Death has a devastating impact, whether it is expected or sudden. The term end of life (EOL) is used interchangeably with no concise meaning defined. The lack of clarity of the term has resulted in confusion for patients, families and healthcare providers. A variety of interventions has been embraced to meet the physical needs of the patient, and as well as, the emotional/ psychological needs of their loved one. The literatures have shown that promotion of pain management can lead to a reduction in stress, thus providing for effective coping mechanisms, and spiritual comfort for the patients when a forthcoming death is near. It is important for healthcare providers to be knowledgeable and assist families in recognizing when the end of life …show more content…
The industry began in the US as an effort to transport hospice care from the United Kingdom to the US. Florence Wald in 1963, who was the dean of nursing at Yale University invited Dr. Cicely Saunders to give a lecture to the students about Hospice Care. Saunders visits led to the establishment of the first US hospice center in Branford, Connecticut which began providing care to patients in their homes. The hospice movement began with the involvement of nurses, chaplains and psychological professionals. The involvements of volunteers made a significant contribution to the movement. In today’s society a vast number of volunteers now work in the hospice society. The National Hospice Society was later formed as a result of a series of national meetings held throughout Connecticut and New Jersey from 1975-1978. Washington, DC in 1977, held the first largest national conference with the publication of the first Standards of a Hospice Program of Care in 1979. The National Hospice Organization (NHO) in1999, changed the name to the National Hospice and Palliative Care Organization, which reflected the conjoining of traditional hospice care with palliative care. Palliative care, as defined by the World Health Organization (WHO) represents an approach that improves the quality of care for both patients and their …show more content…
Palliative care was designed as a state of the art measure that alleviated suffering in the patents which allows for better communication to be transpired between the health care team that will alleviate strains for the healthcare members. Clinicians need to be more involved and advocate for consultation based upon identifiable triggers requiring consultation, and elicits feedback from staff about certain interventions. The clinicians acting as an advocate for the patients must remain knowledgeable in recognizing the shift in the patient’s course that indicates the need for palliative care and communicate poor prognoses and outcomes with the patients, loved ones, and offer palliative care when death is prominent. Despite the many barriers identified here, clinician must be champion for palliative care on both hospital, unit, and as well as, on the level of the patient. (Perrin & Kazanowski, 2015)
Conclusion
Regardless of the benefits of palliative care, many problems remain in the execution of palliative care which is often referred late in the course of one’s illness. Despite the many barriers identified, education that is supported by evidence remains the key to rendering the effectiveness with better outcomes predicted for the patients, love one, and healthcare treatment
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
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.
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
The beginning of life is celebrated. Books and resources are shared among friends and family in preparation for becoming a new parent. So, what happens as one approaches the end of life? Unfortunately, the same care and sharing rarely occurs in those circumstances and many face the prospect of dying unprepared. Though most people state they would prefer to die at home, this is often not where death occurs. Many Americans spend their last days attached to medical apparatus that keeps the body alive, but it does not allow for communication with family and often requires heavy sedation. Additionally, this level of treatment comes at a high price. As a society, we must become as comfortable in addressing the end of life process as we
Rather, the hospice staff and the patient understand the patient is going to die and no further treatment options are available. Therefore, hospice care centers direct their attention towards providing a dignified ending to a patient’s life by delivering comfort and emotional support through a palliative care approach designated to alleviate pain and emotional distress. For example, at Hospice of Dayton, each patient residing at the care facility is provided their own room where their family is able to stay with them and the patient is able to receive the pain management and emotional support they need to die a little closer to peace and security. Additionally, at Hospice of Dayton, there are full-time doctors, nurses, counselors, and religious support-staff that provide patients the physical treatment they need to minimize their pain, as well as the emotional support they need to live the last moments of their life with dignity and emotional well-being. Most importantly, Hospice of Dayton because of its volunteers. Volunteers provide the invaluable service of listening, crying, and laughing with those who may not necessarily have someone to spend time with, while they undergo their long, arduous, and painful experience of
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
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
Paulus, (2008) discusses in her thesis that patients with chronic diseases need symptom control and pain management but are often referred to palliative care services too late and do not receive the care and support they need. Late decision making reduces patient autonomy; patients may become too unwell to participate in formulating their plan of care (Al-Qurainy, Collis, & Feuer, 2009). In a study carried out by evaluating the notes of patients that had died it was concluded that physicians did not feel confident giving an end of life diagnosis; this can cause a delay in care (Gibbins, McCoubrie, Alexander, Kinzel, & Forbes, 2009). Palliative care in hospitals would improve the quality of end of life care. Paulus (2008) believes it is an
Dr. Ira Byock’s latest book, The Best Care Possible: A Physician’s Quest to transform Care Through the End of Life, is a remarkable book written from a personal perspective as one of the foremost palliative-care physicians in the country. Dr. Byock shares stories of his experience with patients in his clinical experience to illustrate how end-of-life care affects each person. He explains what palliative care really is and how to make humane choices in a world obsessed with conquering death. Byock presents an agenda for end-of-life care that stresses compassion, dignity, and each patient being viewed as a unique case with the opportunity to partake in shared decisions amongst a team of professionals and family members. Dr. Byock is an advocate of dying well in a society marked by a fear of death; his highly personal account provides thought-provoking vignettes of how people struggle to make the right decisions in the winter of their lives. Byock urges society to embrace the reality of death and transform the medical community into an environment that will allow patients to live the last of their days in comfort with dignity and peace. This book is a vitally important piece of literature for everyone to devour with fervor. Everyone needs to understand the inevitability of death and the environment end-of-life care can present in what will be the final moments of life.
Patients with chronic or life-threatening illnesses may turn to palliative care for its symptom relieving benefits as well as its ability to improve their quality of life. A key factor in quality palliative care is effective communication between medical professionals and the patient as well as the patient’s caretakers. Pain management, continuity of care among caretakers and medical providers, and concentration on the patient’s personal preference are all major aspects of palliative care. Good palliative care should begin with a discussion on advanced care directives, preferably initiated by a physician. (Fine, et al. 595,
To be a success, the relationship must be a presence with the familiarity, partnership, and support that come together in the curative encounter between nurse and patient. The role of a nurse in palliative care plays an essential role in teamwork as it does with the individual and group which patient and family. Palliative Nurses offer an important role in supportive care which can help the patient and family deal with their condition and treatment process from pre-diagnosis, passing through diagnosis and treatment, to the cure, The nursing role includes relief physical and psychological suffering, treatment of pain, and treatment of associated symptoms, ease mental grief and social isolation and rehabilitation to achieve a high quality of life to and die in the comfortable situation. While not every person agrees, as a case in point, let us argue that the decision is to be made by the patient or the patient's
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