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End-of-Life Decisions1End-of-Life DecisionsSara TomlinCapella UniversityPolicy, Law, Ethics, and RegulationsFebruary 2019
End-of-Life Decisions2IntroductionOften times people confuse end-of-life care, otherwise known as hospice care, withpalliative care. Palliative care can be used under the hospice umbrella, but hospice cannot beused under the palliative care umbrella. The primary focus of palliative care is to treat thesymptoms and improve the patient’s quality of life from the point of diagnosis; while hospicerequires a grim diagnosis of six months or less to live to qualify. Hospice care is becomingpopular within the United States as it can be experienced in a hospital setting, a nursing home, orat the comfort of the client’s own home. According to the National Hospice and Palliative CareOrganization over 1.4 million people were enrolled in hospice care with Medicare in 2016 alone;and over 96% of end-of-life care was in the comfort of the patient’s home (NHPCO, 2018).End-of-Life Decision MakingMaking end-of-life decisions proves stressful and sometimes uncooperative familymembers hinder patient comfort. It may be helpful to have the patient and the family choose aliaison for decision making before the person enters hospice care should the family end up indisagreement on the clients care. In general, the nurse should have the competency to providecare for the patient. The nurse should treat the patient’s pain, and psychosocial needs of not onlythe patient, but the family as well. The nurse should feel comfortable in discussing matters ofapproaching death and some of the signs and symptoms. The nurse’s role is not inclusive to thepatient, but also extends to the emotional care of the family. The impending death of a loved oneis a large stressor for the whole family and may cause disarray within the household. The nursewill act as a representative for the family and the patient, leaving the family with resources theymay need whether it be financial resources, spiritual guidance, or legal advice with advancedirectives and a medical power of attorney. The nurse advocate will educate the family on what
End-of-Life Decisions3to expect when the patient passes, what emotions they may experience after the event, andconsiderations on the patient’s quality of life. Lastly, end-of-life decisions do not stop when thepatient passes onto the next life. The nurse may provide care for the family long after the patientpasses; which may include the same services listed above (ANA, 2016).