...can to support our loved one in their hour of need. The truth is that most of us are not trained to care for our family members and if we could one person could not provide the care and support that they need. The good news is that there is an organization that can help your loved one through this difficult time by providing health care, therapy, comfort, dignity, and emotional support. The health care service that I am referring to is hospice care. Hospice care is different from regular health care in that Hospice is a style of caring for people. Hospice care is intended for patients who’s doctor puts their life expectancy no longer than six months. In the following reading I will provide a detailed description of hospice care including the demographics, services and a reason for choosing hospice as my topic. The beginnings of hospice care is debated by many authors. The majority of authors agree that a form of hospice did exist before the 19th century outside of the United States. The foundation of hospice care started to take form in London somewhere about 1948. Hospice care came to the United States in 1963 by a physician Cicely Saunders who spoke of the new style of care given to terminally ill patients. After the first introduction back in 1963 hospice care in the United States has expanded from the first hospice care center in 1974 to “today there are more than 4,700 hospice programs in the United States.* Hospice programs cared for 965,000 people enrolled in Medicare...
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...A Hospice-At-Home Caregiver is what I became when I took on the vital role of caring for my grandmother in her end of life stage (EOL). I cared for her needs for a period of sixteen hours a day. It was challenging both psychologically and physically because I had never done this type of care as a medical assistant. I learned minor tasks of basic caregiving and was told that “everything you know about medicine and caregiving does not apply in hospice care.” I am used to the medical goal being to cure the patient from their illness, yet instead my new role was to except the “No cure” truth. I was only allowed to keep her both emotionally and physically comfortable. Also, I had to suppress my emotions of frustration, denial, and sadness as we worked through each end of life stage. After two months, my grandmother and I had completed the five out of seven stages of the EOL process. One week later, I had reached my breaking point when I was told not force my grandmother...
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...of patients’ that are coming to the end of their lives and are presenting with terminal illness. As life expectancy increases we are seeing more and more patent that are 65 year old and older in need of end of life care. Research and medical developments have provided a vast array of treatment options available to our patients’. After patients’ have exhausted all available treatment options for their disease processes they face the reality that their life is coming to an end. Patients’ near the end choose between quality of life over quantity of life. One service available to terminal patients’ is hospice care which offers palliative care to patients’ at the end of life. Health care providers must be able to face and appropriately care for patients’ with terminal illness and end of life care. At times it may be difficult for health care providers to face or present the truth to a patient that further treatment is futile and end of life care would be appropriate. Advanced practice nurses’ will face terminal illness and it is required of them to be able to sufficiently treat, manage, and discuss end of life care with these patients. It is necessary for practitioners to establish understanding and acceptance of end of life care. It is necessary to analyze terminal illness, end of life care, and treatment options available to our patients’ due to the ever growing prevalence of our aging population. Review of Literature Upon reviewing available literature regarding terminal...
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...Physician Assisted Suicide Physician assisted suicide is a very controversial subject in today's society. Physician assisted suicide is when one voluntarily makes the decision to end life due to a terminal illness. In my opinion, physician assisted suicide is not ethical because; many people feel taking of a life is morally wrong, it shows no respect for humanity, and it takes ones dignity away. Physician assisted suicide and Euthanasia exist and neither are morally correct. Nothing about ending one's life is ethically right. An act as such would be considered an act od virtue ethics. "Virtue ethics is distinct from both utilitarianism and deontology. Rather than focusing on the consequences of the act we wish to evaluate or the rule that guides the action, we look at the character of the person performing the act."(Mosser, 2010) Each having the same outcome but still different, physician assisted suicide is when a physician gives the patient means to commit suicide but not administering it personally.Euthanasia is a lethal dosage of medicine administered by a physician. (Gula,1999a) This process is called death by mercy but some see it as murder. Death is a natural part of living. Death is something that occurs somewhere every second of the day, it should be from natural cause or accidental never should it be doctor promoted . When people become ill it is the physician they put trust in for the care they need to survive...
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...on caretakers, physicians and more specifically hospice doctors, nurses, social workers and counselors. All of whom care for both the patients who must bear the knowledge that they are dying for as much as six months ahead of time and for their families and loved ones who are present throughout the whole process. Unfortunately, this branch of medicine, palliative medicine, is relatively new. Thus it is critical now more than ever that more funding and research are dedicated to its advancement and upkeep. The need for hospice care throughout...
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...Live to share a new update on how his wife is doing. Things have been quickly going downhill and they are now at home and Joey is on hospice. At this time, Joey Feek is still battling cancer even though they are taking things one day at a time. Rory explained that he is very careful about the photos that he shares of his wife Joey Feek because of what is going on with them right now. Rory went on to share that Joey is braver than he is though. She wants to be remembered as a singer of songs. A devoted wife. A loving mother. Not a cancer patient. And so I have tried to be very careful. To honor her. But my wife is braver than me. Rory explained that he shared with Joey all of the...
