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End of Life

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End-of-life care becomes an issue at some point for elderly clients. Even with the emergence of palliative care programs and hospice programs, the majority of elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your clients in end-of-life care and in supporting their desires. Support your response with evidence-based literature.

Many palliative care patients would prefer to receive care, and to die, at home. Despite of this, many die in institutions. The need for the healthcare provider to discuss plans for discharge with most inpatients reinforces expectations of a choice of place of care. However, many palliative patients do not have a choice of care at home. A significant proportion of patients experience an emergency admission from home, after which it may not be possible to arrange discharge. Reasons for admission often reflect a change in the patient's condition, which may not necessitate inpatient care, but for which alternative arrangements cannot be made rapidly enough (Wheatley, et al, 2007).
There are nearly 40 million senior citizens in the United States. But in the next 30 years, that number is expected to double to 80 million as Baby Boomers and their parents reach age 65 (CDC,nd). And each year, one-third of the people who die suffer from a chronic illness. For every one of these deaths, there is a patient and a family faced with difficult decisions about care at the last stage of life. It is important that a plan is in place, so that the family understands their final wishes.

Whether someone is facing an acute illness, a long-term chronic illness or a terminal illness, advance care planning can help alleviate unnecessary suffering, improve quality of life and provide better understanding of the decision-making challenges facing the person and

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