Comments would be much appreciated. I am evaluating the effectiveness of the PP as an educational tool for my nursing class. Thank So much!!
transcript
Hospice and Palliative Care: A helpful resource for
nurses.
Lets Define Hospice Hospice is a special concept of care
designed to provide comfort and support to patients and their
families when a life-limiting illness no longer responds to
cure-oriented treatments (Hospice Foundation of America [HFA],
2014. Para. 1).
Lets Discuss Hospice Hospice care is based on knowledge,
communication and the cooperation of interdisciplinary teams needed
for the patients rely on. The hospice team collectively focuses on
the care of the patient with a unique focus on his or her
individual wishes. Hospice care includes physical, psychosocial,
spiritual, and emotional care for both the patient and their
family. Hospice care provides support, choices, and dignity during
very difficult time for patients and family. Hospice care allows
individuals and families to take control of what in many cases is
an inevitable situation.
Lets Define Palliative Care Palliative care is specialized
medical care focused on identifying and relieving the pain and
other symptoms of a serious illness. Its goal is to improve quality
of life for such patients at any stage of illness regardless of
current treatment plans, and it is tailored to the needs of the
patient and the family (Strand, Kamdar & Carey, 2013, p. 859).
Palliative Care is focused on quality of life rather then curing
disease.
Why Nurses? Nurses are on the front line of healthcare, we work
at the bedside "Nurses spend more time with dying patients and
their families than any other health professional, and every nurse
will provide palliative care to patients, no matter what setting
they work, making end-of-life care an essential component of
nursing education -(Pullis 2013, p. 463). Simply put, patients and
families trust nurses and in many cases are more willing to listen
to us.
Why Nurses? Nurses are on the front line of healthcare, we work
at the bedside "Nurses spend more time with dying patients and
their families than any other health professional, and every nurse
will provide palliative care to patients, no matter what setting
they work, making end-of-life care an essential component of
nursing education -(Pullis 2013, p. 463). Simply put, patients and
families trust nurses and in many cases are more willing to listen
to us.
The Stigma of End of Life Care. A major barrier to end of life
care is the stigma attached to the care simply because of common
misconceptions including: Accepting Hospice care means one has
giving up and is hopeless or even speeding up the process of dying.
Loss of control. The belief that utilizing end of life care takes
away all control and that the patient and family are at the mercy
of healthcare providers. Must spend ones last days in a facility.
End of life care is too expensive. Palliative care and Hospice care
are the same service.
Hopelessness The utilization of end of life care is often seen
as having given up on hope or speeding up the process of death.
This can be misleading in that death will occur with or without end
of life care; the important choice is not whether one will die but
rather, how one will die. End of life care focuses on the life one
has left rather then what is to come. According to Meierhenry
(2003), hospice does not equate defeat and hopelessness: Hospice
does offer hope; the hope that quality of life, and of death, can
be improved. ( p. 29).
Loss of Control Often end of life care is discussed after
experiencing a traumatic event or receiving overwhelming news. This
leads to poor educational moments and unfortunate associations
between end of life care services and the inability to control the
situation. This misconception however, is far from the truth. Often
one is able to gain personal and day to day control through end of
life care. Patients who begin hospice or palliative care have the
ability to establish a plan of care that meets their desired needs
and future wishes. Hospice care gives the patient and families the
ability to take some control of a seemingly uncontrollable
process.
You Must Spend Your Last Days in a Facility Hospice care is
available for patients wherever they call home and can be offered
in nursing homes, assisted living facilities, and/or in designated
in- patient units (Meierhenry, 2003). Hospice care teams often have
the distinct ability to come to the patient. This gives many
patients the ability to die in their own bed with their own family,
friends, and or pets surrounding them.
Affordability Affordability is a major contributor to the
hesitation associated with end of life care. It is important to
know that financial options are available and no one should suffer
simply because they feel they cannot afford this service. "In 1983,
Congress introduced a Medicare hospice benefit. For a person to be
eligible, a physician must certify that the patient has a six month
life expectancy or less, if the disease progresses as anticipated.
(Meierhenry, 2003)." Eligibility for the service reflects the
diagnosis and need for the program not what can be paid out of
pocket by the individual. It is important to encourage patients and
families to investigate and speak with healthcare providers and
social workers to aid with this assistance.