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...Hospice Creation of Hospice Hospice care is designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life rather than cure. The goal is to enable patients to be comfortable and free of pain, so that they live each day as fully as possible. The term “hospice” ( from the same linguistic root as “hospitality”) can be traced back to medieval times when it referred to a place of shelter and rest for the weary or terminally ill on a long journey in 1948 (History of Hospice Care, 2012). The name of the physician was Dame Cicely Saunders who treated the terminally ill and eventually went on to create the first modern hospice, named St Christopher’s Hospice, in a residential suburb of London. (History of Hospice Care, 2012). Ms. Saunders introduced the idea of specialized care for the dying to the United States of America during a 1963 visit with Yale University. Her lecture, given to medical students, nurses, social workers, and chaplains, about the concept of holistic hospital care, included photos of terminally ill patients and their families, showing the dramatic differences before and after the symptom control care (History of Hospice Care, 2012). Ownership In 2010, there were over 5000 hospice programs nationwide (Facts and Figures: Hospice Care in America, 2012). The majority of these facilities are freestanding agencies constituting 58 percent of all hospice centers (Facts and Figures: Hospice Care in America...
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...really read, is high-cost, curative, and painful end of life care worth it? While the second question is not quite as catchy, it touches on the main problem at hand. When patients are terminal there is no sense in pursuing these extreme treatments. These treatments are very expensive and threaten to jeopardize the health of Americans as healthcare is rapidly moving out of reach for the average American. Also, these treatments can be very painful for patients. With these treatments not offering much in terms of longevity, I would strongly argue that these patients should be seeking out hospice care in order to enjoy the last of their days. Hospice has thus far not been a popular option, but I think this will change, as increasing healthcare costs force the nation visit the issue of costs associated with end of life care. I think that the discussion that follows will remove the stigma associated with hospice and lead to a culture shift in America. Finally, there is a strongly held notion in this country that it is wrong for people to choose how they die. They see it as Thomas does; they see it as giving-up, suicide, irrational. Instead, they prefer to see people in the most awful of circumstances suffer the indignity of their diseases. I hope that the coming conversation also includes the issue physician assisted suicide. In closing,...
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...Whether or not euthanasia commonly referred to as physician assisted suicide should be allowed has been an issue of much debate over the last couple of decades. By definition euthanasia is the act or practice of killing hopelessly sick or injured individuals (as persons or domestic animals) in a relatively painless way for reasons of mercy [1]. As Americans it should be our civil liberty to die on our own terms. A patient suffering at the end of life deserves the right to choose how their life should end with no government involvement in the decision. Clearly, legalizing euthanasia or physician-assisted suicide would not undermine the quality of palliative care that patients receive. As Americans it should be our civil liberty to die on our own terms. While physician assisted suicide is legal in three states Oregon (via the Oregon Death with Dignity Act), Washington (by Washington Death with Dignity Act), and Montana (through the 2009 trial court ruling Baxter v. Montana)[2] it is still not available to all citizens of the united states . To me this is a clear violation of our civil liberties as American citizens. Physician assisted suicide is not an irresponsible practice. The states that are authorized to perform physician assisted suicide have many safe guards in place that ensure the decision being made by the patient is not being made irrationally or hastily. In Oregon the patient must be of sound mind when they request a prescription for a lethal dose of medication...
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...Words of Comfort: What to Say When Someone is Dying Candace Rotolo Being diagnosed with a terminal illness is traumatic. But sometimes, what people say in an effort to offer comfort is equally distressing. The truth is, many of us just don't know what to say to a loved one who is facing their mortality. "Most of the time I really liked when people said nothing," notes Michelle Colon-Johnson, who has been diagnosed with stage four cancer five times and survived. "If I wanted to talk about the cancer, it felt good to know I could talk to others, but I never wanted to be treated differently." Experts who assist patients in their final days say the best thing to do for someone who has recently been diagnosed is to allow them to guide your conversations and actions. "They might not want to talk," explains social worker Edie McCaddin-Bower, vice president of support services at Beacon Hospice. McCaddin-Bower says it's important to respect the patient's wishes, but let them know you're willing to lend an ear to hear their thoughts, wishes and fears whenever they are ready. Fellow social worker Meredith Cinman, ancillary services coordinator at Amedisys Hospice in Valenica, CA, adds that loved ones should try not to worry about saying the "right thing" but spend more time listening to the patient. What NOT to Say to Someone Who Is Dying "Avoid platitudes," adds psychiatrist, Huffington Post blogger and author Marcia Sirota M.D. "Saying things like, ‘Everything happens...
