Introduction
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
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Whilst searching for literature, it shown that some elderly patients specific needs were not being met. The World Health Organisation (WHO) believe that it is important for health professionals to take a holistic approach towards the elderly patients, to see explore any other possible factors that will influence the reduction of their quality of life. (WHO, 2011).
“How is respect and dignity maintained when caring for elderly patients on a palliative care unit in a hospital setting?”
Having a dignified approach and respecting elderly patients in a palliative care unit is important because it is enabling them to have control over their care and treatment. This is going to help the patient to feel valued and throughout their last days of life, as they have a choice. (Social care institute for excellence, 2010). By making the patient feel as comfortable and as pain-free as possible, it will help encourage family members to respond in a positive way. This is because they are seeing that their relative is in a comfortable state.
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
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.
The aim of a hospice is to improve the quality of life of the dying
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.
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.
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.
The guiding principles of Catholic Social Teaching have the overarching, dominating theme of human dignity (Condit, 2016, p. 371). The focus is, that human beings were formed in God’s image and in return, humanities purpose is to follow in God’s footsteps and portray the same love and grace (Coleman, 2008) (Condit, 2016, p. 371). Consequently, this affects how human beings interact with each other, requiring commitment, to look after, encourage, maintain and promote each other (Coleman, 2008) (Herbert, 2016, p. 7). One way to apply, this Catholic Social Teaching of human dignity, is to understand the nurse’s relationship with the patient. Nurses need to approach the patient with respect and maintain the person’s privacy, acknowledging that they are a fellow human being, with their own personal characteristics and beliefs (Condit, 2016, p. 371) (Walsh & Kowanko, 2002, p. 143-144, 149).
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
Giving myself time to read up on nursing experiences, attending more clinical practice labs, participating and watching these duties in the health care setting will allow me to develop a secure level of confidence the next time that this type of situation may occur. Staying in the room allowed me to experience the feeling of support while looking past social norms and how they are challenged. I met my personal values, and I believe that one should respect another person`s privacy. This understanding allowed me to be there to support the resident during her time of need. In the article `starting out` by Jane Schulz, a nursing student shares her experience of helping her colleague assist an elderly patient with daily care. Observing the compassion and care between nurse and patient from fundamental tasks, she took away a valued lesson of how our support and caring methods affect an individual. My relation to this story allowed me to reflect on the effects my care and supporting actions had on our patient.
The first half of this clinical placement, I was on a palliative ward. While others might find it difficult caring for patients at the end stage of life or in great deal of pain, I find that it gives me a great deal of satisfaction that I was able to provide care for these client in my own unexperienced way of palliative care. Being a patient myself of a very serious illness in the past, the goal of a palliative care team which is to provide quality of life during these difficult stages of the client, hits close to my heart. I might consider working in the palliative care unit in the future.
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.
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.
Firstly we will look at ethics in nursing regarding dignity and respect, treating a person as an individual when in hospital can be an important part of any patients healing process, and to make sure these patients
I have always believed that health cannot be optimized through the treatment of disease only. Rather, health should be addressed on a biological, physical, psychological, social, and spiritual continuum. Palliative care addresses an often-overlooked aspect of the patient experience, which is symptom management of their chronic illnesses. Health care professionals tend to treat acute episodes of
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