Exploring Transition and the Aging Process - Coursework Example

Introduction The purpose of this essay is to explore transition and the aging process. Transition is a process that all things on this planet go through. For humans, transition is a complex concept and happens throughout life. According to Kralik, Visentin and von Loon: "Transition occurs when a person's current reality is disrupted, causing a forced or chosen change that results in the need to construct a new reality" (323). In healthcare, people are faced with changes in their lives as they progress through life. These changes can occur anytime. Some of the major transitions will include changes from childhood to puberty, to young adulthood and finally to adulthood. As individuals reach adulthood, decisions will be made about career and whether they will have a family and children. Once children are grown and out of the home, there are other changes like "empty nest" syndrome and challenges in relation to aging and illness. Career changes or job changes can be perceived as positive or negative. In all of these transitions, there will be changes in body, mind and spirit and this will increase as people age. Phases of transition From the moment a baby is born, they experience aging and transition. In a healthy family, a baby will be nurtured and stimulated to promote natural development. A baby will go through transition from the breast to a bottle, to solid food. Their temperament will change from being totally dependant on parents to wanting to have autonomy. As a baby changes into a toddler or young child, their personality may change. If not then, it will certainly change as the child moves into their teenage and young adult years. There will be changes physically and psychologically. As a child enters puberty, there are more physical, psychological and possibly spiritual changes they will make. At this stage of life, hormones begin to kick in and there is a lot more exploration of themselves and other people. They are less dependent on parents and begin to exercise their freedom. As the child becomes and adult, there is more responsibility. Sometimes they are alone and they will make decisions about career and family based on what they have been taught. The young adult will have a different attitude and personality than younger children. Today, the young adult is inundated with information and will have to discern what to use and what to throw out in this information. They will make mistakes in life and base many decisions on their mistakes or their successes. As an individual moves from young adulthood to older adulthood, they will begin to move through levels of awareness that will determine how they act or react in certain situations. Usually, transitions aren't very smooth. Sometimes people refuse to enter a transition until they are ready to do so. To be ready for a transition, Kralik, Visentin and von Loon say that individuals "need to acknowledge that a prior way of living/being has ended, or a current reality is under threat, and that change needs to occur before the transition process can begin" (323). Everyone goes through some type of transition and goes through a myriad of emotions while they examine their lives and their environment. As an individual moves into mid to older adulthood, a major concern will be for health. Transition issues around health are sometimes the most frightening transition, especially when there is a sudden onset of a life threatening disease. As people age, it is expected that they may experience more in-depth health problems and then they move to their final transition of death. Transitions and illness When an individual moves into the healthcare system and finds a chronic illness, their entire personality may change for good or ill. Some people get very depressed or upset about it. Others start out upset, but find a way to positively cope with the illness: For example, older women who have survived a stroke may experience a process of transition/transformation that results in reconstruction of the sense of self. They seek new roles, identify ways of coping and reconcile with the limitations that the stroke imposes (Kralik, Visentin And von Loon, 324). This creates a very positive way for an individual to move through this transition smoothly, and may help them create a full recovery. Death and Dying Although everyone knows that one day they will die, it seems that most people aren't ready to face this situation. Many people are afraid of dying and depending on their spiritually belief may either embrace it as a positive step or fear it. According to Dr. Elisabeth Kübler-Ross, there are five stages of death that people experience -- denial, anger, bargaining, depression and acceptance. And although "each person is unique and individual in dying as in living" (Churchill, ) most will go through these changes at one time or another, even if not in this order. There are a variety of issues that present themselves when an individual develops a chronic disease or are faced quickly with death. Although nurses will work with an individual throughout the aging and dying process, their role in this dying process is key to the family's ability to move through this transition together. Nurses role When a patient is identified as having a chronic disease, or when they are close to dying, nurses must communicate well with the individual and family to create a positive experience. According to Tejada-Reyes, By understanding death as an inherent part of life, we can concentrate on Providing physical and spiritual comfort to the patient and the family with A sense of purpose and ease (1). