...would prefer to die at home, yet only about one-third of adults have an advance directive expressing their wishes for end-of-life care. Among those 60 and older, that number rises to about half of older adults completing a directive. The last 20 years have seen a significant shift in location of death from the community to hospitals and care homes. Those aged over 85 years account for the biggest rise in hospital and care-home deaths. Barriers to advance care planning include, • Lack of awareness: While advance directives are supported by state laws, there is still no clear process to allow an individual’s wishes to be known and ensure that care is tied to those documents. • Denial: A key part of the problem is our society’s denial of death and dying, and of being in a circumstance in which we are unable to make our own decisions and speak for ourselves • Confusion: Concern that emphasizing palliative and end-of-life care options could interfere with doing whatever it takes to help patients extend their lives as long as possible. • Cultural Differences: The majority of Medicare beneficiaries of all racial and ethnic groups say that in the event of a terminal illness with less than a year to live, they would want to die at home and would not want to receive life-prolonging drugs with uncomfortable side effects or mechanical ventilation to extend their life for a week or a month Among community-dwelling Medicare beneficiaries age 65 or older: • Blacks (18 percent) were...
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...End of Life Care Student’s Name Institution End of Life Care The cause for the trend of majority of elderly people not dying in their own homes as their preference is NHS failings, incorporating a scarcity of health visitors, which ensues in the desires of the elderly persons being ignored or not adhered to. Owing to poor co-ordination of social and health care services for the dying, the preferences of the individuals nearing death frequently go unidentified, and in instances where the preference to die at home is clearly stated, it frequently cannot be met (Rensbergen, Nawrot, Hecke, & Nemery, 2006). The social and healthcare providers conventionally offer low priority to end-of-life care as is evident in the lack of adequate training among significant staff. Another reason encompasses social-contextual elements. Gender, living status, and age are predictors of the location of death; however, the implant of a nursing home in a domestic community is the fundamental factor (Rensbergen, Nawrot, Hecke, & Nemery, 2006). As a nurse, to support clients in end-of-life care, and in reinforcing their preferences, one can come up with creative partnerships with healthcare professionals, patients, policy developers, and others to ascertain that care of the dying is prioritized. Moreover, one can record the comprehensive requirements of dying patients and families and taking note of individual, organizational, professional, and societal hindrances to quality end-of-life care...
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...After watching two videos and reading an article, “Death with dignity” is about chronic and terminal patients, who are diagnosed six or fewer months to live, allow to have personal choices of stop suffering and start dying in their own hands anytime they want by taking “death pills”. Moreover, those patients think and believe that it is important for them to have the rights to choose the way they live and die and people should honor and respect their choices. End of life care is care happening when patient has diagnosed only few months to live. Palliative care is care focusing on improving the patient’s quality of life and care when patients have chronic and terminal illness. (Admin, 2011) Under palliative and end of life care, patients...
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...EVALUATION Current Business Research Project Reporting Characteristics of Cancer Pain: A Systematic Review and Quantitative Analysis of Research Publications in Palliative Care Journals by Senthil P. Kumar used descriptive methods of research to discover the number of research journals of the pain experienced in cancer patients toward the end of life. The research delved into the end-of-life care journals published from 19 facilities from 2009 – 2010 (Kumar, 2011). The study involved finding the percentage of research journals for end-of- life cancer patients’ pain in comparison to actual number of research findings. The data collection methods involved a search of Journals that had terms such as hospice, end-of-life, supportive, and palliative in the titles (Kumar, 2011). A total of 19 journals included in the study, which had a total of 2600 articles researched in the study. The studies uncovered articles concerning cancer pain, of which most were categorized into ‘original articles’ and ‘review articles’. Original articles were separated to studies of quality and also of quantity. Quantitative studies were grouped according to the study designs. Once the findings of the number of articles study designs were computed, the total number of journals pertaining to end-of-life pain of cancer patients was determined. Later categorization of articles were sort into groups such as those related mostly to cancer pain, articles with studies related to pain...
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...what does this tell us? There is a high volume of chronic disease patients that may benefit from Hospice for end of life care. In 2015, 1, 381, 182 Medicare beneficiaries were enrolled in hospice (National Hospice and Palliative Care Organization, 2016). Hospice was designed to improve the experience of dying for the patient with the help of interprofessional care. The design also included improving the healthcare costs associated with the end of life (Stevenson, 2012). Eligibility for hospice is based on a physician documented life expectancy of six months or less. There are four levels of care are covered under the Medicare benefit for hospice. These include in home care, general inpatient care which covers symptom management such as pain control, continuous care,...
