Palliative Care Nursing - Quality Care to the End of Life - Assignment Example

PALLIATIVE CARE Name: Course: Professor: Institution: Date: ASSESSMENT PART A Short answer questions Define palliative care and outline some of the key aims or principles. Palliative care is an active medical care for the patients with chronic and serious diseases. It aims at improving life of the patient and the family, providing the patient with pain relief from the illness stress, offers support to patients to enable them to be active until their death. Define the term ‘life limiting illness’ and give examples in your answer. “Life limiting illness” is a condition or a chronic disease that shortens a patient’s life and eventually may lead to death. Examples of such illness are heart failure, cardiovascular disease, dementia etc. Identify some of the common concerns experienced by people facing a life-limiting illness. Pain, fatigue and exhaustion Vomiting , nausea and lack of appetite Shock, fear, anger, frustrations and denial Helplessness, sadness, relief and acceptance How would you explain a ‘palliative approach’ to a person with a life-limiting illness and their family? Palliative care focuses on pain relief and symptoms management so as to help the individual live actively and also enhance his/her quality of life. It also provides support for the family, E.g. through counseling. Summarize the main aims of a ‘palliative approach’ in residential aged care. To provide the best quality of life to the individual and give support to the family and their Caregivers during the person’s illness and at bereavement. It mainly focuses on living well with dignity until death by reducing suffering and pain of the patient and family Provide examples of how you could incorporate a ‘palliative approach’ to care within your work role. By assessing and monitoring pain triggers and disease symptoms in a patient. Addressing the patient’s needs and providing supportive care to help them cope with the illness. Helping the patient live until they die by eliminating factors that can cause premature death. By teaching and promoting positivity to grieving for deceased family and caregivers (Quill & Battin, 2004). Identify some of the relevant policies, protocols and practices of your workplace in relation to the provision of palliative care. Early symptoms assessment and management practices. Making and maintaining an imprest system of medication containing use of drugs. Proving medication, spiritual and self-care for persons when necessary. Providing healthy aging and longtime care and palliative care as core essential component Issuing death certification. Outline some of the roles and responsibilities of various team members in your workplace involved in delivery of palliative care. Dieticians –they advise on better for the patient to improve their health. Palliative care doctors-they prescribe treatment for the person’s pain or symptoms. Specialist physician-they offer treatment for a specific symptom or pain. Nurses-they administer injections, they clean the patients, report changes to the doctors. Social workers-they provide support to the person’s family and the caregivers. Physical therapists-they administer prescribed therapy to the patient. Chaplains-spiritual support to the patient and family Outline some of the resources available to your workplace which support palliative care. Referrals for pain and symptoms management Psychological, emotional, socio and spiritual support by religious leader or focus group. Caregivers and specialists support. Bereavement support program. What do you see as some of the challenges and issues when admitting a new resident who is requiring end of life care? The caregivers will have to spend more time to attend to the needs of the residents. Transfers to and from the hospital for treatment is a tedious activity for the resident and nurses. The residents coping with the new environment and treatments. The residential home will need more resources at the time they will be admitting the person. Understanding between the person and caregivers can be challenging because most of these residents under report and have much greater drugs sensitivity (Quill & Battin, 2004). Define the following: Advance care directives A written statement that empowers an individual to make preferred legal arrangements with wishes and instructions for his/her future healthcare, living arrangements, personal matters and end of life. Advance care planning It is a voluntary process of communication between health agents and individuals to think, talk, discuss and plan for future healthcare needs for a situation where the person may not be able to decide on issues concerning their healthcare. Bereavement The mourning period and a grieving process for the death of a family member or a friend. Dignity A behavior or appearance that suggests the state of being worthy of respect. Enduring guardian A person an individual legally appoints- while he/she has the capacity to make decisions for himself or herself- to make lifestyle or personal decisions on their behalf when they are not able to do it on their own. Grief Deep mental suffering, anguish or distress caused by bereavement. Loss Act of failure to keep or to have something like a patient’s death. Power of attorney A written legal document that gives one or more persons appointed by an individual the power to perform certain functions on the behalf of the appointee. Quality of life An individual ability to appreciate and enjoy doing normal activities of life and also the state of well-being, life satisfaction and happiness of that person (Boog & Tester, 2008). Activity – The Five Domains of Holistic Care Using the diagram below, brainstorm what you see as some of the key issues or care considerations for each domain. Write your answers in the space around each domain. Recognition of the Providing good diet, treatment of symptoms, the pain Considering patient’s spirituality management procedures and therapies, exercises of beliefs, race needs of whatever faith of the muscles, massages directly to the areas ethnicity before the patient and family have that are affected by the disease makes any decision Discussing issues on death Reduction of depressants Bereavement support meditation, Counseling and providing comfort self-acceptance and having