BSN-FP4006_TomlinSara_Assessment_3-1.docx - End-of-Life Decisions 1 End-of-Life Decisions Sara Tomlin Capella University Policy Law Ethics and

BSN-FP4006_TomlinSara_Assessment_3-1.docx - End-of-Life...

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End-of-Life Decisions 1 End-of-Life Decisions Sara Tomlin Capella University Policy, Law, Ethics, and Regulations February 2019
End-of-Life Decisions 2 Introduction Often times people confuse end-of-life care, otherwise known as hospice care, with palliative care. Palliative care can be used under the hospice umbrella, but hospice cannot be used under the palliative care umbrella. The primary focus of palliative care is to treat the symptoms and improve the patient’s quality of life from the point of diagnosis; while hospice requires a grim diagnosis of six months or less to live to qualify. Hospice care is becoming popular within the United States as it can be experienced in a hospital setting, a nursing home, or at the comfort of the client’s own home. According to the National Hospice and Palliative Care Organization 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 Making Making end-of-life decisions proves stressful and sometimes uncooperative family members hinder patient comfort. It may be helpful to have the patient and the family choose a liaison for decision making before the person enters hospice care should the family end up in disagreement on the clients care. In general, the nurse should have the competency to provide care for the patient. The nurse should treat the patient’s pain, and psychosocial needs of not only the patient, but the family as well. The nurse should feel comfortable in discussing matters of approaching death and some of the signs and symptoms. The nurse’s role is not inclusive to the patient, but also extends to the emotional care of the family. The impending death of a loved one is a large stressor for the whole family and may cause disarray within the household. The nurse will act as a representative for the family and the patient, leaving the family with resources they may need whether it be financial resources, spiritual guidance, or legal advice with advance directives and a medical power of attorney. The nurse advocate will educate the family on what
End-of-Life Decisions 3 to expect when the patient passes, what emotions they may experience after the event, and considerations on the patient’s quality of life. Lastly, end-of-life decisions do not stop when the patient passes onto the next life. The nurse may provide care for the family long after the patient passes; which may include the same services listed above (ANA, 2016).

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