End Of Life Care

A legal requirement of end of life care is that the wishes of the individual, including whether CPR should be attempted, as well as their wishes how they are cared for after death are

The term “hospice” goes back to medieval times where it was referred to as a place of shelter and rest for the ill or weary travelers on a long journey (NHPCO, 2016). In 1948, the term was referenced to by Dame Cicely Saunders, a physician, for dying patients (NHPCO, 2017). Saunders created the first modern hospice program, St. Christopher’s Hospice, located in a suburb of London. However, it wasn’t until a visit to Yale University, in 1963, Saunder’s gave a lecture on the concept of hospice care. During the lecture, she emphasizes the differences before and after symptom control care. Thus, this lecture was the stepping stone for the advancement of hospice care.

Judge Neil Gorsuch, President Donald Trump’s nominee for the Associate Justice of the U.S Supreme Court, is soon up for a vote to join their rankings. The article proceeds to mention a book that Judge Gorsuch wrote in 2006 and his stand-point on the matter of End-of-Life Care where he is against the idea. The article switches to the perspective of Dan Diaz, the husband of a patient who needed medical aid in dying after being diagnosed with a terminal brain tumor. Diaz says that if Gorsuch would have been in his position at the time of his wife’s situation he would have a different outlook towards medical aid in

Care designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life, rather than cure. The goal is to enable patients to be comfortable and free of pain, so that they live each day as fully as possible. Aggressive methods of pain control may be used. Hospice programs generally are home-based, but they sometimes provide services away from home in freestanding facilities, in nursing homes, or within hospitals. The philosophy of hospice is to provide support for the patient's

Routine home care is the first level of hospice care that is designed to let the patient have access to medical services in the comfort of their own home. This level of care is available when a patient 's condition or illness does not require around the clock support from a doctor or registered nurse. Although the patient is terminally ill, there pain and comfort level can be managed by family or friends.  Many supportive options can be used by the patient and their family at this stage to ensure quality of life. A religious representative or chaplain may make regular visits to the home and offer “spiritual guidance”. Social workers assist families in many ways during hospice care, some examples include; helping to find community and nonprofit organizations (support groups, meal assistance, etc), assistance with insurance issues and funeral planning or other end of life decisions. Nurses and physicians help to educate family members on pain management and keeping their loved ones comfortable. During this stage of hospice, a nurse makes regular scheduled visits and does not “stay” with the patient 24 hours a day. Medical equipment such as a special bed or other assistance items are supplied to the hospice patient as well as medications and special support services. With the ultimate goal of keeping the patient in their own comfort, not going back

During the dying process the hospice nurse cares for the patient and family by providing comprehensive and compassionate end-of-life care (EOL). Part of their caring includes recognition of when death is near and conveying that information to the patient and family. The nurse begins collaboration efforts, immediately, regarding the decision-making process and, at times, an ethics committee or palliative care team may be included. It’s important the hospice nurse maintain the role of an advocate and act in the patient’s best interest; sometimes what the family wants is not always what the patient wants. Other responsibilities of the nurse include addressing physiologic changes and realities of EOL care and death; and recognizing what, clinically, may or may not be accomplished (ANA Center for Ethics and Human Rights, 2016).

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

In reviewing the two studies I found, it is very clear there is a difference in quantitative and qualitative studies. To start, Lee et al. (2017) conducted a qualitative study in which the problem statement recognizes that end of life care (EOLC) in dementia patients is less than optimal when compared to cancer patients. The researchers aimed to determine what service managers and frontline staff at different facilities felt were the key aspects in improving EOLC in dementia patients (Lee et al., 2017). As a result, the researchers purpose was to contribute to the current evidence base on good EOLC and interventions to increase quality of care of end of life dementia patients.

Hospice is compassionate care provided to patients facing terminal illness or illness for which there is no cure. These patients are diagnosed with an illness from which they will never recover and usually have a life prognosis of six months or less (Hospice Foundation of America, 2014). The goal of hospice care is improving quality of life and managing the symptoms of disease and the dying process. The care hospice offers is focused on pain management and emotional and spiritual support for both the patient and family (National Hospice and Palliative Care Organization, 2012). Hospice care can be provided in many different settings, often the patient’s own home. Hospice care can also be provided in hospitals, nursing homes, long-term care facilities and free-standing hospice centers and is available to patients of all ages (NHPCO, 2012). A patient receiving care in a hospice program has a team of healthcare individuals that can consist of the patients own physician, nurses, home health aides, clergy, social workers, and speech and physical therapists (NHPCO, 2012). Usually, a care plan is developed by the hospice team and care of the patient is provided by family members with the support of the hospice staff (NHPCO, 2012). Nurses make regular visits to the patient and family and are on call 24/7. Once enrolled in a hospice program hospice covers everything that will be needed to care for you, from medications to manage pain to

This might be one reason why some patients choose conventional treatment instead of choosing a hospice program, there is many other factors that may contribute to this decision such as; financial status. This research will help give nurses a stronger knowledge base of characteristics and advantage of hospice care. In addition, nurses will be able to explain the advantages of Hospice programs to more of their patients, thus, they will be able to educate and encourage more families to choose hospice care. Not only will it help the patient live out a comfortable life it will also help the caregivers with

My perceptions have changed dramatically since the Clinical 1 rotation. I have noticed that the minute I walk into my patient’s room, I start to collect data. I notice if they are breathing normal, what their skin looks like, what their cognition level is, and what equipment they have in their room. I have started to connect the “puzzle pieces” of the patient’s health, rather than just feeling like I have a bunch of random information. My perception of people has continued to stay the same from Clinical 1. I continue to have an interest in learning about patients and believe that they also have something to teach us. I have learned so much from the patients and it is fun for me to get to know different

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

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.

Caring Hospice is a company that will provide nursing care to patients that are terminally ill. The ultimate goal is to insure the patient is kept as comfortable as possible while maintaining dignity during the dying process. This company will send registered nurses to the patient’s home for routine physical assessments, medication teaching and administration, education about terminal diseases and the dying process. The nursing staff will also create and maintain appropriate plans of care for the multi-disciplinary team to provide holistic care to the patient.

This research article indicates addressing the communication problems in a hospital setting between the doctors, nurses and any other medical team member since effective communication is paramount with end-of-life care. Having effective communication with the patient and patient’s family members will improve the overall satisfaction of care during a loved one’s end-of-life care. In a time of a health crisis, the patient and patient’s family members may not be sure of what is going on or what is to be expected. They may not have enough knowledge about their diagnosis or comprehend the meaning. In the research most family members felt they had unfilled communication needs, had feelings of being a burden, left abandoned, felt a lack of trust