Palliative Care: Problems Associated with Dangerous Illnesses - Essay Example

Palliative Care of 15TH August Palliative Care Introduction Twycross (2003) defined palliative care as an approach taken to improve the quality of lives of various patients and their loved ones facing problems associated with dangerous illnesses through prevention and relief of suffering by early identification of dangerous symptoms, impeccable assessment, treatment of pain, and other major physical problems. The main goal of palliative care is to assist the patients with serious illnesses such as cancer, lung diseases, heart diseases, kidney failure, diabetes, HIV/AIDS, dementia among others to feel better. The specialists in palliative care treat the symptoms and the side effects of diseases and hence improving the quality of life of the patients. Twycross (2003) noted that palliative care helps in the treatment of social, emotional, spiritual, and practical problems that the illnesses bring up. Palliative care is advantageous because it can be done the same time with treatments targeted to cure the diseases, that is, when the disease is diagnosed, during treatment, at follow-up stage and at end of life stage. Health care providers such as nurses, doctors, registered dietitians, psychologists, social workers, chaplains, and massage therapists give palliative care. The exercise takes place in cancer centers, hospitals, long-term home care agencies and other care facilities. This essay involves a case scenario where Mark who is 56 years old is referred to the palliative care team because he has many serious illnesses that require extra care from the medical specialists. Mark was admitted due to the post haemodialysis where he was unwell, he also had restless legs and was also vomiting. Mark has a history of hypertension end stage renal failure on haemodialysis, prostate cancer not responding to chemotherapy, a diabetic toe wound, and Type 2 Diabetes. This essay is going to demonstrate a critical understanding of the external influences, which have a direct effect on end of life care and the strategies employed by the practitioners to facilitate the delivery of quality palliative care services. The essay will further evaluate a variety of physical, social, and psychological factors that affect the client’s experience in relation to palliative care. External influences According to the case scenario, the external influences that have a direct effect on End of life care for Mark are the general weaknesses due attacks by dangerous diseases such as renal failure, type 2 diabetes and prostate cancer, which is not responding to chemotherapy. Mitchell (2008) defined End of life care as the care that helps all those individuals with complex, progressive, incurable illnesses to live perfect lives until they pass away. End of life care make it possible for palliative care and supportive needs of the patients and family members to be identified and fulfilled throughout the final stages of life and into mourning. Lugton and Mcintyre (2005) stated that End of life care is provided for individuals who are likely to pass on within the next twelve months. From the case scenario ,the insertion of a temporary line for urgent haemodialysis in order to treat the deranged blood functions portray an external influence which has a direct effect on End of life care because it proves that the Mark’s condition was critical and could lead to death at any time. Mark was reffered to the palliative team after a discussion with the family members because his condition was critical and needed to be watched closely by medical practitioners. The services provided by the palliative team would enable the family members to relax and take care of other activities in the family that need attention and Mark would be helped to live his last days comfortably. Hallenbeck (2003) confirmed that financial resources are part of the external influences that have a direct effect on End of Life. The family requires a lot of money to treat individuals suffering from progressive incurable illness and not all families can afford since they have other basic requirements in the families that need to be taken care of such as education of the young children, food, and shelter. Mark’s critical condition and the history of other diseases like diabetes showed that he was soon going to die and hence the family needed to seek palliative services to help them overcome the challenges involved at his last phases of life. Strategies There are various strategies employed by the medical practitioners to facilitate the delivering of quality palliative care services to ensure the patients and their family members are comfortable throughout the illness and bereavement period. The World health Organisation (WHO) define palliative care as a strategy that improves the lives of various patients and their families undergoing problems associated with dangerous diseases through prevention and pain relief by identifying the illnesses early, assessment and treatment of pain and other psychosocial, spiritual and physical problems. According to the research studies done by Watson (2009), it was noted that most of the cancer patients and their families experience various degrees of spiritual, physical, social, psychological suffering and distress. The palliative teams