The Misunderstanding Of Palliative Care

The World Health Organisation (2010) defines palliative care as: An approach that improves the quality of life of patients and their families facing problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. It is also our duty to support John and his wife`s in their decision for John to die at home, Department of health (2008) patients should have a choice over the care they receive and where.

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.

A 2011 study of 234 countries, territories and areas found that palliative care services were only well integrated in 20 countries, while 42% had no palliative care services at all and a further 32% had only isolated palliative care services (Lynch T, 2013). And as the population continues to drastically increase with older adults living longer,

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

Great strides have been made to improve end-of-life care through palliative care and hospice programs, but sometimes that’s just not enough. In America, the care that is offered to the elderly and the chronically ill is less than ideal. Statistics show that an

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

Despite significant advances in the multidisciplinary approach of palliative care and the growing body of evidence-based practice, a multitude of variables continue to interfere with excellence in end-of-life care for everyone (Anonymous, 2007). Because of this the primary nurse must be diligent in administering the proper medications to allow the patient to have minimal pain or suffering and provide emotional support and reassurance to family members, and possibly fellow staff 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

According to the National Hospice and Palliative Care organization, in 2011, an estimated 1.651 million patients received services from hospice care, while 1,059,000 patients passed away from this form of care in the same year (NHPCO pdf, 2012). Hospice end of life cares mission/goal is to provide compassionate care for patients and their families who are living with a life limiting illness. This type of medical service gives expert medical care, pain management, and emotional and spiritual support (NHPCO, 2016). End of life care is beneficial for ones well being while they are passing away. Giving someone a peaceful and warm environment to spend their final life moments in. This form of end of life care is something that most people can relate to as many friends and family members have gone through this process. Hospice care is delivered to many patients, residents, and in general people all around the world, having many factors that go into hospice such as the requirements to receive hospice, the care team and the levels of care one receives, all of these factors are extremely important when it comes to the care for one’s life, family member, or friend.

The Clinical Oncological Society of Australia (COSA) supports the formation of a federally funded national palliative care agency to provide quality palliative care to all Australians in need of palliative care regardless of their life stage (Wiener, 2015). They found the importance of integration of the palliative care with cancer care. This involves providing education in quality palliative care to general practitioners within the community, as well as financial incentives for time spent on palliative care training. This agency is responsible for education, funding, palliative care standards, access, and research in Australia by promoting the value of palliative care to the community and facilitating education of the health-care workforce in the practice of quality palliative care (Wiener,

I agree with you Philip regarding the refusal of treatment, as it can be made under Medical Treatment Act 1998 in exercising Dorothy’s autonomous rights and aside from that, she needs to be assessed by her treating doctor as a competent person to refuse lifesaving treatment and thus, Refusal of Treatment Certificate can be executed. Also, the refusal of treatment certificate only applicable to existing treatment like haemodialysis and does not extend to future care planning. Therefore, the palliative nurse has the responsibility to provide information about advance care planning and treat Dorothy holistically including referral to culturally competent person in her cultural group such as aboriginal healthcare worker in promoting cultural safety.

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.

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