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...How effective communication can contribute to health, care and early years workers valuing people as individuals. All of the Migrant Helpline staff are effectively trained and know what to do automatically and so do not unnerve the client or make them feel uncomfortable by making obvious mistakes or faults if trying to communicate them. Migrant Helpline staffs also know efficient background information on each client. This is through referral forms. Referral forms are used to write down all the client details. Case booklets are filled in by all professionals, a detailed admission section and daily notes added from medical note to family details, patient’s concerns etc. case conferences held to set up support for patients going home. All written information must be sensitive and with agreement of the clients, who can see them at any time. . A follow up consultation may be needed, where questions can be answered. Stress and being upset are barriers to good communication, as is confusion and being emotionally distressed. Multi skilled professionals all work together to meet the client needs. Case workers, voluntary organizations, social workers and managements staff meet regularly to discuss and to make new plans. How client confidentiality can be maintained. Most people in caring professions and roles are aware of the need for confidentiality, but we must not assume that the client will know about this, or expect it. Some clients will have heard stories of confidentiality...
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...Physician-Assisted Suicide Must Be Legalized Sheryl Tello GEN 499 Prof. David Ward March 14, 2014 Physician-Assisted Suicide Must Be Legalized Imagine that you just received a phone call from your physician’s nurse and she told you that the doctor wants to see you right away. When you ask her what is the problem; she tells you that it would be best if you came into the office as soon as possible. You tell her that there is no way that you can come in until next week; she asks if you can hold for a minute while she relays the message to your doctor, and the next thing you know your physician is on the phone and tells you that he wants to see you today. You try to rationalize everything that your physician could possibly tell you. Then you tell yourself that it cannot be too bad because you have always taken good care of your body, you eat right, you get plenty of exercise, and you see your doctor once a year. At the doctor’s office, the doctor informs you that there is no easy way of telling you that a large amount of cancer cells have been found in your blood work. As you try to speak, he continues to inform you that the cancer cells have completely taken over your blood and have migrated to your vital organs. As you try to speak again, he interrupts you one more time, however, this time it is to deliver the final blow; you only have six weeks left to live, which you will surely spend in extreme pain and unremitting suffering as your body goes into complete organ...
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...washing and proper identification before treatments, to arguing that an early discharge will harm her patient's recovery and etc…. Advocacy also means, if a nurse observes a practice or procedure she believes to be wrong, advocating for the patient demands means, she will speak out even if that practice was carried out by her superior. This is not always easy and may have a cost for the nurse because it is like she is stepping on her superior toes. Before advocating a nurse had to be trained and she has to know her patient rights. She needs to accept her patient’s rights in order to be an effective advocate. She must believe in the patient's right to participate in decision-making about treatment. She must accept his right to be told the truth about their...
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...secondary agents. In her directives, she made a clear statement about life prolongation: if she were somehow, “to end up in anything like PVS, from which I am not apt to recover, I do NOT want my life to be extended by means of medically assisted nutrition and hydration, ventilator, or other life support” (Rosell). Although they aware of their daughter’s pregnancy, the parents, who are both health care professionals, want to respect their daughter’s wishes and arrange the transfer of their daughter to a hospice unit where she would await her death. Nevertheless, Janet’s pregnancy complicates the situation. In the state of Kansas, “a woman’s health care directives about “withholding or withdrawal of life-sustaining procedures in a terminal condition” may not legally be in effect while pregnant” (Rosell). Thus, the physician notifies the parents and states that they need legal assistance and an ethic consultation regarding the case; hence, they must postpone Janet’s transfer to the hospice unit. The parents are upset with the possibility that their daughter’s advance directives may no longer be effective and that her life may be possibly prolonged against her will. The main ethical dilemma of this case is determining if Kansas is in the right or wrong in invalidating a woman’s health care directives during a period of pregnancy. One ethical theory that justifies this law as ethical is John Stuart’s Utilitarianism. Since this theory considers actions as “good” if they create the most...
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...Do Not Resuscitate Orders in Pediatric Patients Ethical Issues in Healthcare Abstract Children with terminal illnesses frequently have do not resuscitate orders. Dealing with dying children, and letting them die without major intervention can be hard issues for nursing and other health care professionals to cope with, and can cause an internal ethical dilemma. The seven nursing ethical principles are discussed in regards to do not resuscitate orders, and ethical theory is applied. The ethical dilemma faced by nurses with do not resuscitate order is discussed, and how to resolve it. Do Not Resuscitate Orders in Pediatric Patients Children throughout the United States are diagnosed with terminal diseases daily. Once medical treatments begin to not further the quality of life of the child, discussions will begin with the family to consider a do not resuscitate order. A do not resuscitate order is intended to protect the patient from resuscitative efforts that are not wanted by the patient and family (Baker et al., 2010). As a charge nurse at a pediatric ventilator unit, do not resuscitate status comes into discussion frequently, and it is an uncomfortable topic for some. A do not resuscitate order on a child can cause an internal ethical dilemma for nurses. Children are seen as lively beings, and are supposed to outlive their elders. Also there are many myths surrounding do not resuscitate orders with both family members and members of the healthcare team. Some...
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