DQ

Responses such as “I agree”, “thanks for that information – I didn't know that”, “I experienced that also”, etc. will not receive participation credit. Please do not repeat what is already mentioned in the post. Responses should be a minimum of 150 words and minimum of 2 peer reviewed or scholarly sources with 5 years

Please do not to "cut and paste" answers from your references such as lists, bullet points, etc. This will not receive points for responses that are "cut and paste" even if you provide a citation.

POST 5:

The dying process is often long, depressing, lonely, and painful moment. Patients with advanced health conditions who may be approaching the end-of-life phase are entitled to available high quality, compassionate, Evidence based care that coincides with their wishes. Many elderly people die in the hospice or in skilled nursing facilities because they will not have any family members willing to look after them at home. (Custer, W, S. 2019). These patients must be handled with dignity and respect. To assist with a patient’s wishes as professional health care providers we need to advocate for the patients to prepare an advance directive that will specifies the type of care and treatments the patient does not want to receive and the ones that they would like to receive under certain medical conditions and include family members and care givers of the patients. Within the hospice setting the looming reality of a patient’s death can be extremely depressing for the family and the patient to accept. This is the time when several difficulty decisions are made regarding treatments that will benefit the patient in their last days of life. Nurses step in currently to provide guidance, love and support for patients and family members confronting those tough decisions and helping them to adapt to painful realities.

Usually, nurses are the closet source of support at this depressing time. Families are often confused, scared, and overwhelmed. Therefore, the nurses are there to help the patient and family as they struggle to adjust to the reality they will be facing. The nurse’s primary responsibility is to take care of the patient and making sure their wishes are honored (Lorenzini, E, A. 2017). The nurse must maintain a focus on the patient’s preferences and respecting their autonomy while at the same time supporting the family as they navigate a process they have likely never been through this before. The nurse must be skilled in pain management to make sure the patient remains comfortable, in addition to disease management nurses must also attend to psychological, interpersonal, and spiritual needs of the patient as well.

References

Custer, W. S. (2019). End-of-Life Care. Journal of Financial Service Professionals, 73(3), 26. Retrieved from  https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?  direct=true&db=edb&AN=136192764&site=eds-live&scope=site 

Lorenzini E, A. (2017). The process of death and dying: challenges in nursing care for patients and family members. Rev Rene, 18(4), 528–535.  https://doi-org.lopes.idm.oclc.org/10.15253/2175-6783.2017000400015  

POST 6:

End of life care is the point in which there is no longer a cure or chance of recovery, it is the period in which care and comfort are truly emphasized. Hospice and palliative care programs offer ill and elderly patients the opportunity to spend their last few months of life in a comfortable and familiar place rather than an impersonal place such as the hospital. About 80% of American adults would prefer to die at home, however only 20% die at home and 60% of those deaths occur in a hospital (“Where,” 2013). End of life is a sensitive and uncomfortable topic for most people which is a factor resulting in the shortcoming of meeting one’s wishes and preferences in death. Although the statistics reveal that American adults would prefer to die in their home, two thirds of adults do not have an advanced directive (Yadav et al., 2017). An advanced directive ensures that the person receives their preferred health care treatment. Denial and uncomfortableness involving death is the reason many do not have a health directive; many choose to ignore and talk about the issue (“Advanced,” n.d.). Unfortunately, it gets to the point in which the older adult can no longer make decisions for themselves due to cognitive decline or disease severity and there is no clear preference for life supporting measures documented. 

As a nurse it is important to discuss common misconceptions about death and dying such as believing that hospice is giving up on their loved one (“Hospice,” 2020). However, the reality is that hospice is stopping the uncomfortable, painful treatments that may be prolonging life but can be diminishing one’s quality of life. It is also important to promote advance care planning goals by having open discussions with patient’s and family and providing appropriate resources. Death is a difficult topic to deal with, however it is our job as nurses and humans to advocate and respect our patient’s end of life wishes.

Advanced care planning critical issue brief. Centers for Disease Control. (n.d.).  https://www.cdc.gov/aging/pdf/advanced-care-planning-critical-issue-brief.pdf

Hospice and palliative care. HelpGuide. (2020, September).  https://www.helpguide.org/articles/caregiving/hospice-and-palliative-care.htm

Where do americans die? Stanford School of Medicine. (2013, April 21).  https://palliative.stanford.edu/home-hospice-home-care-of-the-dying-patient/where-do-americans-die/

Yadav, K. N., Gabler, N. B., Cooney, E., Kent, S., Kim, J., Herbst, N., Mante, A., Halpern, S. D., & Courtright, K. R. (2017). Approximately one in three US adults completes any type of advance directive for end-of-life care. Health Affairs, 36(7), 1244–1251.  https://doi.org/10.1377/hlthaff.2017.0175