Palliative care is a form of end-of-life care that aims to improve the quality of life of the dying. It also supports the family of the dying. In these few years, palliative care is receiving increasing recognition in Singapore and efforts are made to improve it. This paper discusses about the perspectives of people in Singapore about death and dying, and palliative care. It also discusses about the roles that palliative care has and does not have in Singapore, and the possible solutions to improve palliative care.
Subtopic 1: Death in the social context
This subtopic discusses about the perspective of Singaporeans about death and dying, and palliative care
.
The location of death is a consideration by Singaporeans. In a study done by The
…show more content…
76% of Singaporeans are willing to receive palliative care and 63% of Singaporeans who knew people who underwent palliative care gave good ratings about it. (Lien, 2014) This could be due to the holistic services provided by hospices in Singapore. For example, pain management caters to physical aspect, bereavement support and counselling caters to psychological aspect and religious counselling, caters to the cultural aspect. These holistic aspects of care allow the patient and family to feel respected, dignified and empowered.
There is social and psychological care provided. The Caregiver Training Centre train caregivers to increase their proficiency in caring for the patient. (HCA,2007). This is meeting the social aspect as there are services and resources used to help those involved in palliative care. Psychological needs of the patient and their families are met. For example, caregivers cope better as they know how to care correctly for the patient. They can contribute meaningfully to their loved ones in the last days of their lives, instead of unable to help and feeling hopeless day by day. This can aid them psychologically because they are in control of the situation and feel empowered. This change allows the caregiver to be receptive about the patient’s condition and cope better with death. This allows the patient to have fruitful last days as their loved ones are caring for them. This facilitates a better quality of life, meeting the goal of palliative
The services provided by Hospice are emotional support, medical services and spiritual resources for people who are in their last stage of a serious illness. Family members are not forgotten as services are provided to them for managing practical details and emotional challenges of caring for someone who is dying. The loved one that comes to Hospice is usually within the life expectancy of 6 months. BBH uses a team approach to provide professional services to provide individualized care to the client. The health care team includes attending physician, the registered nurse, hospice aides, social workers, the hospice chaplain, music therapist, trained volunteers and
They areinvolved in providing palliative care,into a system of medical care that emphasizes palliation and psychosocial support of patients diagnosed with a life-limiting illness, through professional nursing or other therapeutic services, such as physical therapy, home health aides, nurse assistants, medical social work, nutritionist services, or personal care
Atul Gawande’s book, “Being Mortal: Medicine and What Matters in the End,” explores different themes such as, aging, death, and the mishandling of both aging and death by the medical profession’s. This book also addresses what it means to live well near the end of life. It is not just to survive, not just to be safe, not just to stay alive as long as the medical technology allows, but, according to the author it is about what living truly means to an individual. The author describes that the idea of “Being Mortal” developed as he watched his elderly father go through a steep decline in his health and the eventual death. He soon realized that during his medical education and training he was never taught how to help his patients with managing
When a patient is at the end of life it is very important to value the patients self dignity and their decisions at the mere end of their lives. The end of life care is to relieve the weight of the patient 's shoulders physically and mentally. I approve of end of life caring. Basic end of life care is summarized by improving the care of quality of life and dignity of the ill person. The important themes to good ethics of end of life care is a combination of human rights,respect,dignified care,and privacy.
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.
Hospice and palliative care can be easily intertwined; they are both concerned with promoting comfort and relieving patient pain. Hospice and palliative care, however, are different in some aspects. Patients who receive hospice care are nearing the end of their lives and there is no effort to cure their disease; the goal is to provide pain relief, a sense of belonging from family and friends if desired, support through the dying stages, and to assure that the person is able to die with dignity. Palliative care is also focused on reducing discomfort; however, the patient receiving care can be at any stage in their disease. Additionally, palliative care can also be administered during a time when a patient is receiving treatment to cure their illness.
Pain is not just physical but can be psychological and spiritually as well. It does not just effect the person who is dying but the friends and family associated with this person feels like they are dying on the inside. Palliative care can be associated with Hospice. Palliative focuses on treating the patient to get back to their normal lives. For example cancer patients.
1 Outline the factors that can affect an individual’s views on death and dying •Social •Cultural •Religious •Spiritual 2 Outline the factors that can affect own views on death and dying •Emotional •Past experience •Psychological •Religious •Social •Spiritual 3 Outline how the factors relating to views on death and dying can impact on practice Current and previous professional roles and responsibilities and past; boundaries limited by legal and ethical issues; professional codes of practice - internal and national; impact of management and leadership; input from other team members and workers. 4 Define how attitudes of others may influence an individual’s choices around death and dying different models of nursing care; person-centred
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.
SDLA 4: Activity 1 Palliative care continues to evolve in providing better end-of-life care and so does nursing care. Thus, nursing practice is enhanced to satisfy the demand of the palliative care. A nurse provides complex care and fulfils the needs of the patients. Nursing involves in caring work, which focus on patient experiencing agony in palliative and haematological cancer care. Nurses worked in a taxing environment, that can be highly stressful, and often they experience physical, psychological and spiritual exhaustion.
It brought to my awareness both the limitation and the capacity of medicine. Although there was no medical intervention that could cure the diseases of those terminal patients, their quality of life was improved by an outstanding team of doctors, nurses and volunteers. This awareness helped reconcile myself to the fact that certain things, such as death and terminal illness, can not be avoided or changed. By viewing death as a natural part of life, I will be able to offer my dying patients the best care possible while also understanding my limitation as a physician and a human being.
An Integrative Review. JAN Journal of Advanced Nursing, 1744. Karlsson, M. B.-F. (2015). A Qualitative Metasynthesis From Nurses’ Perspective When Dealing With Ethical Dilemmas and Ethical Problems in End-of-Life Care. International Journal for Human Caring, 40-48.
Advanced care planning encompasses a collaborative approach, which includes not only the patient, but the family, clergy, caregivers, nurses, and physicians as well. The goal of the planning process is to establish the wishes of the patient in advance of adverse system responses, in addition to completing any legal documents that will specify the treatment specifics. The purpose of this proposed change is to guarantee the establishment of this advanced care plan early in the hospice process, in an effort to avoid any restraining forces that would inhibit holistic care for the patient. By educating all parties earlier in the process, the likelihood of emotions preventing rational decision-making is avoided. When the potential for harm from continued administration of artificial nutrition and
There is a large difference in the quality of care between minorities and whites. As time progresses, this becomes an issue because the number of minorities are increasing and soon that number will double the population of whites. Disparities in palliative care for minorities is limited and lacks true quality. Minorities have a harder time receiving quality palliative care because of lack of access to medication and communication with doctors. African Americans and other minorities are more likely to die in the hospital from illnesses than whites.
The Peaceful End of Life theory is paramount as the authors stated that every individual deserved to die in a peaceful manner with dignity. The theory is empirical based which is applicable to nursing practice in caring for dying patients, assessing interventions, maximizing care, promote dignity and enhancing end of life to be peaceful. According to Moore and Ruland, a good life is simply defined as getting what one wants (Alligood, 2014, p. 702). The approach of given patients what they want or their preference is a practical approach to the end of life care. This theory stands out to me because it fit into my patient’s diagnosis and I believe everyone deserves to die with dignity and peacefully.