about the different models of care, and how they have changed over the years, it became evident that the use of palliative care has changed drastically over the past several decades. In the 1800s to 1900s, palliative care was only used once the patient had reached the dying stage, and only included the patient in this care, not their families1. Before taking this course, this is what I thought of palliative care as well. Since the late 1900s though, palliative care has been used in a more proactive approach. From the moment an individual receives a life threatening illness, palliative care begins. This includes caring for the family of the patient as well. This care increases as the patient’s illness progresses, and even continues for the family after the death of the patient. Learning this has really made an impact on how I would like to work as a

Although nurses have their experience to guide their practice, as the health professional most involved with the client at the end of life, there is a need for review of current assessment tools and management strategies to ensure the care given is evidence based and best practice.

The purpose of this assignment is to demonstrate understanding of long term conditions and palliative care. Nursing care in general entails holistic care and collaborative care of individuals of all ages, families, groups and communities, whether sick or well (Royal College of Nursing, (RCN) 2007). Better management of lifelong conditions has been the priority of the National Health Service since the 1990s. When long term conditions are managed well in the community, patients’ can live a quality life without visiting hospital frequently (RCN, 2011). In Britain, six in ten people are reported to be suffering from long term conditions that currently cannot be cured; and these people are often suffering from more than one condition that makes their care challenging. It is estimated that by 2030 the UK will have double the number of people aged 85 years or over, who are living with one or more long term condition (Department of Health, 2014).

The present-day misconception of palliative care possibly comes from the circumstance that palliative care was used interchangeably with hospice care until the 1980s. (Clark & Seymour, 1999). Clark and Seymour (1999) extensively write on the beginnings and evolution of palliative care. They describe the progression of palliative care as a whole and explain the movement from palliative starting out as supplemental care to terminal patients to the concept division of palliative and hospice care. They describe the differences in each and explain why palliative is its own concept that differentiates from hospice care. In 2002, the World Health Organization defined palliative care as “an approach” that increases the quality of life of

The assessments of the patient in an end of life situation must occur frequently as to detect rapid and/or minimal changes in the patient’s condition. It is also the primary nurse’s role to report any and all changes to the multidisciplinary team, including the family members.

There is a need for evidence on palliative care because improving strategies could potentially improve the patients end of life care and could ensure that they die in a dignified

The Institute of Medicine (IOM) September 2014 Report brief- Dying in America: Improving Quality and Honoring Individual Preferences near the End of Life addresses several necessities regarding end-of life (EOL) care. These necessities include; the needs and opportunities for improving EOL care, delivery of patient-centered and family-oriented care, clinician-patient communication and advance care planning, professional education and development, public education and engagement, as well as policies and payment systems to support high-quality EOL care. Taking care of the family and the patients near the end of life requires professional commitment and responsibility from all health care professionals including clinicians, clergy, caregivers, and support staff. The health system managers, payers, and policy makers also have obligation to make sure that EOL care is compassionate, affordable, sustainable, and high quality as possible. The IOM report point out that there has been a broad improvements towards the

Staying hydrated is so important to your overall health, Tina. I recommend you drink at least eight glasses of water a day. By glasses, I mean that each glass should be at least 8 ounces. If you find it hard to drink this much water, try adding a sugar-free water flavoring to the water. This can help make the water more appealing to taste and you can change the flavor each day. Just be sure the flavoring you add is sugar-free because high sugar drinks will increase your blood sugar. Even though it can be hard to drink water, it is vital to help keep your blood sugar levels down. Water also helps to keep your kidneys working properly. When taking your diabetic medications, be sure to drink a full glass of water. By drinking that full glass of

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.

The case study based on the palliative patient Mrs. Mavis looks at issues both the family and the patient are dealing with in regards to the end of life treatment Mrs. Mavis is receiving. Mrs. Mavis is a palliative patient, currently unconscious, who is dying and only wants comfort measures within her nursing care. This was made clear through her advanced care directive, which was made weeks before beginning to receive her end of life care. Mrs. Mavis’ comfort measures include pain relief, hygiene and keeping her comfortable. Mrs. Mavis’ family want her to have fluids and medications to help improve her health. They also want oxygen and pain relief to help with her breathing. Issues such as educating and supporting the family, pain management, the effectiveness of having an advanced care directive and pain assessment will be evaluated to determine the best effective interventions for Mrs. Mavis and her families care. Interventions that will be discussed through-out this essay include the use of analgesia medication, the use of subcutaneous injections and syringe drivers, emotional support for the family, effective communication, educating the family on Mrs. Mavis’ wishes and the importance of having an advanced care directive. These interventions will be evaluated to ensure they are the best practice for Mrs. Mavis’ care.

3. Palliative Care Council of South Australia. (1996). Good palliative care project: final report. Retrieved September 4, 2002, from Palliative Care Council of So