Medication and Risk Management - Report Example

Medication and Risk Management 2007 Scenario 3. Tony is in the advanced stage of stomach cancer. He is not liable to treatment anymore and there is no hope for cure. However, it doesn’t mean that the professionals can do nothing for him. Patients like Tony need care pathways very much. The last stage of cancer is characterized by pain (physical and moral), fear, anxiety and depression, changes in appearance and physical abilities. Pain control is one of the issues of the disease treatment. Pain caused by cancer deteriorates the quality of the patient’s life. Nobody has to suffer from pain; it can and should be relieved. A wide range of drugs is being used. The set of recommendations for patients and their families has been gathered in a specially designed guide (ACS 2007). As to the staff, their task is to constantly communicate to patients, learning about all the problems and disturbances, to think over the course of individual pain treatment. Patients in the advanced stage experience problems with nutrition, such as loss of appetite, constipation, nausea, vomiting, dry mouse and trouble swallowing, taste change, etc. Near the end of life they lose appetite at all and are unable to digest (ACS 2005). The purpose of the professional care is to maintain the patients’ dignity and quality of life. Besides, the patients’ families experience hard times as well. They should know how to help their beloved and need support themselves. Another problem is the patients’ preference about the place of death. Many people want to die at home, and not in the hospital. For a long time there were little opportunities to provide appropriate care for the patients in the last stage of life. However, the situation has changed. A number of acts (Medical Treatment Act 1988), policies (e.g. Austin Health Policy), and Palliative Care programmes have been admitted in the UK in order to ensure the decent end of life for the sick with mortal diseases (Silvester 2006). One of the programmes for the community palliative care working in the UK is the Gold Standards Framework, which is aimed at the developing of an integrated care having such goals as to provide an opportunity to live and die well, control the patient’s symptoms, ensure support and security for the patient (information, better advanced care planning, less fear, fewer crises and admissions to hospital), to inform and support carers, to improve staff confidence, co-working and communication, to provide care in the dying phase (GSF 2005). Effective palliative care can be provided only by a multidisciplinary team. Such teams consist of specially trained physicians and nurses, physiologists and social workers, chaplains and volunteers. Multidisciplinary team working has proved to be the only way “to ensure truly holistic care and a seamless service for patients throughout their disease trajectory and across the boundaries of primary, secondary, and tertiary care” (Jefferies, Chan 2004, p. 210). The advanced care planning is ‘a process, whereby a patient, in consultation with health care providers, family members and important others, makes decisions about his or her future health care, should he/she become incapable of participating in medical treatment decisions’(Peter Singer et al 1996 In Silvester 2006, p. 2). From undertaking this activity I understood that the advanced care planning is important because people dying of cancer still have the right and desire to decide on their life and death. Nobody needs to suffer from humiliation and discomfort in his last days. Their families have to know their views. Besides, it can help the doctor managing your case. A staff nurse on the community or in secondary care might access these services in the MDT. However, there exist a standard for nurse specialists in cancer and palliative care that should be leaned by anyone going to work in the field (NHS 2005). References: American Cancer Society (2005). For Those With Advanced Cancer. Retrieved March 7, 2007 from American Cancer Society (2007). Pain Control: A Guide for People with Cancer and Their Families. Retrieved March 7, 2007 from www.cancer.org/.../MIT/content/MIT_7_2x_Pain_Control_A_Guide_for_People_with_Cancer_and_Their_Families.asp - 107k Jefferies, H & Chan, K.K. (2004). Multidisciplinary Team working: Is It Both Holistic and Effective? International Journal of Gynaecological Cancer, Vol. 14 (2), pp. 210 -211 NHS (2005). Making Cancer Caring Count. A Network Strategy for Cancer Care. Part I: Nurse Specialists in Cancer and Palliative Care. Lancashire and South Cumbria Cancer Network. Retrieved March 7, 2007 from www.cancerlancashire.org.uk/cn-making_cancer_caring.html - 12k Silvester, William (2006). Respecting Patient Choices: Advance Care Planning. Austin Health. Retrieve March 7, 2007 from www.mednwh.unimelb.edu.au/news/pdf%20docs/bill_silvester_presentation.pdf