Many terminally-ill patients give up hope when treatments are no longer available to help them and hospice care is given to them as an option. However, hospice care has proven itself to provide the best quality care for the last six months of the dying. The purpose of hospice is to provide the best care for terminally-ill patients at the end stage of their lives. Hospice offer services to support too many aspects a patient’s life such as medical, legal, spiritual care. Hospice includes art therapists, music therapists, and certified chaplains on the palliative team.
A person’s life can end at any age. They can depart quickly or slowly. End of life care, also known as palliative care, is the care of patients that are not only in their final hours or days but the patients with a terminal illness that has become incurable. End of life care takes into mind what the patient desires so it is recommended that they consider an advanced care plan also known as an advance directive and living will. These documents allow the patient to formulate decisions on the future of their care if, at any point, they cannot vocally express themselves.
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.
• Data Protection, recording, reporting, confidentiality and sharing information • The making of wills and living wills • Equality, Diversity and Discrimination • Visitors • Safeguarding of vulnerable adults • Removal of medical equipment from deceased people • Dealing with personal property of deceased people • Risk Assessments • Moving and Handling • Mental Capacity • Health and Safety 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
Trossman (2006) states that at least 50% of patients are suffering from moderate to severe pain at their time of death, that 70 million Americans experience pain throughout their activities of daily living and that nurses hold the keys to pain management. According to Abdalrahim et al. (2010) there have been countless evidence-based studies regarding pain management; nevertheless, the inability to control the patients’ pain has increased due to nurses often devaluing the information they receive from the patients about their current pain level, these actions are directly related to a withholding of
Hospice: Understanding and Caring for End-of-Life 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
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
In almost every case of a terminal disease, pain is intolerable and seeing someone in such agony is heartbreaking. For example, Brittany Maynard, a 29 year old brain cancer patient who had to move to Oregon so she can avail of the Death with Dignity act. “Maynard knew that her form of brain cancer would be excruciating. She would endure swelling of the brain that would very likely cause seizures, painful headaches and the gradual loss of bodily function. Doctors know that for about 5 percent of the population, no amount of morphine can block the agonizing pain the terminally ill endure” (EDITORIAL: Dying with dignity). Palliative care can often be provided for the dying patients and alleviating pain to provide comfort for the dying has always been the priority. “Palliative care focuses on relieving the symptoms, particularly the pain, of incurable illness.” (Palliative Care) But, in relieving pain through the prescribed medications there are also side effects that are caused by the prescribed pain suppressors and two examples will be lethargy and it compromises breathing. In most cases the effectivity of the pain medication may no longer alleviate the pain. If a patient will be in such agony for the remaining days or weeks the quality of life is no longer present. The agony of pain prevents a patient from performing even just the bodily functions.
Initially, many people lie in hospital beds suffering. With the dramatic changes in medical and technology doctors are now able to minimize the suffer of patients, and even prolong their lives. Even with the all of the medicine blocking away pain the people are still suffering.
Introduction 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
Pain and comfort as a rule are considered opposing in the needs of human beings. Pain is defined as an unpleasant sensory or emotional experience associated with potential tissue damage. Pain can be divided into categories of long-term pain or short-term pain and by the type of pain, level of pain, location of pain, and ease of solving the pain. Frequently, there is no way to completely manage pain, specifically in end-of-life care. Pain is at
Introduction Kolcaba defines comfort care for nursing as a “philosophy of health care that focuses on addressing physical, psychospiritual, sociocultural, and environmental comfort needs of patients (kolcaba, 2003, p. 252). With regards to end of life, the national cancer institute defines comfort care as care give to improve the quality of life of patient who has a serious or life threatening disease. Practicing in the area of hospice, I am often faced with caring for patients at end of life. I believe the best way to assist a patient with truly living until their death is to fully understands what comfort care is and to incorporate that understanding into my own practice.
Palliative care is the active holistic care of terminally ill patients, which demands to maintain the quality of life addressing physical symptoms as well as emotional, spiritual and social needs. Palliative care is a difficult time for everybody involved. There are many issues that can occur in end of life (EOL) palliative care, especially when the patient is unconscious. The case study of Mrs Mavis looks at issues experienced by the patient and patients family in EOL care. Mrs Mavis is a palliative patient who has progressed into unconsciousness. Mrs Mavis has an advanced care directive (ACD) in place stating that she would only like to receive pain management and comfort measures. The Mavis family are experiencing some issues in regards to her care, they feel that she should be receiving oxygen for her altered breathing and more should be done to treat her. The Mrs Mavis case study presents numerous issues such as advanced care statements, altered breathing, family grief and emotional support, pain management, comfort measures and hygiene and levels of care. This paper focuses on pain management, advanced care directive education and emotional support of the family and carers in relation to the Mrs Mavis scenario presented in the case study.
Your theory of comfort is so important in all our patients but especially on end life process cases. When a patient cannot longer benefit from active treatment, comfort care can allow a better quality of life at the end of life. Also comfort care is known as palliative care. In our center every time we evaluate a patient for heart or lung transplant or for LVAD implant (left ventricular assist device), palliative consult is necessary for the evaluation process. Patient’s and family members need to understand that is an option to choose, that is designed to focus on the quality of their last days of life rather than quantity. Comfort care is not only base on physical needs, also on spiritual needs as well. This theory it will be necessary always
distressing symptoms in dying patients. Therefore, nurses must use effective These symptoms can either manifest themselves as pain, anxiety, dyspnea, and/or delirium. It is a reprioritization of the patients, as well as their families’, preferences regarding their plan of care. The inclination is to optimize the patient’s quality of life by reducing the amount of suffering they experience with their chronic illness (e.g. COPD, cancer, autoimmune disorders).