End Of Life Care

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.

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

In the beginning there was a hornless bull, and his wife the majestic unicorn who was pregnant with bull’s first born child. As the days got longer, the unicorn grew restless as she was longing to give birth to her baby Bullcorn. Bullcorn will be one of the few longhorn bulls in the world. He would soon grow up to worship his father the hornless bull in the endless battle to try to win back his father’s magical horns that he lost to the evil sharkdog, who wants to claim all the magical powers from Bullcorn’s hornless father. The sharkdog also plans on taking all the magic from his mother as well.

In my nursing practice, I frequently care for dying patients. Instead of simply providing medication to ease pain during the dying process, I wanted to learn about ways to enhance the comfort of the dying patients and possibly assist their family during a difficult time. This desire led me to examine the conceptual model of comfort. Through my research of the concept of comfort care at end of life, I discovered Katherine Kolcaba’s theory of comfort. I found her theory to be useful in describing the concept of comfort care and decided to further analyze it for a more thorough understanding of its usefulness and applicability to nursing practice. Nurses are the ones in direct contact with their patients, providing relief from certain discomforts, continuously assessing, monitoring and providing care that will ensure the patient is at ease. According to Kolcaba, “Comfort is the desirable state that nurses would want for their patients.” (Kolcaba, 2003). With its fundamental emphasis on physical, psychospiritual, sociocultural, and environmental aspects of comfort, the Theory of Comfort care will contribute to a proactive and multifaceted approach to care. This paper aims to describe the origin of Comfort Theory, its primary concepts and relational statements, review of the literature, critique describing its strength and limitation as a middle range theory

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

Planning for end of life care for a loved one can be a very difficult process for some families. Knowing that you are going to lose a loved one and planning for how they will be taken care of can be quite stressful. End of life planning can be used in two different scenarios one of which is for terminally ill patients and the other is for the aging and elderly. Planning for end of life care can be quite expensive with all of the doctor visits and counseling’s. In Obama’s Affordable Care Act there is some hope for the elderly for paying for some of these expenses.

If a family member was terminally ill everyone would be very supportive on that persons wishes, but there comes a point where a person dying and suffering can be very unbearable to watch for that patients’ family. Medicine today is very expensive and sometimes too much for that patients’ family. Being a mentally stable patient knowing that you are going to die within a few months, and everyday towards the “end-of-life” the bills will start to sky rocket. “The cost of maintaining [a person dying] has been estimated as ranging from about two thousand to ten thousand dollars a month” (Dworkin 187). Of course the family will do anything that they can to save their loved ones, but only to be in financial debt after their loved one passes. The author of Life’s Dominion, Ronald Dworkin states that, “many people want to save their relatives the expense of keeping them pointlessly alive”(193). This is a great example of the financial burden that relative will go through just to prolong their loved ones life. These terminally ill patients’ have accepted the fact that they are going to die and would like to end their lives in the most peaceful way as possible. So, if a terminally ill individual decides that PAS is the route they want to take, it will easy their families’ financial burdens as well as their own personal

The setting in which a patient prefers end of life care is a specific choice that is left to the patient and/or their family to decide as well as the decision to pursue hospice care via a physician’s referral. Many people think that hospice is a certain place, however, hospice care can be provided in hospice care facilities, some hospitals, as well as at home. The decision between hospice care provided at home versus hospice care in the hospital setting is a difficult decision to make at the time of tragedy. However, seeking these services early will help the family be able to receive more available care and support (Nemours Foundation, n.d).

The purpose of this paper is to examine communication strategies related to palliative and end-of-life care with a focus on Aboriginal clients. Firstly, I will explain the role of cultural competence in the nursing care of an Aboriginal client. Secondly, I will argue the cultural challenges a nurse may face when caring and communicating with Aboriginal clients receiving palliative end-of-life care. Thirdly, I will present solutions to the aforementioned communicative challenges. Lastly, I will discuss the impact I believe this experience may have on my future practice.

Pew Research Center (2013) data indicates that 35% of Americans state that their wishes would be for a provider to do everything possible to preserve their life even with no hope for improvement and tremendous pain. This trend of sedentary lifestyles combined with poor health behaviors and death denying cultural attitudes must be addressed. The end of life care that we will all be faced with at some point currently accounts for a vast amount of resources, the majority of which are spent in the final months of care (Klinger, in der Schmitten, & Marckmann,

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

Holli, I also learned a lot about Medicare from watching the accompanying media two videos. I found the end of life care issues on the video interesting also. I could see the doctor's point of the extreme measures of treatment some patients were being given in end-of-life care, but I had to disagree with him on making it into a blanket coverage of stopping care after certain ages or medical conditions. I think that it needs to continue to be decided on a patient by patient basis because each individual's health condition is unique. I agree with you that if treatment is shown to be no longer of benefit to the patient, then it should no longer be covered by

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

I often find myself searching for ways to increase efficiency and effectiveness in my professional environment. When instructed to increase education about advance directives and end of life planning by leadership, I immediately approached this from a group perspective. I coordinated with Chaplain Services at the James Quillen VA and began leading a group focused on VA Form 10-0137 and end of life planning. Each page of the 5 page form was reviewed with every Veteran, questions were answered, and the Veteran’s personal experience with end of life planning were discussed. Afterward, Veterans wanting to complete the form remained and were given one-on-one assistance with completing the form. In one month, we educated approximately 48 Veterans,

In today’s world the cost for medical attention and health insurance has increased to the point that it may cause a significant amount of strain to a family of a terminally ill patient. The health insurance issues have become large enough to attract the attention of the political world. We are now witnessing how difficult it has been for Health Care