Question

End-of-life care becomes an issue at some point for elderly clients. Even with the emergence of palliative care programs and hospice programs, most elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your clients regarding end-of-life care in accordance with their wishes. Support your response with evidence-based literature.

Answer 1

End of life care or palliative care is provided to the client whose death is anticipatory, the primary aim of this type of care is to reduce the pain and discomfort of the patient without providing the cure, nurses and physician provide these type of care to the terminally ill patient and the patient who is very near to the end of life.

it is also defined as the support and the care provided to the patient and the family to cope up from the loss which is going to be happening, the support is being provided to the patient family as death is the normal process, care such as spiritual care, psychological care, and bereavement counseling is needed for the family of the patient.

REASONS OF THIS TREND

chronically ill and the more age people numbers are increasing, with an increase in numbers these patients also need to continue care and support to live a meaningful life during the end of their lives,

the trend of caring for the patient who is dying and cares provided to them has changed since 1980, before 1980 the care to the terminally ill client was provided in the acute care settings of the hospital but afterward it was changed and care to the terminally ill client was provided in the home rather than in the hospital,most of the patient used to die in the hospital with chronic illness but after the trend various client choose to get palliative care at home rather than hospitals and nursing homes,

federal reimbursement policy plays a great role in reducing the no of the terminally ill patient in the hospital,

also the cost of stay in the hospital is very expensive for the terminally ill patient, the US has spent almost 1.3 trillion dollars on the terminally ill patient and also a large amount is spent on the last year of death due to the treatment in hospital, hospitals bill was too long due to the use of high tech medical care, rather than spending less money on the palliative care which costs a far less than hospital stay.

these are the reasons for caring terminally ill client in the home than hospitals.

WHAT CAN BE DONE AS A NURSE FOR THIS TYPE OF CLIENT WHILE CARING AT THEIR HOME.

the nurse who has sufficient experience and the knowledge and also has specialization in the GERONTOLOGICAL NURSE PRACTITIONER provides care and support to the terminally ill client, she also provides support to the family of client by providing palliative care, the GNP provides education and training to other staff members regarding the type of care they want from the nurse at their homes,

she provides psychological support to the client and also gives advice to the family of the client in choosing the option of palliative care and to reduce the length of stay in the hospital by assuring them the high quality of services will be provided to the patient in their homes as well,

various research has been conducted on palliative care and more research are yet to be done, the challenge that comes while conducting research is ethic,

one of the studies conducted while providing care to the terminally ill patient who had cancer and the cost of treatment was reduced up to 40 % as compared to a hospital stay, and by comparing these perspectives it is being seen that the cost is reduced with the same quality of care.

but some research also says the quality is not upto the mark in palliative care as compared to the hospital.

as a nurse it is the responsibility to provide support and care to the terminally ill client and the family, most of the patient wishes to die at their home than in hospital and their wish should be respected by the nurse by providing high-quality care at their homes,

it is considered as the crucial phase for the family members seeing their loved one suffering and knowing that their loved one is near to the end of his life, assure client that this is the natural process and everyone has to go through it, as a nurse bereavement support and psychological support should be given to the family members,

spiritual and cultural values of the client should also be respected, allow the client and the family to perform the rituals they wish to perform.