...are considered to have different palliative needs to those people diagnosed with cancer (Blackburn, 1989). It is crucial that the requirements of these patients be realized properly at their life’s conclusion and the option of palliative care be considered even though the primary cause of death in older patients is due to the vast array of problems created by advanced dementia. A variety of these problems may also be of concern as they arise from the primary disease and may include end of life care for a shorter period, communication problems due to dementia or plain misunderstanding and even chances of lack of family motivation (Blackburn, 1989). The elementary design of palliative care is to provide bodily, mental and spiritual support to the family and patient to facilitate the life quality until expiration (Australian Government Department of Health and Ageing, 2004). In the initial phases of the diseases, palliative care can be imbued with prolonging treatments (WHO, 2003) and it is not intended in any way to either accelerate or reduce the dying timeline but is meant to alleviate distress by lessening pain and other factors that result in it (WHO, 2003). It is vital that preliminary diagnosis, evaluation and therapy of pain and various other requirements such as bodily, traditional, social, spiritual and mental requirements be tended to for the accomplishment of palliative methodology (WHO, 2003). It is proper to start the palliative care in the scenario when the illness...
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...ethical dilemma we come across when asking our self whether or not we should place a tube feeding in a patient with a history Alzheimer’s or Dementia. Will this prolong the patients’ life or just the inevitable death? Most often a decision needs to be made regarding the placement of a tube feeding. The question is not initiated by the patient themselves. This is the reason why educating our patients are so important. In this paper I will discuss how important the role of the healthcare professional plays in advocating for a patient. To help answer this ethical dilemma several issues will be explored. I will focus on the seven principles of ethics, education, utilitarianism, top-down theory alternate treatment options. Will Tube Feedings Prolong Life? While working with the majority of geriatric population, we frequently come across patients with Dementia and Alzheimer’s disease. The most common problem in these patients is the inability to swallow as well as the patients are failure to thrive. Many healthcare workers and family members become upset when the patient does not have proper nutritional intake. As human beings it is our nature to take care of our loved ones when they are ill, this is our ways of showing love and affection tore’s each other. We often question the situation regarding the need for artificial feeding. Care givers have misconceptions if we provide artificial nutrition it will help prolong their love one’s life. Further need for education is...
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...Understanding Palliative Care and the Transition from Hospital to Home "Palliative" is a word that means to soothe or relieve. "Palliative care" refers to a team of specialists working together to offer comfort and support to people with serious health-related issues outside of the hospital setting. Palliative care is often confused with hospice care since the two offer very similar services. The biggest difference lies in the time the services are offered, the eligibility for the services and the payment options available. With palliative care, there are no time restrictions on services and they can be received at any time. Since the services are not related to terminal illness, parallel curative-services are available as well. Palliative care is available for patients of any age and with any medical condition. Some of the most common conditions are cancer; heart, kidney or liver disease; dementia and multiple injuries requiring long-term care. Studies have concluded that effective and timely palliative care not only increases a person's quality of life and...
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...Dementia Supporting people with dementia and their carers in health and social care Issued: November 2006 NICE clinical guideline 42 guidance.nice.org.uk/cg42 NICE has accredited the process used by the Centre for Clinical Practice at NICE to produce guidelines. Accreditation is valid for 5 years from September 2009 and applies to guidelines produced since April 2007 using the processes described in NICE's 'The guidelines manual' (2007, updated 2009). More information on accreditation can be viewed at www.nice.org.uk/accreditation © NICE 2006 Dementia NICE clinical guideline 42 Contents Introduction................................................................................................................................... 4 Person-centred care ..................................................................................................................... 6 Key priorities for implementation .................................................................................................. 8 1 Guidance ................................................................................................................................... 11 1.1 Principles of care for people with dementia ...................................................................................... 11 1.2 Integrated health and social care ..................................................................................................... 17 1.3 Risk factors, prevention and early identification...
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...is mourn and watch their loved one fade away. But there are programs out there to help not just the dying person but also the families of the dying person. Palliative care and Hospice care are two of the programs in the U.S that are tailored to medical care, pain management, and emotional and spiritual support for the patient and family. 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. Palliative care focuses on relieving symptoms that are related to chronic illnesses, such as cancer, cardiac disease, respiratory disease, kidney failure, Alzheimer’s and other dementias, AIDS, Amyotrophic Lateral Sclerosis and other neurological diseases. World Health Organization defines Palliative care as “improving the quality of life of patients and families who face life-threatening illness, by providing pain and symptom relief, spiritual and psychosocial support to from diagnosis to the end of life and bereavement” (“WHO”, 2013). Palliative care is accessed at any point during the course of a chronic illness regardless of life expectancy. It is typically provided through regular physician and nursing visits in an inpatient consultation service in a hospital setting. Palliative care is provided by a team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. Some treatments...
