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NRS 434  End-of-life care becomes an issue at some point for elderly clients

NRS 434  End-of-life care becomes an issue at some point for elderly clients

NRS 434  End-of-life care becomes an issue at some point for elderly clients

Introduction

End of life care is the final phase of of a patient`s illness when death is imminent. Years ago, most people died at home but the trend has changed recently due to medical improvements and concepts of care and medical dynamics (National Institute on Aging, et. al.. 2021). Individuals and family now have the options to pre plan the care options they would receive when death comes.

Most people who do not die at their homes as is their preference, is because of family members, caregivers who are not properly educated regarding end-of-life care. Even when the patient is on palliative care, they still get sent to the hospital when they start to die. Many times, the patients have DNR (Do not resuscitate) and Advance directive that states their wishes. Palliative nursing care begins at the time of diagnosis of a noncurative illness. According to the WHO (n.d.a), palliative care improves life for patients and family when faced with life-threatening conditions. Family and caregivers are usually more comfortable with having the patients at the hospital. Educating our patients and families about advanced directives is a good pro-active way to help avoid these situations.

Factors determining place of death

There are many factors that determine the place of death, the care to be given, the readiness of the patient and family, and the affordability of care involved with families. Most people prefer dying at home than at the hospital due to the peace and grief shared by patients and loved ones. However, it is important to discuss the preferences with professionals to ascertain what is suitable for them (National Institute on Aging, et. al.. 2021). What determines the type of care to provide is the patient`s level of insurance coverage and advance directives.

Role of a nurse in end – of life care

Generally, most patients suffer from discomfort in areas such as pain, breathing problems, skin irritations, digestive problems, temperature sensitivity and fatigue. The nurse should ensure that patient`s needs are met by providing comfort care, pain medication, skin care, oxygen, warm environment, and other support measures to satisfy the patient and family (National Institute on Aging, et. al.. 2021). In end of life care, giving love and affection, psychological support, respecting and fulfilling the patient`s desires are important.

Conclusion

Older people once stayed at home under the care of loved ones in their end-of-life period. But this trend has changed and many are now living in nursing homes or assisted living because the loved ones do not have enough time to provide needed care due to jobs or other commitments.

NRS 434  End-of-life care becomes an issue at some point for elderly clients

References

National Institute on Aging, National Institute of Health, U. S. Dept. of Health and Human Services, “Why Population Aging Matters-A Global Perspective,“ March 2007. (Accessed Nov. 17, 2021).

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Replies

Good evening. Your work was very informative and detailed, thanks. Yes, I agree with you that individuals now have options’ completely true, but my experience working with elderly patients at the Extended Congregate Care (ECC) Nursing home for prioritize elderly nursing care of end-of-life and assisted living patient, show that most elderly patients actually want to be around loved ones during death. It is painful for me to see them anxious and confused, wandering to search for home or begging to go home.

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It is sad that we have now started turning to admitting family members to nursing homes or long term assisted living. On the other

NRS 434  End-of-life care becomes an issue at some point for elderly clients
NRS 434  End-of-life care becomes an issue at some point for elderly clients

hand, I understand life expectancy is much older now in comparison to years ago. When we ask patients to express his or her wishes in regards to all aspects of care, we must strongly encourage them to speak freely about what the wishes are in regards to end of life care. We always want those close to end-of-life to pass with dignity, so encouraging them to express his or her wishes with care will give a better chance for being able to match their wishes. Great job again this week.

Hi Stanley,

You mentioned a very good point about the affordability of end-of-life care. Elderly choices should be respected and fulfilled however, if the family does not have resources or if the dying person did not take care of the financial part such as insurance, then it is challenging to fulfill all their wishes. I know there are some community resources available, however they cannot take care of everything. In such scenarios, family members should come together and make some arrangements for the elderly person to full- fill their wishes and provide comfort as much as possible.

NRS 434  End-of-life care becomes an issue at some point for elderly clients

  • JL

James Lokko

replied toStanley Ogbo

Feb 27, 2022, 9:57 PM

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Replies to Stanley Ogbo

Hello Stanely,in my view, an Individual variables and external conditions all impact the location of death, as does the type of illness. Individuals’ socioeconomic factors, their performance, care requirements, support system, and the accessibility of public and care facility healthcare services are all considered. Getting palliative care soon in the course of an illness has been demonstrated to maximize the probability of the patient dying in their or her residence (Wedding, 2021).

In addition, nursing care for people towards the end of their lives encompasses many different facets, including pain and symptom treatment, culturally sensitive methods, guiding patients and their families through death and dying experiences, and making moral choices. Moreover, the nurse-patient relationship is the bedrock of practical advocacy efforts where advocacy is divided into two categories: information and support. Patients require the assistance of an attorney when they feel weak, helpless, or have lost their ability to control their emotions. At the end of life, the nurse’s power to advocate for the patient and advocate on behalf of the patient is a critical characteristic to observe.

VC

Valencia Classen

Posted Date

Feb 25, 2022, 8:54 PM

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Replies to Stanley Ogbo

Most people who do not die at their homes as is their preference, is because of family members, caregivers who are not properly educated regarding end-of-life care. Even when the patient is on palliative care, they still get sent to the hospital when they start to die. Many times, the patients have DNR (Do not resuscitate) and Advance directive that states their wishes. Palliative nursing care begins at the time of diagnosis of a noncurative illness. According to the WHO (n.d.a), palliative care improves life for patients and family when faced with life-threatening conditions. Family and caregivers are usually more comfortable with having the patients at the hospital. Educating our patients and families about advanced directives is a good pro-active way to help avoid these situations.

As a nurse, it is imperative to know your patient’s condition and whether the patient have a DNR or advance directive that specify the patient’s wishes. Educate the patient and family regarding what to expect in the next minutes or hours depending on patient condition. Also make sure that the care team are aware of the patient’s wishes. Compassion, caring and advocating for the patient helps. Nurses who are caring for patients experiencing the end of life need to pause for personal and ethical reflection on their individual perspectives regarding death and dying (Lachman, 2016). The nurse will require use of self-care strategies to prevent compassion fatigue and reduction of effective quality care.

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The purpose of palliative and hospice care is to improve the quality of life when a person has noncurative illness. It provides support to the patient and the family to live life in as active a manner as possible. It is also a process of acknowledging the grief and provide bereavement support to the patient and family (Grand Canyon University, n.d.). Patient wishes should be addressed and respected on timely manner. “Despite the frequency, complexity, and intensity of communication that occurs between nurses, patients, and families, palliative care nurses often struggle with end-of-life communication” (Fuoto et al., 2019). When the patient comes to the emergency room, every nurse and registration clerk should enquire the patient about the code status to make sure and communicate with other team members especially when the patient is elderly and sick so the patient wishes can be fulfilled. There are times when patient and family members have not made that decision and if the elderly patient ‘s condition declines rapidly then the health team professionals do their best to save patient’s life using invasive and non- invasive methods. Nurses should educate the patients and family, the importance having the documents that states the wishes of the patient about end-of- life care.

References

Fuoto, A., & Turner, K. M. (2019). Palliative Care Nursing Communication: An Evaluation of the COMFORT Model. Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association21(2), 124–130.

Grand Canyon University (n.d.). Health Assessment: Foundations for Effective Practice

https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/5