Archive for date: April 2nd, 2015
End of Life
End of life (EOL) care is a sensitive topic that presents challenges to health care professionals, patients, and their families (Walczac et al., 2014). Diseases such as cancer are often lethal and patients are commonly given a set life expectancy (Walczac et al., 2014). In addition, reports state that a significant rise in deaths will occur over the next few decades (Sprinks, 2011). Thus, prompting an increasing need for healthcare professionals to be well prepared in providing care for these individuals. However, nurses and doctors are often challenged with discussing end of life with their patients (Walczack et al., 2014). Research states that healthcare professionals avoid discussing end of life with their patients due to fears of disappointment (Sprinks, 2011). Timely communication and patient readiness also present challenges to many healthcare professionals (Walczack et al., 2014). Nonetheless, understanding how to improve end of life care, communication, and skills is crucial to providing quality patient care.
Communicating with patients at the end of life can be made easier by initiating the process of Advanced Care Planning (ACP), which essentially involves discussing patient prognosis (Walczack et al., 2014). By initiating ACP, patient questions related to timing and progression of disease can be answered and an increasing balance in care can be provided (Walczack et al., 2014). Evidence also suggests that patients should be involved in their care as much as possible (Walczack et al., 2014). Further supporting this idea, reports state that patient needs at the end of life are often not met due to a lack of staff communication and patient involvement (Sprinks, 2011). Aside from communicating with patients, communicating with caregivers and family plays a crucial role in end of life care because they are often given the role of making health decisions for patients who are no longer fit to do so (Walczack et al., 2014). In a study implementing the use of a Question Prompt List (QPL), which contained a list of questions related to EOL that patients and families were encouraged to ask, results indicated that patients and caregivers asked twice as many questions and had fewer unmet information needs regarding future care (Walczack et al., 2014). Thus, patients can be expected to have fewer concerns and a potential decrease in anxiety related to end of life. End of life is something that everyone will have to experience one day or another. Regardless of how prepared an individual is, end of life is never easy. I hope you enjoyed reading my blog, I look forward to reading all of your responses and blogs as well!
References
Sprinks, J. (2011). Nurses lack confidence in providing end of life care. Nursing Older People, 23(2), 6-7. http://dx.doi.org/10.7748/nop2011.03.23.2.6.p5035
Walczak, A., Butow, P.N., Clayton, J.M., Tattersall, M.H., Davidson, P.M., Young, J., & Epstein, R.M. (2014). Discussing prognosis and end-of-life care in the final year of life: A randomized control trial of a nurse-led communication support program for patients and caregivers. BMJ Open, 4(6), e005745. doi:10.1136/bmjopen-2014-005745.
Design Document
My design document for my portfolio!
End of Life Care
Before nursing school I never considered the death of my parents, a loved one, or even myself. Three years removed from that, I am now a lot more knowledgeable on the subject and have a new perspective on the issue. My wishes regarding end of life are as follows: I wish to donate all viable organs, if I have an extremely poor prognosis I don’t want to remain on a ventilator or any other life prolonging measures, and lastly, I would name my sister my durable power of attorney. Although I personally have not had these discussions with my family or peers, I do want to eventually have them. I believe that the best time to hold these talks would be this summer since my entire family will be together.
My parents rarely bring up the topic of end of life because I believe Hispanics rarely have these discussions. I am not sure if it is a cultural issue but I don’t know of any family member that has ever had a living will or appointed a durable power of attorney. When my parents have brought the issue up it is because a coworker or family friend has suffered the death of the family member. Their discussions are usually very brief and they talk about how they don’t want to be in a vegetative state. I plan to have a more formal talk with both of my parents at a more appropriate time. My hope is to have a definite pulse on what my parents’ wishes are regarding end of life issues.
End of Life Care
Death is evident, it can occur to any one at any time. It is important to have a clear understanding of end of life care and what your desires are for when that day approaches. Would you like to be intubated? In a vegetative state? Would you like to be resuscitated or would you prefer to pass away without any resuscitation measures? It is important to have an end of life talk with your family members and the important people in your life. Who will be able to make these decisions for you? Will you write a living will? These are important questions that we should consider and discuss with our family, I did so and the following describes my family’s end of life thoughts.
The topic of death is something I have always avoided. I cannot imagine losing my parents, it brings me to tears. My mom has always expressed her desires to me if something tragic or her death was to occur. She wants to be cremated and not have a memorial service. She does not want me to cry, and she wants me to believe that she has passed away to a better life. She will not be suffering and she would be able to look down upon our family. This may be easy for her to say, but hard for me to believe. The thought of losing my mother is something I cannot imagine. My confident, my best friend, the woman who gave birth to me. I just love her so much that the thought of death is unreal, a reason I believe I would never be able to be her power of attorney nor implement her end of life wishes. My father is the same way. He would like to be cremated, and he would like his ashes scattered in the ocean. My father has never been one to talk about death nor show much emotion. I think it would be easier for me to implement his end of life wishes than my mothers. Why, I don’t know.
In regards to myself, if something tragic was to occur and I was still young I would like to be kept alive. If I have children I would like to be kept alive at all costs because my children deserve to grow up with their mother and father. If I was to have a very low chance of survival it would be ideal to let me go. There would be no point in prolonging my families suffering. I know that my mother would do anything in her power to keep me alive; therefore I would not appoint her as my power of attorney. At this moment I am still unsure of my end of life wishes. It is something that I have to put more thought into and I believe once I have a family of my own I will be able to make a better decision.
It is very hard to have a conversation where end of life decisions are discussed. It is not pleasant and sometimes we are in denial. I am guilty because I cannot imagine my parents passing away. I cannot get over the idea of never seeing my parents or sister; my loved ones being taken away without even saying goodbye or letting them know how much I love them. This topic is difficult for everyone but it is an important conversation that we all must have.
