The Institute of Medicine (IOM) September 2014 Report brief- Dying in America: Improving Quality and Honoring Individual Preferences near the End of Life addresses several necessities regarding end-of life (EOL) care. These necessities include; the needs and opportunities for improving EOL care, delivery of patient-centered and family-oriented care, clinician-patient communication and advance care planning, professional education and development, public education and engagement, as well as policies and payment systems to support high-quality EOL care. Taking care of the family and the patients near the end of life requires professional commitment and responsibility from all health care professionals including clinicians, clergy, caregivers, and support staff. The health system managers, payers, and policy makers also have obligation to make sure that EOL care is compassionate, affordable, sustainable, and high quality as possible. The IOM report point out that there has been a broad improvements towards the …show more content…
The APN as part of EOL health care team should be aware of the ethical issues that may arise in EOL care. According to Fromme and Smith (2014), ethical issues in EOL arises due to concerns about how much and what kind of care should a patient with a limited life expectancy gets. The APN should apply the principalism framework while providing EOL care which is guided by four medical ethics principles: respect for autonomy, beneficence, non-maleficence, and justice. They should be prepared for conflicts that may arise with surrogate decision makers since these decision may greatly affect the care the patient receives. The goal should focus on respecting the patient’s wishes and values (Fromme, & Smith,
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.
.“As medical technology continues to advance and health care choices become more complicated, the preservation of end-of-life autonomy is an increasingly important issue faced by various client populations.” (Galambos, 1998).
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
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
Change is always vital to progress and the field of nursing is constantly in change. The world that we live in today is creating a higher need for more nurses, changing the way that nurses are educated and creating new approaches to utilize nurses out in the field. On October 5th, 2010, the Institute of Medicine (IOM) released the report “The Future of Nursing: Leading Change, Advancing Health.” The report elaborates on the need for the nursing profession to prepare for the changes that are occurring due to the health care reform and the current
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.
The United States Health care system is in the mist of converting to a preventative, health management focus system from a treatment focused system. There has been plenty of benefits and trials during the transformative period, like as with any other changes. The Institute of Medicine (IOM) requested that a report be done that would bring clarity to and direct the nursing profession on their parts and conversions that nursing is going to face. In this essay the IOM report that was completed by the Robert Wood Johnson Foundation (RWJF) on the future of nursing will be explored. There will be discussion of
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
End of life issues involving education on palliative care and hospice; are these issues important to you and your loved ones? The purpose of this paper is to discuss end of life care and how the legislative process affects this important topic. As the American population keeps growing, so does the amount of an aging population. Is the amount of training and education in nursing school sufficient for palliative care and hospice? Do we need to provide more training to the medical field to help support the growing need for end of life care? At some point in our careers we might be faced with helping someone in their final days. Being educated and having the ability to provide appropriate care is part of our scope of practice. (American Nurses Association, 2010, pp.1-2)
with recommendations for changes needed in nursing. This was a response for the need to assess
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).
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 individual as a whole but also an understanding of the
A person’s life can end at any age. They can depart quickly or slowly. End of life care, also known as palliative care, is the care of patients that are not only in their final hours or days but the patients with a terminal illness that has become incurable. End of life care takes into mind what the patient desires so it is recommended that they consider an advanced care plan also known as an advance directive and living will. These documents allow the patient to formulate decisions on the future of their care if, at any point, they cannot vocally express themselves.
Quality of Life and Functioning for End of Life Care. HAT2 Community Health Nursing. Western Governors University.