ensured that the suffering of patients and families is reduced by practicing principles of better palliative care and including a comprehensive model of care that embraces disease-oriented and symptom-oriented treatments (Webb, 2005). The Ministry of Long-Term Care and Ministry of Health work toward supporting the development of a wide-ranging Provincial End of Life Care (EOLC) strategy that is mainly focused on the following ideas to improve the quality of health care. One of the strategies is shifting the care of the patients dying to their alternative settings of preference such as long-term care homes, homes, or residential hospice other than dying at acute care settings. Developing and enhancing a multidisciplinary and a client-centered service capacity among the community members is another strategy that would improve the quality of services in palliative care teams since they would serve the patients at a more individual level hence better results (Forman,2003). The Ministry of Health focused on the strategy of improving access, consistency, and coordination of services and support across the provinces in various places hence ensuring that the palliative care teams are of use to those in need in the society. Sheldon and Campling (2000) confirmed that various regions in the United Kingdom were provided with support in the establishment and development of regional EOLC networks that were accountable for the broad system designs across the care continuum that included integration and coordination of services at the systems level, assessment, and identification of community requirements to promote service innovations. The integration of advanced EOLC service delivery models at various local levels would improve the access to suitable services such as pain and symptom management. The delivery models would ensure coordinated points of entries for clients, application of advanced technologies to meet the requirements of clients and service providers, and offer a 24-hour on-calls health service for the community members (Regnard and Dean, 2010). Schrier (2000) noted that strategies to implement better health care in palliative care facilities were supported majorly by the Ministries of Health in various states by funding the care centres in the community to provide better services and to reduce the acute sector pressures. Funds provided to support personal support and nursing services in the residential hospices strengthen the roles of the hospice volunteers. Another strategy was to identify the challenges experienced in palliative care facilities such as lack of skilled staff, caregiver burnout, and poor pain and symptoms management. The solution to the challenges was to identify the right mix of the workers, the appropriate balancing of informal and formal care, and supporting the informal caregivers to avoid cases of burnout. Impacts of palliative care There are a variety of physical, psychological and social factors that affect the client’s experience in relation to palliative care that make them respond to the treatment positively or negatively. Perrin (2012) noted that providing palliative care to the sick individuals and their families is extremely rewarding, but it could also be emotionally draining and stressful. From the case scenario, Mark is suffering from many diseases, prostate cancer being one of the major chronic diseases. These chronic diseases are permanent and leave the patients with disabilities that are brought about by pathological alterations that are nonreversible and require them to be rehabilitated in order to be supervised and provided with the required care (Foyle et al., 2007). Mark has to cope with stress and worries caused by the cancer diagnosis and his family must cope with the stress that is induced by physically demanding treatments for the diseases and permanent disability, health impairment, pain and fatigue that can occur even when the signs of the various illnesses no longer exist. Physical impacts Patients in palliative care are those with serious progressive illnesses that require careful supervision in order to have a comfortable quality life. The physical effects for cancer-induced patients like Mark include disability and health impairment, pain and fatigue. Charlton (2002) stated that early detection and the treatment of majority of cancers has increased from 43%-64 % in men and from 57%-64% in women although the survival of the victims is accompanied by damages that are permanent to the clients’ physical health. Disability and health impairment Dangerous diseases such as prostate cancer and diabetes lead to disability and health impairment. Mark already had a diabetic toe wound and his fistula was blocked hence the medical practitioners had to insert a temporary line for urgent haemodialysis to be done in order to treat the deranged blood functions. Wee and Hughes (2007) observed that the side effects of radiation, surgery, chemotherapy and other treatments lead to substantial permanent impairments of organ systems that result to disabilities. The disabilities brought about by the illnesses cause poor health and limit the individuals from performing their daily activities. Those patients under the age of 65 like Mark are unable to work because of their health conditions. Fatigue Emanuel and Librach (2011) stated that