how to provide the best possible holistic end of life care

 

 

 

Write an essay to explain how to provide the best possible holistic end of life care to a person while managing your own personal values and beliefs and how they affect your interaction with a patient.

 

PALLATIVE AN END OF LIFE CARE

Palliative care is considered as a specialized category of medical care targeted to the patients who are suffering from serious illness. The care of this category gives importance on providing the people with serious illness with some relief. The serious illness often comes with huge amount of stress for the patients. The aim of palliative care includes providing the patients with relief from such illness. The palliative care not only improves quality of life for the patient , but it also improves the quality of life for the family members as well. The palliative care is usually provided by a team of multidisciplinary health care professionals. The team offering palliative care to the patients often includes the doctors, nurses and other specialists. In other words, the patients suffering from serious illness face several issues and need extra care. The professionals in the group of palliative care work with the doctors to provide patients with the additional care. Even sometimes, the palliative care is provided with the curative treatment in order to ensure overall well being of the patient.
The end of life care is one of the most crucial aspects of the palliative care. The patients suffering from terminal diseases also need extra care to get rid of the pain and also for improving quality of the life. The right palliative care techniques can help these patients to reduce their suffering and lead a happier life. 
The end of life care varies with the personal values and beliefs of the individuals. Therefore , the need of end of life care also varies with the individuals. The current essay deals with analysis on the end of life care and palliative care for the patients suffering from serious illness. The essay also includes discussion on how the nurses can provide better palliative and end of life care services to the patients . The facts of how personal beliefs , values and culture of nurses shape the way of providing the end of care or palliative care approaches are discussed in the essay.
 The end of life care is applicable for the patients suffering from terminal diseases. The end of life care focuses on the concept that death should be viewed as an integral part of life; it is a natural incident and is inevitable (Brinkman-Stoppelenburg et al.2014). However, it is necessary to ensure that a person, at the last stage of life receives care and support from the family members and the health care provider so that the final stage becomes peaceful and comfortable. Although in end of life care, death is considered natural, the care is based on the principle, that the final stage of one’s life is equally important as the other stages are (Wright et al.2014; Hui et al.2014). The needs of an individual should be met at the final stage of the life also just like the needs were fulfilled at the other stages of the life. So, goal of the nurses providing end of care support to the individuals is, ensuring that quality of the life of a dying person is maintained. It is also ensured that the spiritual and psychological needs of a person are also fulfilled at the final stage of the life (Goldberg et al.2018). Another aim of the end of life care is protecting individuality of the persons to make the days more comfortable. The terminal diseases often come with the burdensome treatment interventions. The end of life care also focuses on providing the patients with the choice of selecting their medical interventions, if possible.
The end of life care mainly aims at addressing few needs of the patients for reducing pain of the disease. The factors which are given the most importance in the end of life care are –

Managing the pain and symptom of diseases: 

One of the primary goals of the end of life care is, reducing the symptoms of diseases and the pain among the patients. It is the most important stage of making the last phase of the patient’s life more comfortable. The end of life care of the cancer patients can be considered as a prominent example in this case. The cancer patients at the last stage of their disease often experiences intense pain and suffering (Wright et al.2016). Along with continuing other medical interventions, the nurses should give more importance on reducing pain among these patients. Use of right = tools and medicines for pain management is the factor that gets the most attention from the health care professionals for these patients.

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Preparing to accept the end of life:

The death is an obvious outcome of the patients suffering from the terminal diseases. Therefore, an individual after being diagnosed with the terminal disease needs to be mentally prepared for accepting the death. The end of life nurses should also focus on convincing an individual to accept death as the natural art of the life (Virdun et al.2015).

Improving the relationship between the patient, healthcare service providers and the family members:

Improving the relationship with the family members, health care service providers are another important part for making the last days of an individual highly comfortable. So, the nurses dealing with end of life care also give importance on improving relation with all the parties involved with the patient to make the last phase more enjoyable (Halpern, 2015). However, the sympathy and care of the nurses play a vital role in this case to improve the relation of patient with the family members and the health care service providers and improve quality of the life.

