During the past year, many health care workers have been worried when caring for patients at the end-of-life stage. Despite death is certain, it is a challenge to our society as well as to the medical services to withhold or stop resuscitation which is one of their responsibilities. Death remains as less pleasant topic and least talked about, but when our beloved one’s choice to die at home and order a DNR healthcare providers should respect and follow the patient and his/ her family last wishes especially if the patient condition is terminal and been through physical and emotional stress.
Thank you for the sharing of your personal experience. If I knew, the patient was dying, I would like to contact the patient’s loved one and allow them to have time say goodbye. Death is a process of life. We cannot avoid or run away from it. Therefore, ones need to learn the harmony of life. Grief is unavoidable during the death process. However, if we deal with it well, we can learn and obtain valuable experience on it. Life is sharing and love.
The importance of end of life issues and decisions are now being discussed at the time of admission to most acute care and long term acute care facilities. More attention is being placed on these specific decisions to ensure that the patient's
According to this article, in order for caregivers to provide a ‘good death’ to their love ones, they need the support of health care professionals. The health professional will help guide the experience, there are many factors that weigh in on this; the patient’s home might not be accessible for some cumbersome equipment that might be needed. They also need financial support because in some cases the machinery has to be rented. The comfort of the patient in most cases take precedent over all. The will of the patient wanting to do die at home in their bed provides an incentive to the caretaker to try their best to abide by the patient wishes.
Very often, deliberate decisions are made which results in the end of a life. For example, a person could be kept on life support, but instead, a family member or other significant person might choose to switch off the life support machine resulting in the official death of a patient. There is also the case that resuscitation of a patient may eventually prove to be trivial and a doctor might suggest just making the patient as comfortable as possible until their eventual passing. In the above situations, a medical professional’s decisions would not be questioned or doubted. It is conventional practice (Warnock and MacDonald 2008).
“The final moments of one’s life are difficult for everyone involved-the patient, loved ones, and even the healthcare provider” (Klein, 2005). If a patient’s final wishes regarding his/her care are undefined or not clear, then the situation could be worse or uncomfortable. During what should be a time of caring, mourning and supporting one another can quickly become overshadowed by ethical and legal battles. However, this can be prevented and avoided by the execution of advanced directives.
There are complex religious, moral, ethical and legal aspects associated with placing a DNR order. Most of the religions agree that God alone has the right to initiate and terminate life. But is it morally right to resuscitate someone who is at the end stage of life to survive a poor quality of life? When it comes to ethics as a health care providers are we following the principle of do no harm? is cardio pulmonary resuscitation always beneficial for the patient? More, if choices are to live with morbidity or to die with dignity you have to do what’s good for the patient. Lastly patient has the right to make decision about their own health, therefore respecting their wish to die is only fair.
1.1 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.
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
Some people think we can have an altered way of not applying the DNR order. Some people think that if a healthcare worker would apply the life- sustaining treatment the patient would have a better chance of fighting the condition or even feel better or happier. A physician is going to look at the goals of the patient and the family or whomever the caregiver is an help them achieve those goals or at least put them in the right direction towards
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.
There are many factors that play a role when caring for the seriously ill and the dying patient that can cause a patient to experience a good death or a bad death. According to the Institute of Medicine’s Committee, a good death is described as “one that is free from avoidable distress and suffering for patients, families, and caregivers; in general record with patients’ and families’ wishes; and reasonably consistent with clinical, cultural and ethical standards” (Lawhorne, 1999). However, a good death does not mean a perfect death or a problem free death, but is to respond to the patient physical needs, suffering, and to support the family that ensures a good death (Ferrell & Coyle, 2010). The purpose of this paper is to do a case analysis on the care of a patient who is facing death or has died. The Framework of a Good Death by Emanuel & Emanuel (1998) will also be incorporated into the case study analysis to evaluate whether a good death was achieved or not.
Usually either patients or families have the legal rights to determine what medical course to take with the patient when it comes to the diagnosis of death, in this case the family's conflict needs be considered. The healthcare staff involved in the patient’s care must communicate with the family members during this difficult time. If the patient is determined to be dead, the family will need support from the health care staff that has been involved in the patients care, all available hospital resources, including medical, nursing, social work, ethics, and pastoral care will be a good resource for the family members. Lawyers will usually advise health care staff to work with the family in the most compassionate way possible, the lawyers should be there to help with any conflict between the family members, and this will also help the organization against any future malpractice suits against the health care staff and organization.
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
This paper will explore what would entail “A good Death”. I will discuss Pain Control, No Excessive Treatment, Retention Of Decision Making By The Patient, Support For The Dying Patient And His/Her Family And Friends, Communication Among All Parties And Acts Done Out Of Love That Make Dying More Difficult.
A literature review conducted by Crowe (2017) examines the role of ICU nurses in providing high quality end of life care in the ICU. He states that palliative nursing in the ICU is de-emphasized due to an increased focus on curative treatment. Four major themes have been identified that contribute to the poor management of critically ill patients needing palliative support. These themes include decision-making challenges, barriers, obtaining support and formation of guidelines to effectively implement comfort care therapies. Hence, a checklist has been developed to allow nurses to properly facilitate the provision of quality care to patients experiencing the end of life, as well as giving needed