Palliative care and Hospice are not the Same Service. Often a
palliative type of care is applied by hospice services which, many
times causes confusion about what palliative care is and how it is
used outside of Hospice care. Facts: A person does not need to be
actively dying to render Palliative care services. Palliative care
gives focus on comfort and managing symptoms such as pain, and
difficulty breathing but is not simply limited to hospice care.
"The aim of palliative care is to reduce physical, psychological
and spiritual suffering (Stringer, 2013, p 28). Studies have shown
that palliative care is very effective in treating patient
suffering much earlier than end of life. Its goal is to improve
quality of life for such patients at any stage of illness
regardless of current treatment plans, and it is tailored to the
needs of the patient and the family (Strand, Kamdar & Carey,
2013, p. 859). The provision of palliative care is not restricted
to those with incurable disease (Stringer, 2013, p 28).
So, What is the Purpose of End of Life Care? What do the
experts say? According to Sander (2014) "The person who is dying
Good death means different things to different people but, Beland
(2013) suggests that it contains elements of choice and control
over what happens, for example: Being made comfortable, Maintaining
dignity, Being surrounded by family and being able to say goodbye
to loved ones Having access to information, expertism and spiritual
and emotional support (p 96). At the center of hospice and
palliative care is the belief that each of us has the right to die
pain-free and with dignity, and that our families will receive the
necessary support to allow us to do so (Iversen & Sessanna,
2012, p. 43). End of Life Care provides expert and individualized
care for patients and families through an inevitably unbearable
situation. The purpose of this care is to allow patients to die
with dignity and minimal suffering while maintaining control and
support for families.
So, What is the Nurses Role? Advocacy! The practice of advocacy
in end-of-life care yields the outcomes of safe care, improved
quality of life for the patient and the family, patient autonomy
and self-determination, patient satisfaction, dignity, comfort and
decreased suffering, and nurse satisfaction and empowerment
(Pullis, 2013, p. 46). Nurses see the need for end of life care up
close and have the unique ability to educate in a way not many
other do. By advocating for a patient, the nurse is empowering the
patient to make informed, autonomous decisions (Pullis, 2013, p.
46). Timely education and Referrals of end of life care done by the
healthcare staff and in this case nurses, can decrease so much
suffering!
Remember.. End of life care is not hopeless but, rather offers
hope of dying comfortably, the way you would like, with the people
you want around you. End of life care can offer a valuable sense of
control over ones life during a time when the inevitable will
happen with or with out this care. End of life care can give
patients the ability to take their last breaths in their home
surrounded loved ones and familiarity. End of life care has many
types of funding and is very often affordable. Palliative care does
not mean death and although it is often utilized by hospice care is
not the same.
Remember.. Nurses are on the front line. We spend a significant
amount of time with each patient and it is the nurse who has the
ability to gain trust and provide influence. As nurses we deliver a
unique type of care that is essential for treatment including the
patients response and acceptance of treatments. The nurse
patient-relationship often creates a unique circumstance which,
allows for the nurses suggestions and education to be more widely
accepted. We are trusted and therefore our educated opinions and
assessments can impact patients and families thinking. Nurses have
the opportunity to change thinking. Remember. to advocate when end
of life care is needed.
Thank You for watching! Please ask any questions in the comment
section below and I will be happy to answer.
References Hospice Foundation of America, (2014). What is
hospice? Retrieved from
http://www.hospicefoundation.org/whatishospice Iversen, A., &
Sessanna, L. (2012). Utilizing Watsons Theory of Human Caring and
Hills and Watsons Emancipatory Pedagogy to Educate Hospital-Based
Multidisciplinary Healthcare Providers About Hospice. International
Journal for Human Caring is the property of International
Association for Human Caring, 16(4), 43-48. Meierhenry, P. (2003).
Continuing education for nurses: hospice 101. Nebraska Nurse,
36(4), 29-32. Pullis, B. C. (2013). Integration of End-of-Life
Education into a Community Health Nursing Course. Public Health
Nursing, 30(5), 463-467. Sander, R. (2014). Don't be afraid to plan
ahead for end-of life care delivery. Nursing & Residential
Care, 16(2), 94-96 Stringer, S. (2013). Moral choices in end of
life care for children. Cancer Nursing Practice, 12(7), 27-32.