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...Counseling for Dementia for all Adult People is a Must in the World for Better Living The word Dementia and its types are most common with old age people, who are the major sufferer of this chronic disease. The early onset Dementia may not know until he or she may show aggressive behaviors and totally become a different personality apart from living with his or her earlier lifestyle. It has three stages and the early or beginning is most often, ignored to diagnose due to ignorance from family, friends and may not have a family with them. The Dementia patient at the early stage may become normal if they are taking proper treatment from a neurologist. Cause of People Affected with Dementia in Later Adult Stage • Dementia is cause due to damages...
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...Research Report Palliative care education is an educational factor that could give education to undergraduate nursing and medical students on how they can be a part of broad management of the physical, psychological, social, and spiritual, needs of patients. Palliative care education is needed especially for those who will be involved in caring for patients who are terminally ill to assist them to obtain the best quality of life possible by providing relief of pain and suffering, controlling symptoms, and reinstating functional capacity. Nurse educators have recognized that traditionally nurses have not been well prepared in caring for dying patients. Research also has acknowledged that nursing students have nervousness about dealing with death and dying. Many aspects have been recognized as influencing nurses’, nursing students’, and medical students’ feelings towards caring for the ill. Providing palliative care to dying, elderly patients will always be a challenge for healthcare providers. In 2009, Germany implemented palliative care as an essential part of medical curriculum. In many western countries, the number of patients with multimorbidity is increasing which makes it difficult to care for them. As recognized by the ministry of health and health experts, teaching palliative care of the elderly to the medical and nursing students can improve care. In this study, an interdisciplinary curriculum was studied and created which focused on the palliative care needs of the...
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...Demographics on Patients Requiring Long-Term Care HCS/490 Ada Martin February 4, 2013 Cindy Perkins Populations around the world are aging, and more people are living with the effects of serious chronic illness toward the end of their lives. Meeting their needs presents a public health challenge. Better palliative care practices are needed to help those involved in planning and supporting care-oriented services most appropriately and effectively suited to the elder care needs. Long-term care encompasses a wide assortment of medical, social, personal, supportive and specialized housing services needed by individuals who have lost some capacity for self-care because of a chronic illness or disabling condition. With long-term care needs and, services are wide-ranging and complex, statistics studies vary from study to study. A report prepared by the U.S. Senate Special Committee on Aging (February 2000) described long-term care as follows: “It [long-term care] differs from other types of health care in that the goal of long-term care is not to cure an illness, but to allow an individual to attain and maintain an optimal level of functioning…” The first estimated yearly percentage contribution of an aging population development to rise in price for the periods of 1975 through 1990 and anticipated their probable development between 1990 and 2005. Comparable outlines of change are given an account for the hospital, physicians, and other sectors. Predictable demographics influences...
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...Ruben Salcedo Professor Palmer English 112 10/5/15 Legalization of Euthanasia Euthanasia is a topic that has been debated by many over the years. Although Euthanasia is presently illegal in the United States, physician assisted death, or PAD is legal in the states of Washington, Oregon, Vermont and Bernalillo County, New Mexico. To understand Euthanasia, one must understand the way it differs from PAD. The key distinction between the two is that euthanasia requires either a physician or third party to administer the drugs, while in physician assisted death, the drug is administered directly by the individual. The debate over euthanasia dates back to the Greeks and Romans, but it reached the United States in 1870 when Samuel Williams proposed using morphine and anesthetics to intentionally end an individual's life. Debates continued for another 35 years when Ohio attempted to pass a bill which would legalize euthanasia in 1906. While the bill was never passed, it was the first of its kind, and laid the foundation for bills to come (Humphrys). There are many arguments as to why Euthanasia should remain illegal in the United States. Many individuals argue that it fits the definition of murder, and “For present purposes, murder can be defined as the intentional unjustified, unexcused and legally unmitigated killing of another human being. Active euthanasia fits this definition on the basis that it is the, or a cause of, death” (Lanham 2)...
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...as well as the high cost of providing mealtime assistance. The effectiveness and appropriateness of tube feeding has been the subject of much debate as it applies to those with severe cognitive impairments and those who are in a persistent vegetative state (PVS). Recent research shows that in these vulnerable populations, tube feeding alone does not necessarily prevent malnutrition and risk of infection or improve functional status and comfort. While advanced directives allow an individual to make decisions about his or her care at the end of life, court cases and religious doctrine examine the individual’s right to autonomous decision making in opposition to preserving the sanctity of life. As long as the outcome of this debate is largely undecided, the process of dying may be prolonged for those who can no longer advocate for themselves. Keywords: Enteral feeding, tube feeding, ethics, persistent vegetative state, dementia, palliative care Introduction Nutrients are introduced into the body in two ways: by enteral feeding through the digestive tract, and by parenteral feeding through a tube inserted in a vein in an arm or leg (peripheral line) or through the chest wall in...