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...Culturally sensitive care is essential in caring diverse patient population in any kind of healthcare settings. Oncology nurses are in forefront to implement cultural, spiritual and religious compassionate care while caring terminally ill and end-of-life care. Nursing practice to meet the needs of the patients, families and community, require the culturally competent nurses who can reflect sensitivity, knowledge and skills to bring positive outcomes. Although we are able to coordinate with our patients and family requirements broadly to satisfy their basic needs in the unit, further conceptual approach is essential. Ethical committees are on board to regularize the activities of the healthcare professional for understanding and providing supportive care concerning health, illness, death and dying, grief and bereavement the preferences varied in certain situations (Halm et al., 2012, p.337). For example, decision making in life sustaining measures are seems to be complicated until unless it had been decided earlier with poor prognosis of the illness with help of socio-cultural interprofessionals intervention....
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...The Comfort Care Concept at End of Life Introduction End of life is a concept that is often ignored despite the fact that everyone will die some day. It is because death is a part of life that people are familiar with comfort care given at the end of life. Comfort care is offered when someone is dying, and when the end is predictable. Comfort care is an essential part of nursing care at the end of life. It is care that helps or soothes a person who is dying. The goal is to prevent or relieve suffering as much as possible while respecting the dying person’s wishes (NIH, 2012). The goal of comfort care in nursing is the immediate state of being strengthened by having the needs for relief, ease, and transcendence addressed in the four contexts of holistic human experience: physical, psychospiritual, sociocultural, and environmental (Kolcaba, 2010). I have worked in the oncology field of nursing for 16 years and have seen several patients go through the end-of-life process. I have seen the better outcome of the dyeing process take place, this is when all four holistic human aspects are met, but sadly I have also seen a few complete the process without having one or more of the holistic context met. I must emphasize that delivering exceptional nursing comfort care to the patients who are in their final days or even hours prior to death, is just as vitally important as delivering critical care to the acutely or critically ill patients. The purpose of this paper is to evaluate...
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...The Schiavo Perspective on End-Of-Life Care The Schiavo case showed that most Americans believe that end-of-life issues should not be decided by politicians. ABSTRACT: Americans have reached consensus that (1) people have a right to refuse lifesustaining medical interventions, and (2) interventions that can be terminated include artificial nutrition and hydration. The one unresolved issue is how to decide for mentally incompetent patients. Only about 20 percent of Americans have completed living wills, and data show that family members are poor at predicting patients’ wishes for life-sustaining care. But despite court cases and national consensus that these are private and not legislative matters, the Schiavo case is unlikely to change practices except to increase the number of Americans who complete living wills. Remember 197 6? That was the year the United States was engaged in the case of Karen Ann Quinlan, the first so-called right-to-die case.1 When Quinlan was twenty-one years old, she ceased breathing for two fifteen-minute periods while at a party. In the emergency room her pupils were nonreactive, and she was unresponsive to deep pain stimuli. She was placed on a respirator, and a year later she was respiratordependent, in a persistent vegetative state, and receiving nutrition through a feeding tube. After consulting his priest, Quinlan’s father requested that the respirator be discontinued, but her physician refused, and a series of court cases ensued...
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...End-of-life care, and making medical treatment decisions is a complex and emotionally charged topic that APRNs must be knowledgeable about. It is essential that APRNs are familiar and comfortable with taking a Values History, as this form can ethically assist patients and assist them in making well-informed decisions that are in accordance with personal preferences and values. Similar to the Values History, Fischer, Min, Sauaia, & Kutner (2012) highlight the fact that advanced directives may include various documents, including a “broader more comprehensive document outlining goals, values, and preferences for care in the event of decisional incapacity” (p. 3). Questions from various areas of a patient’s life are addressed with this tool; therefore I believe this form is an excellent way to explore personal feelings and attitudes that patients may not have taken the time to think about. However, after reviewing the Values History form, my concern is that it is not a legal document. It would be...
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...Ella’s end of life care: Outline Gurbani Virk SOC313: Social Implications of Medical Issues (CGF1516A) Instructor: Mark Mussmann Date submitted: May 4, 2015 Introductory Paragraph Miller family is filled with traditions, diversity and cultural values. In the scenario, Grandma Ella has been experiencing various issues with regard to having alternative treatments and medicines. Ella’s decision is hugely influenced by her cultural and traditional expectations that may influence directly or indirectly on the care given to her in her end of life days. In addition to that, there are other systems like micro, mezzo, and macro influences affecting Ella and her family members due to her medical condition of having cancer for more than 10 years and its prognosis. The debate is over whether Grandma Ella would have advantages or disadvantages by receiving end of life care at a hospital setting or hospice and palliative care will be given for her at home. As a social worker, I have a big responsibility for deciding on Ella’s treatment plans which may get affected by her other family members who have to take care of their own medical and personal problems. Outline I. Introduction A. Background Information 1. Grandmother Ella’s condition has significant implications on her life and the lives of other family members 2. Cultural and traditional issues, context of health care setting as well as psychological and social issues affect decisions on privilege of care given ...