hope Involved in care decisions and treatment Involved in care decisions and treatment Educational resources Cultural support- offering sensitive care for people with different cultures, backgrounds, ethnicity and race Consideration on the choices that have been determined by the person’s beliefs. [Diagram adapted from the PEPA Project 2010] Activity - Physical symptoms and their management Complete the table below by summarizing the key management techniques for each of the listed symptoms. Symptom Management techniques – summary Anxiety Anxiety management requires a lot of determinations and patience by identifying potential factors that trigger stress. Find possible solutions that will help solving the problem. Choose the best option. Develop a plan on how to implement the option. Implement the option. If it is not a success try the other options. Perform breathing exercises. Develop thought management. Introduce lifestyle changes of eating right, exercising, planning instead of worrying, and manage time and reduce alcoholic drinks. Breathlessness Applying relaxation techniques Reduce anxiety and fear Breathing techniques taught by a physiotherapist Using morphine Constipation Eating foods with fiber Avoid foods that produce gases such as cabbage Take hot drink then wait for an hour before making bowl movement Exercising often Increase intake of fluids Surgery Cough Take a personal history of times suffered by cough Change of lifestyle e.g. quit smoking Improve ventilation of a room Practice breathing techniques like huffing Seek medication Diarrhea Vaccination against diarrhea causing pathogens and using of selective antibiotics Promoting better dietary practices Proper sanitation practices Use of clean, treated water Washing hands before eating or touching food and after using the toilet Proper storage of food stuff Using Oral Rehydration Salts (ORS) Fatigue Exercise –putting effort on increasing physical activity Psychosocial wellness through counseling Body rest to keep the energy the body needs Relaxation therapies, yoga, massage therapies are helpful Nausea / vomiting Identifying factors that induce nausea, document its frequency, and intensity then begin correct therapy Non-pharmacological management by focusing on oral care and hygiene Pharmacological management by using prescribed medicine Use of acupuncture Avoid acidic meals Pain - breakthrough Pharmacologically with the use of opioid medication Anti-neoplastic therapy Use of analgesics chemotherapies Pain - neuropathic Use of spinal cord stimulator Use of therapies Review changes the medication regularly Overlap new and old treatment methods to encourage steady pain control Pain - nociceptive Check past pain history, the duration it takes, the pains intensity, causes of the pain and relieving conditions Massages to the body muscles Relaxation techniques Restlessness Use a good number of staff in situations of aggression until the situation is controlled Used prescribed drugs like haloperidol Offer massages Use of relaxation techniques Exercise and provide warm and cool compresses to the patient’s body Outline some of the features and impact of grief. Features-disorganization, low concentration, lack of interest in things, exhaustion and fatigue, Restlessness, imitating traits and mannerisms of the dead, drastic mood changes. Impacts- numbness, crying, sadness, loss of appetite, anxiety, body pain, lack of sleep, muscle Weakness or tightness (Matzo & Sherman, 2009). What are some strategies that you could use to support staff and families who are experiencing grief? Allowing grief time, provide staff debriefing, conduct a memorial service for the deceased, provide visits to the family, offer spiritual support, acceptance of support or help when offered, Provide training to help staff cope with loss, professional counseling. Identify some of the services you could refer to for specialist palliative care support. Therapeutically services, nursing care to monitor disease symptoms, social services, physician or doctor services, counseling and spiritual support, bereavement support in time of mourning Activity – Good communication skills What specific communication strategies do you believe are required and will assist with the following situations? Assisting a resident and their family to explore end-of-life care options. Developing good rapport with the family and resident. Demonstrating care and show empathy throughout the consultation. Identifying the reason for their consultation, establish how much they would like to know considering the factors that influences their preferences. Using of clear and understandable language. Discussing the expectations in a sensitive manner. Providing of information to patient understanding. Explaining the limitations and uncertainty of the information. Ensuring consistency in your information provided to family members, patient and staff. Being honest, encouraging questions, check the understanding and provide space for future discussions (Boog & Tester, 2008). Putting in writing of the discussions in a medical record. Responding to an individual’s emotional distress. Introduce yourself and give your intentions. Make an observation and ask the individual how you can help. Good listening is essential. Keeping it simple do not repeat yourself when talking to the person. Asking what they would need by keeping a distance. Acknowledge and respond well to their concerns and fears. Calming the individual down and reassure him/her the problems faced can be solved. Encouraging the individual participation in decision making process. Responding to questions about dying. Be friendly and provide an environment that can allow the person to ask questions. Paying attention and listening to the person. Use simple terms that can b understood. Being honest and provide accurate information as per the question asked. Show concern and use a good tone while explaining. Write down what you have discussed with the individual. Working with a colleague who is experiencing grief after the death of a resident. Mention the deceased name and encourage a discussion about them. Listen without passing judgments on what the colleague says. Do not fill conversations about the deceased with outside news. Allowing the colleague to talk about it repeatedly (Berger, et al., 2012). References Read More