Unit 332 Support Individuals in End of Life Care

Bauer-Wu, S., Barrett, R., & Yeager, K. (2007). Spiritual perspectives and practices at the end-of-life: A review of the major world religions and application to palliative care. Indian Journal of Palliative Care Indian J Palliat Care, 13(2), 53. doi:10.4103/0973-1075.38900

Nurses: Assist the patients and families to cope with the end-of-life process such as assessing and

According to the National Hospice and Palliative Care organization, in 2011, an estimated 1.651 million patients received services from hospice care, while 1,059,000 patients passed away from this form of care in the same year (NHPCO pdf, 2012). Hospice end of life cares mission/goal is to provide compassionate care for patients and their families who are living with a life limiting illness. This type of medical service gives expert medical care, pain management, and emotional and spiritual support (NHPCO, 2016). End of life care is beneficial for ones well being while they are passing away. Giving someone a peaceful and warm environment to spend their final life moments in. This form of end of life care is something that most people can relate to as many friends and family members have gone through this process. Hospice care is delivered to many patients, residents, and in general people all around the world, having many factors that go into hospice such as the requirements to receive hospice, the care team and the levels of care one receives, all of these factors are extremely important when it comes to the care for one’s life, family member, or friend.

Whenever the topic of death arises, at least in American culture, it is treated with special care and caution. We unofficially and yet unanimously treat death as a taboo. Not many people enjoy talking about death or the potential of their deaths. People tend only to discuss death when buying life insurance or creating a will. Other than this, details about the aftermath of their death are never discussed until they are on their deathbed. This practice leaves few seconds for loved ones to collect thoughts and explain their last

Different cultures and religions have many different customs and rituals. In Islam it is common practice for women to be covered from head to toe. In Tibetan Buddhism it is common for devotees to practice asceticism. In Hopi culture and religious tradition food and sex play large and important roles, although in different situations the roles may be completely opposite.

Allen believes that paternalistic secrecy was a major feature in health care, but the ideas of patient autonomy and informed consent do not happen. Health care is changing from the doctor is always right, to asking questions about care and making decisions with the health care team. He does maintain that in some cultures, this is tolerable, and wanted by patients, as it is what they know and seek conform in this method. The family can take care of them as the patient is ill and will prepare for the end of life care. Allen does go on to state that if deception is wrong, then lying about medical treatment and prognosis is unethical (Allen, 2015).

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

Death is something that everyone talks about daily, but the most important thing that people do talk about when someone is deceased is whether he or she wanted a religious burial. While many similarities exist between different religions, the beliefs and rituals surrounding death in the Hindu and Jewish religions vary greatly. The Jewish community and the Hindu community play important roles in the death of their deceased loved ones. Upon the death of a loved one, Hindu people believe that the ashes or remains must be scattered, preferably on water, while the Jewish faith strictly believes that all deceased people must have a tombstone to mark their permanent resting place. Hindu people believe in reincarnation, or life after death, while

1. We have the responsibility to tell the truth because it creates trust between human beings. I think professionals in the field today might have second thoughts about telling the whole truth to a patient in fear that the news might cause them more distress than it would help them. They might be acting with the best of intentions. But, I think that it violates the ethical code A.9.a. Quality of Care “to be given every opportunity possible to engage in informed decision making regarding their end-of-life care.” If professionals do not share all of the information with the client then the client is unable to make a well informed decision about his own decision making. I think the risk for me would be if I withheld a vital piece of information from my client and he made a life altering decision, like to have treatment or not. He might decide not to take a lifesaving course of action and could pass on. It might not only be an ethical issue, but, how would I feel if I felt I was reasonable for another human beings death? I bet the feeling would be guilt!

End of life care does not just begin at the end as the name suggests, but it is the care a person receives once they have accepted the prognosis of a rapidly approaching end. The elderly population with multiple comorbidities may be “living, and dying” at the same time. This was a new idea brought about by this very class; The patient may be living with one or more chronic illnesses and may require a lot of assistance and care for days, weeks, and sometimes even months leading up to their death. The continuity of care is even more pertinent at this late stage in life. Continuity of care is, at its most basic of definitions, the quality of care over time. Establishing continuity of care is based on promotion continuous, caring relationships between patients and healthcare providers. It also includes ensuring a safe, coordinated transition of patients between healthcare environments, either from

shame , insecurity, blame, inadequacy and again anxiety. If the deceased was terminally ill the

“It is important for all staff to know what it is that the person has asked for” when dealing with patients under end-of-life care (Sander, 2014, p.96). Sander (2014) suggests that staff must first consider the wishes of the person who is dying over the family wishes. Once the patient’s wishes are considered first, then the staff can focus on the family who will be affected by the treatment and care of their loved one (Sander, 2014). After first looking to the patient’s wishes and then family wishes, the staff must consider staff and other residents’ experiences (Sander, 2014). Considering all those factors in that order promotes what Sander (2014) calls a good death. The administrator should have spoken to both Ann and John. Both are trusted persons of interest that Mrs. Smith established during her competent days. Both health proxy and durable power of attorney are important decisions makers. The health proxy makes healthcare decisions for incompetent patients (Pereira, 2013). Durable power of attorney assists communications between medical team and family members (Pereira, 2013). This assures there is respect for the patient’s values and expressed wishes (Pereira, 2013). The administrator did not value the patient’s wish. The administrator did not utilize Mrs. Smith’s trusted

Nurses have been at the bedside of the dying since the beginning of the profession. At any given time a nurse may face someone in the last stages of life, whether they are newly diagnosed with a terminal illness, currently fighting a terminal illness, in a traumatic accident, etc. Since end of life care has been a controversial issue, many laws have been enacted to protect health care professionals and to respect the wishes of the patient. End-of-life choices are a quality of life issue. Nurses, individually and collectively, have an obligation to provide comprehensive and compassionate end-of-life care, including the promotion of comfort, relief of pain, and support for patients, families, and their surrogates when a decision has been made

Todays taking care of patients is increasing, especially, those who their life are close to the end. So, we should concern about the last stage of their life and how we could make their wishes come true.

Finally, from the Socio-Cultural perspective, our country is fast moving towards being a more culturally and ethnically diverse country, and Whites are estimated make up less than thirty precent of the population by 2040 (Frey, 2014). These diverse cultures and ethnicity differences influence peoples’ thoughts about death. Usually, cultures determines people’s choices for life support and whether they want to know a terminal diagnosis, die at home, in a hospice, or in the hospital, and whether they only want to promote quality in EoL. Interestingly, talking about death is even a taboo in some cultures because it may