Nursing: Palliative Care Issue

Introduction

There has been an increased appreciation of palliative care in the recent years. It is viewed by many as the act of keeping Patients Company or at times the act of controlling the patient’s symptoms. Such descriptions are an injustice to a palliative caregiver professional. Organizations such as the World Heath Organization have come up with their own definition basing on the services they offer as palliative caregivers. Such definitions entail goal description, the group being targeted by the exercise, the processes involved, and the palliative care principles. The definition of palliative care as per WHO is still considered as being broad yet what is desired is a practical definition. This calls for the need for a better definition that will give an empirical understanding of the process giving palliative care its specificity (Dunne and Sullivan, 2008).

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Most of the studies on palliative care focus mainly on its isolated aspects which include; care satisfaction, control of its symptoms, education and stress. Some researchers have in the recent past conducted studies on the nature of palliative care. This has been achieved through researching on the professionals, relatives and caregivers discerning the main palliative care concepts. Most of the results of such researchers have come out as being inconsistent while others conflicting with palliative care philosophy. The outcomes of most of the researches have not been consistent while other conflict the philosophical perspective of palliative care.

This paper has taken the issues at that juncture and is going to address the palliative care issue with its objective being to describe the specificity and concept of this kind of medical care. To achieve this, the paper will look at the experiences of all the involved parties including the patients, the relatives to the patients, and the caregivers’ professionals (Holmes and Lamond, 2007).

Research Questions

  1. What is involved in the processes of offering palliative care?
  2. How do the team members, the patients and their family members appreciate the care given to them?

By managing to respond to these exclusively, the paper will be in a position to achieve a step further on understanding and appreciating palliative care as a complex but important health care process

Conceptual/Theoretical Basis

Despite the several varying definitions, palliative care can be generally described as the care that is provided with the aim of preventing and releasing pain from patients and goes further to support a quality life that is best for families and patients regardless of the disease stage and the therapies needed. Palliative care is viewed as being a philosophical type of care as well as a highly organized system that is structured to offer care. This type of care in based on traditional models that were previously used in the medical treatment of diseases but has expanded such models so as to include quality life enhancing the goals for both the families and the patients (McGrath 2007). Such models also ensure functional optimization and better decision-making process while looking at both spiritual and psychological requirements. With such an approach, palliative care can be provided both as the care focus as well as a care to prolong life.

Palliative care legal framework ensures close and efficient cooperation among the institutions. The government role in this type of care is to provide financial resources so as to ensure that the palliative care provided is adequate. Patients whose treatments are readily available are admitted only if there life expectancy is less than 3 months. The other condition is that patients can only leave the hospital after the hospital approves a request presented to them by from their family members or their own request on condition that their life expectancy and availability of treatment are not available. When the patients are not in a position to receive the appropriate care, they can be admitted at their homes or in other care facilities (Taylor and Stirling, 2007).

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Literature Review

The origin of palliative care as a care for ‘end of life’ was in the 1960’s. At the time it was introduced, it was mainly centered at offering psychosocial and symptoms control and support the patient’s family during the late stages of diseases. Since its introduction, its scope and meaning of the care have grown beyond its original roots. The developments around palliative care have changed its scope in that the care now involves improving and maintaining the life quality of all patients together with their families at all stages of the illness regardless of whether the illness is chronic, acute or terminal (Gelfman and Morrison, 2008).

WHO looks at palliative care as the care that is aimed at preventing and releasing patients pains and suffering through identifying the disease early enough, assessing it and going ahead to offer treatment of the associated pains and other kinds of, physical, emotional suffering and spiritual. It is preferred that all patients under restorative or therapeutic health care should be put under palliative care that is simultaneous and of an intensity that is individualized according to the needs of the patient and family(Payne and Turner, 2008).

