Introduction Nutrition and adequate hydration are fundamental needs for the body. Most people see the act of eating and drinking as an enjoyable or pleasurable part of life that meets the biological, social, psychological and cultural needs. Loss of appetite and no desire to drink is a natural process for a person in the end stages of life. The simple task of eating and drinking can cause a great deal of discomfort as well as cause a lot of anxiety or stress to the family. As an advocate for the patient in the nursing profession, the cessation of nutrition and fluids to the terminally ill or dying patient is ethically challenging for both nurses and families. Article Summarization In the journal “Nutrition and hydration in dying patients: the perceptions of acute care nurses” (2013), they discuss how the perception and expectation of palliative care is to take a holistic approach to the relief of suffering verses acute care where the perception and the main focus is on ‘cure’ and the maintenance of life where nutrition and hydration are key aspects or treatments in achieving these goals. During the end stages of life, there is a gradual reduction of oral intake to which medical nutrition or hydration is not likely to be used when patients are no longer able to take or tolerate fluids and nutrition to alleviate suffering. Through studies, it has shown that nurses and doctors can struggle with their own values or beliefs withdrawing treatment or with the hopes, values and
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
Nurses in specialty care continue to change the health care system to meet the needs of patients regardless of the setting. Hospice and palliative care is an area of nursing specialty care that has grown since the 1970s when it began (Cowen and Moorhead, 2011). Leaders in nursing identify change that is needed and discover ways to make the changes possible. The leadership in nursing brought forth attention for patients with terminal illness. Nurses defined hospice and palliative care, developed core principles, practices, provided education and then pushed for the care to be available in multiple settings (Cowen and Moorhead, 2011). The continued growth in this specialty area of nursing is related to the positive outcomes of patients that have
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
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.
Dr. Bowron also incorporates the opinions of his fellow professionals to embolden his ethos in this article. Nurses, in his hospital, share with him the desires of the elderly to embrace natural death rather than being subjected to medical advancements such as dialysis.
Long-term care is a result of people having terminal conditions, disabilities, illnesses, injuries, or being elderly. The purpose of long-term care is to provide services to people and to aid people at a time in their lives when they cannot depend on themselves to maintain daily activities. There are many variations of long-term care available – such as home care, adult day care, and independent and assisted living, personal care facilities, nursing homes, and hospice.
Death is one of the most significant life events people experience. Most people want to die a peaceful death and desire the same outcome for their family and friends. Medical advancements have resulted in people living longer lives with chronic illnesses. Despite the advancements in medicine and the available treatments of today, sometimes the patient is still unable to escape intolerable suffering; the patient’s quality of life diminishes.
This report is focusing on elderly patients who are on a palliative care unit, and how they are respected and their dignity is persevered throughout their end of life care in a hospital setting. Throughout the Inter-Professional Learning (IPL) seminar sessions, there was many student midwives, student adult, child and learning disability students. There were many topics suggested and discussed between the group, which helped aid us choosing our focused topic. Grumbach and Bodenheimer (2004) reinforces the argument about IPL groups are important, as they found that when health practitioners work together has a positive impact on the patient outcomes. Therefore, they believe that IPL groups should be fundamental part of health professionals
This is recognized to be an issue, and throughout the article the authors provided an understanding of how palliative care and end-of-life care are provided too late for a patient and should be provided at an earlier time in order to bring more comfort to the patients. The authors suggest that when and how end-of-life care is provided should be altered, with nursing ethics in mind, so that patients and nurses may feel better about the care they receive. This source will help my research by providing information on how changing the policies of end-of-life care and palliative care can result in the patient feeling a relief from their suffering and ultimately feeling more comfortable. This will also help my argument in how altering the current policies and focusing on providing better end-of-life care can lead to the diminishment of physician-assisted
There are many cultural and religious beliefs in the world in which many individuals base their end of life care according to those beliefs. As a nurse it is important to be aware of the different varieties of religious and cultural beliefs and be open minded when caring for these individuals. It has been shown that individuals who are dealing with end of life are better able to cope and have a better overall experience when their cultural and religious practices are respected in the healthcare setting.
The role of the expert palliative care nurse is complex and unique. The nurse functions as an integral part of a Multidisciplinary team, providing expert skilled assessment and nursing care, supporting the patient and the family to make informed choices thereby encouraging the patient to continue to make autonomous decisions about their care towards the end of their life.
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.
Care team members need to be aware of this tendency to overestimate survival, to reduce residents’ and families’ potential distress.