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...The primary aim of my assignment is to look at the issue of end of life care in dialysis satellite units, as these areas tend to be nurse led units. My interest in palliative and end of life care has arisen from the growing number of poorly patients we continue to dialyse, this has proved distressing especially for the patient, who often has unmanaged symptoms and for their families, it is also upsetting for the staff involved in their care, as it is felt nobody is acting as the patients’ advocate and helping the decision to facilitate the withdrawal of what is now an ineffective and unnecessary treatment. One of the latest developments by the Government and Department of health is the concept of Advance Care Planning. I have looked at this from various perspectives and would like to be involved in introducing the process to Sheffield Kidney Institute. In 2004, the number of patients receiving renal replacement therapy in England, Scotland and Wales was 33,511, this figure is sourced from data which has been made available to them from participating renal units throughout the country, the number of patients receiving dialysis since 2000 has risen by 7% (Ansell et al 2005) with it projected to rise by a further 10 percent over the next 5 years (Ansell et al 2005). About 15-29 percent of deaths of patients with end stage renal disease results from a decision to discontinue dialysis (Davison 2006). Importantly we need to explore which patients especially those reaching...
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...School of Health Nursing & Midwifery Assessment Title Page Title Page Information | Module Code | NURS09189 | Module Title | Research Evidence and Practice | Assessment wordage (if applicable) | 3,000 word assignment – no more than 3,300 words | Submission deadline (Date and Time)**The assessment must be submitted prior to this deadline to avoid penalty | Date: 11th December 2015Time: 9am(If the submission is via drop box, the time must be 9am) | To be completed by the student prior to submitting assessment | Assessment Title- please specify the question you have chosen | People experience distress in different ways and so attempting to measure it Is pointless | Banner ID number(this is an 8 digit number, preceded by the letter ‘B’, e.g. B00123456) | B00188060 | Have you been granted a formal extension? | YES Audrey Cund Revised submission deadline for extension: 18th DEC 15 | Contents page Page 2 Introduction Page 3 Literature search Page 5 Critical Appraisal of a Quantitative Study Page 8 Critical Appraisal of a Qualitative Research Study Page 10 Conclusion Page 12 Appendix 1 Page 15 Appendix 2 Page 18 Appendix 3 Page 21 References Critical Appraisal of Quantitative and Qualitative Nursing Research Introduction Contemporary nursing continues to not only strive for evidence based practice, which according to the Nursing and Midwifery Council (NMC) 2008 Code of Performance and Ethics should be part of nurse’s professional...
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...edical care is rising at alarming rates as our American population is aging with the baby-boomer generation reaching retirement levels. Adult patients 65 and older are taking up more than 40% of acute care hospital beds, while 70 million Americans will be turning 65 by 2030, making this the country's fastest growing generation. The geriatric population appear to be requiring more medical care due to an increase of chronic conditions, such as diabetes, high blood pressure, and arthritis. These illnesses can be costly because of continuous expensive treatments. To effectively meet the health care needs of these patients there needs to be an improved system, along with planning and supporting care given appropriately by palliative care practices....
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...to meet the needs of this client group. At the same time one pain, management strategy will be chosen critically evaluated and explored in light of the available evidence. The final part of the assignment will identify the improvements that need to introducing in the clinical area, in order to improve the management of pain. The student of this assignment works on a busy medical ward admitting both young and elderly patients with acute and chronic pain. However, most of the patient’s admitted to unit have dementia. The British Pain Society (2010) states that, “pain is under recognised and undertreated in older people,it is a subjective personal experience only known to the person who suffers”. Dementia is said to be caused by a variety of conditions with a complex of symptoms characterized by progressive global deterioration of cognitive functioning. Patterson et al (1999). The chronic pain coalition ( 2007) states that poor pain management impacts on quality of care and recovery and patients’ morbidity and mortality resulting in prolonged hospital stay coupled with economic implications for the health service. Pain has many defintionss have defined pain differently, the International Association for the study of pain (IASP,1989 ) has defined pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage has defined pain differently.McCaffrey (1968) defines pain as “whatever the person experiencing the pain says it exists whenever...
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...Is End of Life Care Really Worth It? When it comes to the end of life many people tend to echo the thoughts of the Welsh poet Dylan Thomas, in his foremost work “Do Not Go Gentle Into That Good Night”. Thomas wrote the poem for his dying father. In the poem, he reminds his father of all of the things that could be and so urges him “burn and rave at close of day.” This concept of fighting until the end seems to make a lot of sense. Why would someone want to go gentle into that good night of their death when medicine is as advanced as it is today? Today, doctors can intravenously feed you when you are unable to eat. Doctors are able to administer several drugs that can prolong life even in the case of a terminal illness. Doctors can even intubate...
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