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...exploring perceptions of reiki therapy in end-of-life care amongst nursing students. Some people do not believe reiki to be an effective form of therapy, or may not even know what reiki is to begin with. I am curious to research how much nursing students know about reiki and to what extent they believe it is effective in end-of-life care. Caring for patients at the end of life is a special kind of nursing, as nursing skills and priorities may contrast from those regularly seen in typical medical-surgical settings. Reiki helps people and animals transition from their bodies with grace and ease....
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...We often spend our lives living in the moment instead of preparing for the future. Many people do not consider that they will grow old and may require extensive healthcare needs in their elder age. For many, Medicare assumes the responsibility for the payment of their end of life care. Every employed citizen that pays taxes is contributing to the Medicare fund. Therefore, Medicare should continue to pay for the end of life treatment for patients. Needless to say there should be procedures and regulations in effect to reduce the amount of spending on end of life care. Physicians should not order test and procedures that are not beneficial to extending the patient’s life or improving their quality of life. Physicians are preying on the aging...
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...Discrete Structure To be submitted to: Mr. Roger Intong Faculty BITE DEPARTMENT CATHERINE PIANO BSIT2 DESIGN * ------------------------------------------------- Device type: * Tablet * ------------------------------------------------- OS: * Windows (8) * ------------------------------------------------- Dimensions: * 11.97 x 7.46 x 0.39 inches (304 x 189.4 x 9.9 mm) * Weight: * 26.46 oz (750 g) the average is 17.4 oz (496 g) DISPLAY * ------------------------------------------------- Physical size: * 11.6 inches * ------------------------------------------------- Resolution: * 1366 x 768 pixels * ------------------------------------------------- Pixel density: * 135 ppi * ------------------------------------------------- Technology: * LCD * ------------------------------------------------- Colors: * 16 777 216 * ------------------------------------------------- Touchscreen: * Multi-touch * Features: * Light sensor MULTIMEDIA * ------------------------------------------------- Music player: * Filter by: * Album, Artist * Features: * Album art cover, Background playback * Speakers: * Stereo speakers TECHNOLOGY * Data: * LTE, HSPA (unspecified) OTHER FEATURES * ------------------------------------------------- Sensors: * Accelerometer * Voice recording ...
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...Terminally Ill Patients' and End of Life Care: A Multidisciplinary Concept Analysis Jennifer Thompson UTA Analysis of Theories in Nursing Nurs 5327 Ronda Mintz-Binder, RN, MSN, DNP April 19, 2014 Terminally Ill Patients' and End of Life Care: A Multidisciplinary Concept Analysis With an aging population in our country we are facing an increasing number of patients’ that are coming to the end of their lives and are presenting with terminal illness. As life expectancy increases we are seeing more and more patent that are 65 year old and older in need of end of life care. Research and medical developments have provided a vast array of treatment options available to our patients’. After patients’ have exhausted all available treatment options for their disease processes they face the reality that their life is coming to an end. Patients’ near the end choose between quality of life over quantity of life. One service available to terminal patients’ is hospice care which offers palliative care to patients’ at the end of life. Health care providers must be able to face and appropriately care for patients’ with terminal illness and end of life care. At times it may be difficult for health care providers to face or present the truth to a patient that further treatment is futile and end of life care would be appropriate. Advanced practice nurses’ will face terminal illness and it is required of them to be able to sufficiently treat, manage, and discuss end of life care with these patients...
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...Dying in a Hospital Setting Elizabeth Allegro Aspen University Abstract Acute hospitals play a significant role in end of life care, it is the place where most people die. Evidence suggests that end of life care in hospitals needs improvement. The purpose of this paper was to investigate patient and family experiences of hospital death, the weaknesses within the hospital setting and possible solutions to improve. A literature search identified common themes, these included: * Hospitals are seen as a place of treatment and cure; death may be viewed as a failure. * Good communication between physician and patient is vital for a patient to make an informed choice regarding their care. * Patients may not receive palliative care if end of life is diagnosed too late. * A lack of resources such as short staffing contributes to suboptimal end of life care. Dying in a Hospital Setting Most Americans die in hospitals; many suffer unnecessarily due to the lack of knowledge about end of life care. Some patients receive aggressive treatments up until the time of death. Patients often suffer in vain attempts to prolong life instead of receiving compassionate, comfort care. Death is part of life, sooner or later everyone will face death. It would be easier if one was prepared for it. Communication is important to prepare for death. There is often an expectation of a cure when a patient is hospitalized;...
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