Helping the patient to achieve a sense of completion:

Achieving satisfaction is another crucial factor for the end of life care. The nurses should focus on attaining satisfaction of both the patient and the family. The end of life care should be personalized, easily accessible and should involve high quality communication (Combs et al.2015). The end of life care also focuses on providing the patients with adequate support for decision making.
 The nurses providing end of life care to the patients should focus on fostering skillful communication among the patients and the family members. With the quality communication only, the nurses can address concerns of the patients and their families (Hui et al.2015). Understanding the requirement of patients and their families is also important for providing the end of life care. Quality communication from the nurses also helps the professionals to identify and address their needs. 
The nurses should understand that the person who is suffering from the terminal disease is dying imminently. Therefore, it is necessary for the nurses to ensure that the person and the family is getting the optimum comfort and satisfaction. Shared decision making is important for all the treatment process. However, shared decision making is even more important for the persons suffering from terminal disease (Walczak et al.2015). Carrying out the complex medical interventions can affect comfort of such patients. Therefore, before undertaking any such treatment, the nurses need to focus on informing the patients about the treatment process and their effects on the patients’ health. 
The current discussion on the end of life care indicates that the nurses should have sympathy and a focus on care to provide the dying patients with the optimum comfort. However , the nurse should give focus on using quality communication to understand need of the patients and address those.

References:

Brinkman-Stoppelenburg, A., Rietjens, J. A., & van der Heide, A. (2014). The effects of advance care planning on end-of-life care: a systematic review. Palliative medicine, 28(8), 1000-1025.
Combs, S. A., Culp, S., Matlock, D. D., Kutner, J. S., Holley, J. L., & Moss, A. H. (2015). Update on end-of-life care training during nephrology fellowship: a cross-sectional national survey of fellows. American Journal of Kidney Diseases, 65(2), 233-239.
Goldberg, J., Goldman, D., McCaskey, S., Koo, D., & Epstein, A. (2018). Illness Understanding, Prognostic Awareness and End of Life Care after Drainage Percutaneous Endoscopic Gastrostomy for Malignant Bowel Obstruction in Metastatic Gastrointestinal Cancer (FR481C). Journal of Pain and Symptom Management, 55(2), 633.
Halpern, S. D. (2015). Toward evidence-based end-of-life care. New England Journal of Medicine, 373(21), 2001-2003.
Hui, D., Didwaniya, N., Vidal, M., Shin, S. H., Chisholm, G., Roquemore, J., & Bruera, E. (2014). Quality of end?of?life care in patients with hematologic malignancies: A retrospective cohort study. Cancer, 120(10), 1572-1578.
Hui, D., Kim, S. H., Roquemore, J., Dev, R., Chisholm, G., & Bruera, E. (2014). Impact of timing and setting of palliative care referral on quality of end?of?life care in cancer patients. Cancer, 120(11), 1743-1749.
Virdun, C., Luckett, T., Davidson, P. M., & Phillips, J. (2015). Dying in the hospital setting: A systematic review of quantitative studies identifying the elements of end-of-life care that patients and their families rank as being most important. Palliative medicine, 29(9), 774-796.
Walczak, A., Henselmans, I., Tattersall, M. H., Clayton, J. M., Davidson, P. M., Young, J., ... & Butow, P. N. (2015). A qualitative analysis of responses to a question prompt list and prognosis and end?of?life care discussion prompts delivered in a communication support program. Psycho?Oncology, 24(3), 287-293.
Wright, A. A., Keating, N. L., Ayanian, J. Z., Chrischilles, E. A., Kahn, K. L., Ritchie, C. S., ... & Landrum, M. B. (2016). Family perspectives on aggressive cancer care near the end of life. Jama, 315(3), 284-292.
Wright, A. A., Zhang, B., Keating, N. L., Weeks, J. C., & Prigerson, H. G. (2014). Associations between palliative chemotherapy and adult cancer patients’ end of life care and place of death: prospective cohort study. BMJ, 348, g1219.

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