Educating Patients on Palliative Care
Christi Verbick
Chamberlain College of Nursing
NR224 Fundamentals – Skills
Professor Perkins June 07, 2016
Educating Patients on Palliative Care
Introduction
Palliative care is a service provided by trained medical professionals to provide comfort to the patient that is suffering from a serious illness. Many people do not have a clear understanding of what palliative care is and how it provides relief for the patient, as well as the patient’s family. There is a definite need for education on this topic as well as many other topics concerning patient education and safety. The Joint Commission (2016) launched a Speak Up™ campaign in 2002 and one of the main topics the campaign focuses on is palliative care. The brochure offered is titled What You Need to Know About Your Serious Illness and Palliative Care (The Joint Commission, 2016) and is available for the public to download or print at no cost. The brochure provides useful information on what services are provided and where you can receive those services. It includes other information that is not only beneficial to a patient, but a patient’s family member, or anybody who knows someone that may benefit from palliative care. Summary The very first point the Joint Commission (2016) makes in their brochure on palliative care is to educate the reader on who should seek this type of care. Many people instinctively equate palliative care with death. However, it is a
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.
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
Palliative care is one of the most sensitive specialists in nursing today. Hence the guidance published in nursing times [2012]recommends that trusts draws up a plan to raise awareness of end of life issues in all wards as to improve rapid discharge process for patients who choose to die at home, as it is becoming common nowadays for end of life to occur within the hospital settings [Main, 2002]. The National Institute for
The purpose of this assignment is to demonstrate understanding of long term conditions and palliative care. Nursing care in general entails holistic care and collaborative care of individuals of all ages, families, groups and communities, whether sick or well (Royal College of Nursing, (RCN) 2007). Better management of lifelong conditions has been the priority of the National Health Service since the 1990s. When long term conditions are managed well in the community, patients’ can live a quality life without visiting hospital frequently (RCN, 2011). In Britain, six in ten people are reported to be suffering from long term conditions that currently cannot be cured; and these people are often suffering from more than one condition that makes their care challenging. It is estimated that by 2030 the UK will have double the number of people aged 85 years or over, who are living with one or more long term condition (Department of Health, 2014).
Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illness. It focuses on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.Palliative care is provided by a specially-trained team of doctors, nurses, social workers and other specialists who work together with a patient’s doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.
What was once believed to be a form of neglect has resulted in a change in practice with the idea that doing less is more. Culture is an important factor in how care is rendered and thus, the limitations of palliative and hospice care lie within the desires of the family and patients. A thorough understanding of our surrounding demographics helps to ensure a seamless approach to providing care without bias or imposition of ones beliefs. However, just as with all things, providing care for the sick and comforting the dying should be rendered in moderation as to prevent the effects of burn out. Likewise, the same effects occur in the caregivers who sacrifice their responsibilities in order to care for their love ones. Finally, and with some closing thoughts, the writer wishes to express with gratitude the benefit of having taken this course to better understand oneself and others in the realm of healthcare. The lessons learned throughout have expanded this writer's knowledge and understanding of the human desire to make a connection through communication, emotion, compassion, and spiritually - the platform from which this writer wishes to continue seeking further knowledge and
Palliative care is a relatively new concept. Palliative care programs have become more numerous and better utilized since 2000 and continue to grow. It is now accepted that the palliative care model is appropriate for patients with life-limiting illnesses. Chan et al. (2013) stated that the ultimate goal of palliative care is to relieve suffering and to maximize the quality of life for dying patients and their families, regardless of the stage of illness or the need for other medical treatments (p. 133). As life-expectancy increases, there is a growing need for these services. People are living longer with chronic diseases and palliative care services can provide an extra layer of support to patients and their families. Evidence has shown that 13% - 36% of hospital inpatients qualify for palliative care services (Robinson, Gott, & Ingleton, 2014).
Palliative care is a holistic approach to support a patients symptoms who have an advanced progressive condition. Healthcare professional’s objectives are for the patient and families to have the best quality of life throughout their illness, this also involves psychological, social and spiritual support (NCPC, 2015).
Gelfman et al. reviewed the literature before beginning this quantitative study. The previous study has shown that hospitalized patients with terminal illnesses and their families need care to alleviate physical distress, help making decisions, improvement in relationship between patients and their families, and the reduction of the family caregivers’ burden. Another study found that comparing with people dying at home, people dying in healthcare settings had unmet needs they wanted. The prevalence of terminal illnesses and the family caregivers’ burden have created an enormous demand for expert palliative care. Unfortunately, the scientific knowledge of palliative care is limited. Gelfman et al. (2008) stated that the impact of hospital palliative care programs on surviving family members is not well studies, while the previous studies have explored that the burden in families of patients with terminal illnesses are significant high. Therefore, Gelfman et al. conducted a quantitative study to examine the impact of a hospital palliative care
According to Allen et al. (2012), “millions of people with chronic illnesses endure unrelieved pain, uncontrolled physical symptoms and unresolved psychosocial or spiritual problems.” This issue occurs because palliative care is often considered a form of end-of-life care. Palliative care is a treatment that can be used for patients who suffer from chronic illnesses and diseases while receiving curative treatment. (Horowitz, Grambling & Quill, 2014) purposely states the misconceptions of palliative care and advocated for seriously ill patients that education must bring under control the misconceptions. Some patients do not receive appropriate symptom management because the palliative care treatment needed is often confused with end-of-life care. However, end-of-life care attempts to relieve pain and suffering when a disease is no longer responsive to curative treatment. Pain and suffering could ultimately be controlled or even eliminated through the proper utilization of palliative care. Patients who are not referred to palliative care in a timely manner is more likely to have poor quality of life, uncontrolled symptom management and increased amounts of visits to the emergency room during the disease process. Patients with life limiting illnesses bear the burden of increased discomfort and increased suffering. Nurses experience clinical practice issues and difficulties in the clinical setting during the delivery of comfort and symptom management. These issues
Communication with families and patients on end of life education is very important. To fully comprehend how this process works education is necessary. It helps with decision making on how the patient may lean in relationship with his or her disease process. “Consistent communication with patient, families, and care team is vigorous for high-quality end of life” (Singer, Ash, Ochotorena, Lorenz, Chong, Sherve, Ahluwalia, 2016). Engaging with families on the process and keeping all individuals updated on condition and prognosis, as well as share information in regards to what the patient may have a preference and goal of the care (Singer et al., 2016).Showing active participation in their decision makes the transformation slightly relaxed. The way things are announced can make an impact on the families in addition to the heavy burden they are experiencing. Make the setting comfortable when approaching the family about any discussions about the patient. “Nurses that are skilled and relaxed with communicating with patient and families about end of life care may improve the quality of the patient in the hospital setting” (Moir, Roberts, Martz, Perry and Tivis, 2015). Whether the transition is made efficiently and progressively will depend on the communication and education that is received from the doctors, and other team members involved. About 70-80 percent of patients die in the hospital or other institution (Durham, Alden, 2008). Along with that static 19 percent of
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,
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
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