Palliative care is carried out through managing the pain and the distressing symptoms in effective ways while at the same time putting into practice spiritual and psychological care while taking into consideration the preferences, beliefs, values and cultural identity of the patients and their families. The treatment as well as the evaluation process under palliative care should be carried out in a comprehensive manner and the patients taken as the main decision maker of the family. Palliative care tries to affirm the life of patients through supporting the future goals of the patients and their families including their hopes of having a prolonged life or getting cured. Palliative care also gives hopes for dignity and peace during the time the patient is suffering, when the patient is almost dying and when the patient dies. Palliative care is designed in such away that it provides guidance to the patients and their families in settling on decisions that help them direct their efforts towards their hopes and goals during the time they have been left with. For palliative care services to be comprehensive, there has to be some expertise coming from various providers so as to asses and treat any complicated need adequately. Collaboration, leadership, communication and coordination are important elements employed to ensure effective integration of such services (Tiernery and King, 2009). Nurses have been appreciated for the crucial role they play in palliative care. Researchers by nurses have come up with vital results and findings that encompass the palliative care spectrum cutting across different care settings and populations (World Health Organization, 2010). Nurses have positively contributed to the changing evidence that guides healthcare practices in all care domains.

Palliative care units help the patients and families come to terms with the reality that there is more is more to the life of a patient than the ailment and the treatment they receive. Life of any patient is raised above the illness the patient is suffering from. Palliative care makes patients change the notions that they are fully dependent on their relatives and caregivers and that they are powerless as they approach death by making them feel that they retain the self-government right (Morrison, 2009). After palliative care, patients feel they still have the chance to make decisions on the things they still want in life and look forward to live another day to accomplish their goals. Now that it is characteristic of patients to loss their future perspectives due to loss of hope, it is very important that the palliative care provided makes the patients and their relatives feel that that particular moment is the most important time of their lives. The caregiver’s priorities should be to color to the patient’s life. This can be accomplished through supporting the patient by making the best of every time they spend and give priority to the details that mean a lot to the patient (Hansen-Flaschen, 2010).

Significance of the Study

This study has managed to clarify the palliative care specificity from the [point of view of all the involved parties. The study has also been able to clarify the definition of palliative care and its interaction thus positively contributing to a better understanding of its specificity. From the study, it is clear that palliative care involves a particular concept of care with the main focus of the concept being the life of patients rather than their death. Palliative care that traditionally involved treatment of illness has been transformed to coming up with opportunities so that the patients live their last moments fully and enjoy it. By doing this, palliative care ensures that patients don’t have the notion that they are just in a room waiting for death (Sanders, 2010).

The study helps in understanding the complexity of the palliative care concept. The concept involves putting together conditions and strategies that are normally hard to disentangle. The caregivers demonstrate their expertise through coming up with ways of ensuing that the patients enjoy their lives. The patients and their families on their side consider such care as being effective and of the best quality as it manages to improve their life’s quality. These results from the study show that palliative care is valued but still remains a vulnerable concept. The palliative care process expertise and excellence depends on several procedures and circumstances indicating how the caring concept is complex. For such care to be effectively provided, the caregivers must take into consideration all the processes and the conditions involved.

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The study also resulted to the development of topics that most research and studies have not addressed or explained as they have received very little attention. Such topics form subjects of further research and they include; palliative spiritual care, the role played by the family during palliative care, volunteer’s contribution in palliative care and understanding the patient’s experiences during palliative care.

References

Dunne, K. & Sullivan, K. (2008). Family experience of palliative care in the acute hospital setting. The Australian Educational Researcher, 34 (6), 170-174.

Gelfman, L. & Morrison, S. (2008). Research funding for palliative medicine. Journal of Palliative Medicine, 11(1), 36-43.

Hansen-Flaschen, J. (2010). Advanced lung diseases: palliation and terminal care. Clin Chest Med, 189(2), 645-655

Holmes, S. & Lamond, D. (2007). General nurses’ perceptions of palliative care. International Journal of Palliative Nursing, 3(2), 92-99.

McGrath, P. (2007). Keeping the hospice spirit alive in client satisfaction surveys. Journal of Palliative Care, 17(2), 78-85.

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Morrison, R. (2009). Palliative care. NEngl J Med, 350(2), 2582-2590

Payne, S. & Turner, J. (2008). Research methodologies in palliative care: a bibliometric analysis. Palliative Medicine, 22(2), 336-342.

Sanders, C. (2010). Oxford Textbook of Palliative Medicine. Oxford, UK: Oxford University Press.

Taylor, B. & Stirling, C. (2007). General nurses’ perceptions of palliative care. International Journal of Palliative Nursing, 3(5), 253-258.

Tiernery, A. & King, M. (2009). Measuring the costs and quality of palliative care: A discussion paper. Palliative Medicine, 8(2), 273-281

World Health Organization. (2010). Cancer Pain Relief and Palliative Care. Geneva, Switzerland

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