fatigue is the most frequent reported symptom among chronic illnesses such as cancer that causes major interference with the daily activities of the patients. Fatigue arises from the complex combination of psychological and physical effects of the dangerous illnesses. Fatigue is manifested in the patients through decreased vigor and motivation in completing required duties and tasks, compromised in problem solving and limited work capacity because of the interference with mental and physical functioning (Webb, 2005). Pain Payne et al. (2008) stated that pain is a physical factor that is experienced by all the patients suffering from progressive chronic illness due to their treatments. The patients experience pain despite administration of various therapies and analgesics hence their normal activities are affected. Pain and other physical effects make it difficult for the patients in palliative care to bath, use the toilets, and prepare meals, dress, and feed themselves. Social impacts Patients in palliative care experience financial problems that result from the high cost of health care, low incomes, lack of health insurance, reduced employment that increase their stress levels. Financial stress Bern-Klug (2010) observed that families that have individuals with chronic conditions such as cancer had difficulties in paying the medical bills and 63% of these families were reported to also have problems paying their mortgage, rent, food, and transportation due to medical debts. Hallenbeck (2003) observed that most of the palliative care facilities are nonprofit agencies that support the individuals with chronic illnesses and they provide financial grants to cater for the transportation of the patients but 11% and 18% respectively are cited to have skipped medications or cancelled medical appointments because of financial issues. Lack of health insurance Lack of health insurance makes it difficult for the patients with chronic diseases to access quality health care facilities. Williams and Wilkins (2007) confirmed that many of the patients and their families have modest insurance covers that are coupled with income levels that limit their ability to sponsor their own costs of health care. The patients who are employed are at risk of losing their incomes and health insurance coverage when their health conditions get worse and have to stop working. Reduced income and employment Individuals diagnosed with chronic diseases have a high risk of losing the jobs because of the stresses that their conditions bring about. The fatigue and pain experienced by the patients make it difficult to maintain a job and earn incomes because they have to concentrate more on medical care and palliative care services. Psychological impacts The progressive incurable diseases affect the patients and their families emotionally and mentally. The patients in palliative care facilities are helped to deal with the stressing situations of distress by being assisted to live comfortable lives but majority of them still experience adjustment disorders, anxiety and depression (Addington-Hall et al., 2007). The family members are affected emotionally when they see their relatives suffering with the dangerous diseases and end up having post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD). According to the writings by Perrin (2012), chronic illnesses cause feelings of guilt, anger, loss of control, confusion, sadness, and fear. In addition to that, the patients experience mood disturbances, anxiety, concerned about body image and have fear of recurrence. The family members are distressed when they think about losing their loved ones to the chronic diseases. Conclusion Palliative care is the initiative taken by medical practitioners to improve the quality of lives of patients and their families that are facing problems that are associated with progressive incurable illnesses through prevention and pain relief of the suffering by identifying the symptoms early, assessment and treatment and providing solutions to other physical, psychological, and social problems. The case scenario in the essay describes the history of the diseases that Mark is ailing from that require palliative care services because his condition is critical. The palliative care teams employ various strategies to ensure providence of better health care to the patients and families. The patients experience physical, social and psychological impacts such as pain, fatigue ,financial stress, lack of health insurance, emotional and mental stress that limit their daily activities such maintaining jobs ,feeding ,bathing, and taking care of their families. The palliative care facilities hence play a vital role in the community by enabling the patients and their loved ones to cope with the stresses involved in the treatment and management of chronic illnesses during the last phases of life. References Addington-Hall, J. M., Bruera, E., Higginson, I. J., and Payne, S. (2007). Research methods in palliative care. Oxford,Oxford University Press. Bern-Klug, M. (2010). Transforming palliative care in nursing homes: the social work role. New York, Columbia University Press. Charlton, R. (2002). 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End-of-life: a nurses guide to compassionate care. Philadelphia, Lippincott Williams and Wilkins. Read More