The Gold Standards Framework Programme England. A Programme for Community Palliative Care. NHS, End of Life Care Programme. Keri Thomas and Department of Health England 2005. Retrieved March 7, 2007 from Scenario 4. Until a person is able to live at home and perform the greater part of household activities he/she can be delivered home assistance in washing, cleaning, shopping etc. The assistance is provided by the community as well as by the professional nursing bands (which of course should be paid for). However, some people prefer or are persuaded by their families to live in long term care establishments. This is usually done in order to provide constant nursing support for those elderly who have medical conditions substantially reducing the quality of life. Long term care is not a cheap pleasure. Not everyone can afford it. Different tariffs exist providing the opportunity to get the desirable place in the nursing home. The NHS and the Local Authority can cover a part of the funding or you can get full assistance: for this the annual incomes of the elderly, family conditions and medical conditions as well as risk factors are assessed. For instance, in England the Local Authority provides full assistance if your capital is less than £12,250. In case your capital excesses £20,000, there would be no assistance (Sharing Pensions.com. 2001). During the application to the long term care, the individual comes through the single assessment process (the SAP). It includes the collecting of information about the individual’s health and social needs and the circumstances affecting one’s independence, daily living and quality of life as well as strengths and abilities. The assessment is done in cooperation with care organizations, but all the views and wishes of the individual is a priority. There several types of the SAP, each having its goals: contact, overview and specialists assessments. The process is constantly reviewed. The complaints are minded (SAP 2007). In the SAP the risk assessment is done with the help of the Anderton Diagnosis Index, which “considers the medical condition suffered by the applicant as well as their ability to perform certain activities of daily living”. The specialists assess the individual’s abilities of communication, orientation and behaviour, feeding and nutrition, etc. All the factors influence the cost of one’s living in the residential care (Sharing Pensions.com. 2001). Studying the issues of care standards, I came to a conclusion that this item is not highlighted properly in the U.K. One can find much information on care standards laws and policies in Canada or the USA, but in the UK there turned to be little initiatives. In 1999 BBC News hotly discussed the plans of improving the standards which was to be done in 2000. The paper covered “elderly peoples right to be consulted about their care, to be treated with dignity in the area of personal care, to have a minimum size of bedroom and the choice of a single room and to be given a choice of healthy food”. Standards for recruitment and training of the staff and care home management were set by the paper either. According to the paper the standards are to be overseen by 8 regionally-based independent Commissions for Care Standards (BBC News 1999). In April 2007 the Mental Capacity Act, which goals are to strengthen and protect people with disabilities, comes into force. The Act is to ensure that voices of disabled people will be heard and considered, and that everything will be done in the interest of the disabled person. The Act covers a wide range of people: those lacking capacities as well as those who are likely to lose it in future (The Mental Capacity Act 2007). The elderly people’s rights are advocated by a number of organizations. Some of them are Abbeyfield Society UK, Brendoncare, Royal Commission on Long Term Care for the Elderly, Scottish Care, etc. Their aim is to improve the quality of life of the elderly people living in need for the long term care (Yahoo! 2007). LTC is a good way out for those elderly whose families are not able to provide necessary assistance at home. On the other hand, many elderly people often see it as the end of their life. However, today’s standards give possibility to decide on all the details of LTC, and promise that entering the nursing house you won’t lose your rights to be a human being. References: BBC News, Health (1999). Standards aim to end elderly abuse. Retrieved March 8, 2007 from < news.bbc.co.uk/1/hi/health/441358.stm - 39k > Sharing Pension. com. (2001). Annuity to cap the cost of long term care. Retrieved March 8, 2007 from < www.sharingpensions.co.uk/annuity_long_term_care.htm - 86k > Single Assessment Process (2007). Devon County Council. Retrieved March 8, 2007 from The Mental Capacity Act (2007). Retrieved March 8, 2007 from Yahoo! UK & Ireland Directory (2007). Long Term Care. Organisations. Read More