Essay on Quality of Life and Functioning for End of Life Care

A physician must understand that when it comes to deciding to withhold or withdraw life sustaining treatment it is ultimately the patient’s decision unless the patient is not competent enough to make this choice. I believe that a person can lose their life at any point. Death is certain and no one can run from it. In my opinion, a patient’s autonomy is of utmost importance anytime during healthcare however the physician can name some recommendations of what would be the best option for the patient. When it comes to patients they deserve to be treated with respect and ultimately be treated as an end not as a means to an end.

Last year 23 September 2012. I had a resident called “Mrs X” she was a 72year-old widowed living at ---, a Nursing Care Home. She’s not a religious type of person as she was Atheist. She has lived in the home for the past two years, and during that time I was assigned as her key worker. Mrs X had One Son and 3 grand daughters they are all regular visitors to the home. She has recently been diagnosed with renal failure, and her life expectancy is only a couple of months without dialysis. In the past Mrs X has made it clear that when her “time comes” she wants to be able to stay at Belmont House, and “go quietly”. She has stated that she does not want any treatment that will prolong her life. This means

This is why treating the person with dignity and respect is vital in end of life care in case of an individual with dementia.

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

Key people could be family, doctors, carers, religious leaders etc. Each may own distinctive role to play in order for the choices and preferences of the individual to be respected and carried out. [ Every person’s end-of-life trajectory is different and needs differ in intensity and quality over time. End-of-life care must adapt to the varying and changing needs of the individual over time and that it cannot be limited to certain settings or services. The provision of good

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.

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

Comparatively, Bailey et al. (2014) studied the effects of implementing interventions to improve end of life care for inpatient veterans. The problem statement was determined to be that end of life care in the inpatient setting was lacking, which drove the aim of the study to improve EOLC and to minimize suffering of the patients (Bailey et al., 2014). The researchers theorized that this could be accomplished if recognition of end of life was increased and if home-based palliative interventions were implemented. Therefore, the team sought to study the effectiveness of implementing staff education of three items: evaluating patients who are actively dying, communicating end of life interventions with patients and families, and implementing home-based best practices for end of life care (Bailey et al., 2014). The purpose here was to improve inpatient end of life care.

they can offer a wealth of information and can help to make them feel useful.

End of life care does not just begin at the end as the name suggests, but it is the care a person receives once they have accepted the prognosis of a rapidly approaching end. The elderly population with multiple comorbidities may be “living, and dying” at the same time. This was a new idea brought about by this very class; The patient may be living with one or more chronic illnesses and may require a lot of assistance and care for days, weeks, and sometimes even months leading up to their death. The continuity of care is even more pertinent at this late stage in life. Continuity of care is, at its most basic of definitions, the quality of care over time. Establishing continuity of care is based on promotion continuous, caring relationships between patients and healthcare providers. It also includes ensuring a safe, coordinated transition of patients between healthcare environments, either from

All the symptoms that are associated with end of life care are of great concern. They all in one way or another affect the quality of life of the patient undergoing that journey. I would have to say that to me dyspnea would be of the most bothersome. I think of the instances where perhaps you may be choking on food, having an asthma attack, or any other situation which can lead you to be short of breath for a short period of time and reflect back on how uncomfortable and anxious you feel at that moment and apply it to attempt to form a picture of how the patient may feel undergoing this problem for an extended amount of time. Not only does being short of breath increase anxiety, but it also affects so many other aspects, such as not being able

The author seeks to differentiate ‘end-of-life-care’ from palliative care in the context of symptom management. The former being comfort care for advanced incurable illness and the latter being the managing quality of life in acute or chronic patients. The focus of palliative care is pain management but the unpredictable referral point means patients can have an array of presenting symptoms for an indeterminate time period. Some of the symptoms include nausea, vomiting, dyspnoea, and delirium. Symptoms that can cause significant distress and discomfort to a patient if not managed. Therefore, individualized care is necessary for proper holistic treatment in palliative care.

Hospice is a concept of care that is based on the belief that meaningful living is achievable during a terminal illness that is free of interventions that prolong physiologic dying. The role of a hospice nurse is to take on a holistic approach to patient care that involves a careful evaluation of not only physical problems but also the psychosocial and spiritual dimensions of the patient and the patient’s family (Hinkle & Cheever, 2014). The hospice nurse is culturally aware and sensitive in their approach to communication that respects beliefs, attitudes, and values of the patient and family about end-of-life care. The hospice nurse also provides support to families even after the death of the patient (Nies & McEwen, 2015).

With major advancement in medical treatments, it is now possible to keep a patient alive, which would not have been possible in former times. This has made end of life issue one of the most controversial issues in healthcare. Medical improvements have set the stage for ethical and legal controversies about not only the patient’s rights but also the family’s rights and the medical profession’s proper role. It is critical that any decision made in such situation is ethical and legal to preserve the rights of the patient and also protect the healthcare institution involved. It is very important when making decisions to discontinue treatments to make sure all other alternatives have been explored.

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.