Advanced Care Planning Theory

The past year I have seen how much of a big difference hospice makes. I have seen how patients and their families become attached to their hospice team. I have witnessed all hospice team members working together to be supportive to families when their loved one has passed. I never knew how much of a difference hospice can make until my time at Homestead. I saw how the entire hospice team cared for each and every patient and wanted to make the patient’s last days the best they could possibly be.

In all my experiences as a nurse, I’ve realized the importance of communication, providing holistic care to an individual and empowering them with the knowledge to manage their health. When an illness strikes a person, it affects not just his body, but also his mind and spirit. The art of communication is invaluable to patient interaction and establishing a therapeutic nurse-patient relationship, that facilitate coping mechanisms for patients, moreover it prepared myself as a nurse to meet their individual needs. Furthermore, there is at the moment an insurmountable demand for survivorship care as a result of the advancement in technology and medicine, which made living beyond life expectancy possible for increasingly more people. Living after cancer treatment is not free of complications as there are acute and chronic side effects of treatment that requires constant monitoring and attention, and this information spurred me to shift my focus from palliative to survivorship care.

Being offered these services further highlights his declining health. This hospice clinical made me experience a variety of emotions. My first initial emotions were nervousness and awkwardness, I believe I felt this way because I have never been directly involved with hospice. The second wave of emotions consisted of sorrow and hopelessness. I felt these emotions because I couldn’t fathom being in their situation, but then I realized I cannot let these emotions affect the way I care for this patient and his family.

In order for a patient to receive the prescription for medication, a physician must declare the patient to be terminally ill, which means they have an incurable and irreversible illness, and they must have no more than six months to live. Also, a second doctor must agree with the first doctor. In addition, the terminally ill patient has to be mentally competent and able to administer the medication themself (“Threat” A12). These rules act as safeguards to ensure that the patient requesting aid in dying is making an informed decision and is acting voluntarily (Gopal

According to Karaim in 2013 “Decisions about sustaining life, allowing it to end or even hastening death are among the most difficult choices terminally ill patients and their families can face” (para 1). Patients going through this have a bountiful number of things going

Nurses lack of education, training, and lack of comfort in providing care was also seen as another barrier to good end of life care. Lack of knowing the patience preference or wishes regarding their care and treatment also created another obstacle for end life care. To make changes to these factors one of which that was made was the effective opening of communication, both with their team and with the patience family. Related to this is the use of a family care model and family involvement in clinical decision making. Nurses ability to act on previous experiences and their ability to support one another was also recognized as a positive factor to providing quality end of life care.

It is nearly impossible for the patient to rely on another person to make the best decision that they would have made for themselves, particularly when it involves personal interests such as profiting from a will. If there is something to gain, the family members’ motives seem questionable. If the patient falls ill, then there lies a possibility that their heirs will hope for the patient’s death so that they could receive their inheritance. The inability to confirm whether the family actually has the patient’s best interest in mind supports the argument that any form of euthanasia is unethical. Moreover, health care costs for terminally ill patients, including nursing homes, prescription drugs, and home health care deserves consideration.

This act would mirror the legislation regarding death with dignity in Oregon, and the requirements set by the legislation. The CARE Act would allow for terminally ill patients who meet certain criteria to request medication that will end his/her life in a dignified and humane manner that is completely up to the discretion of the patient. The requirements would be that the patient has to be as resident of the state of Pennsylvania, the request must come from the patient themselves on a form that would be standardized by the statute, the request must be witnessed by two individuals, one of the individuals being someone who is not related to the patient making the request and has absolutely no financial stake in the process. The patient making the request must be at least 18 years of age, and must be deemed competent by all health officials providing treatment. The next requirement would be that witnesses must agree that the patient is of sound mind at the point of signing, and the patient’s physician must attest to the fact that the patients illness is terminal with less than six months projected to live, there is no hope of recovery, and all options have been exhausted in terms of palliative or comfort care.

Oftentimes, grief can be a challenging thing to overcome as a healthcare provider. It not only stymies people from making sound decisions, but it can end up with blame focused in areas where it should not be. This is with particular regard to patient families. In the case of this 72-year-old patient, there are a number of issues in this situation that are both unethical and downright illegal, including the fact that the patient’s living will is not currently being respected. Legal/Ethical issue 1: The legality of the living will parameters Both the legal and ethical issues of this situation have the do with the legality of the living will.

Once the requests are made two doctors then must sign off stating the patient will die in 6 months or less (The Editorial Board, 2015, September). Witness are to oversee the patients written request and certify that he or she is of good mind (The Editorial Board, 2015, September). The patient must then receive counseling about hospice and palliative care (Thompson, 2015). A statement must be signed within 48 hours of self-inflicted death that they are still sound of mind (Thompson, 2015). They are reminded before the doctor writes the prescription that they do not have to fill the prescription nor take it the choice is solely theirs (Thompson,

Each morning patients came in for assessment and the treatment team developed or altered existing treatment protocols. I longed to be part of this team, working to stabilize each patient so they could return home to pursue their goals. The nurses stood out to me as the team members at ground zero in the unit, working directly with patients, and advocating for them in meetings. As a Nurse Practitioner, I will provide this same standard of holistic care to my patients, taking into consideration their biological, social, psychological and cultural needs while developing and implementing treatment decisions.

Advance directives help you plan out choices you make regarding care for end of life before the time comes. Patients have so many choices regarding death and dying, assisted suicide needs to be a choice they

The debate over whether or not physician-assisted suicide should be a legal option for dying patients has long been a topic for discussion amongst members of the medical community. There are pros and cons for each argument, however, at the center of this debate is the consideration of patient advocacy and well-being. Although every health care profession centers their profession around providing the best ethical care for the patient, the most important value to consider are the decisions the patient makes for themselves. Currently, patients are given many safeguards such as living wills, a durable power of attorney, and the option for do not resuscitate that act as guidelines for end of life treatment. Physician-assisted suicide

While it is known that adequate water and nutrition is needed for survival, many health professionals are currently going through the dilemma of whether it is ethical or not to provide artificial tube feeding for patients with terminal diseases. Family and Consumer Science professionals, such as dietitians, know the benefits and risks associated with artificial nutrition and hydration (ANH) and have the ability to suggest the most ethical decision to this controversial issue. Recent studies have demonstrated that artificial nutrition provides higher risk of medical complications, increases pain, and false hope of health recovery. Over the years, this historical debate has changed the way the community supports or opposes ANH on terminal disease cases, (Brody et al., 2011) however the justice for each patient is different depending on their diagnosis (Best, 2010). To further demonstrate the intensity of this issue, the research of Hartshell and Williams (2010) indicates that this emotional decision is better made by the patient themselves.

Individualised approach to care planning essay The care planning process is a fundamental part of nursing, Barrett et al (2012) emphasises the importance of the process by recognising it as a clinical skill that needs to be learnt and developed. Care planning enables information to be gathered, taking in to consideration an individual’s biological, psychological, sociocultural, environmental and politico economic status. These factors are incorporated in to the care planning process to enable an individualised care plan that meets the holistic needs of the individual (Doenges and Moorhouse, 2012). The aim of this assignment is to explain and explore an individual approach to care planning and how using a nursing process and nursing model collectively will provide a holistic approach to care.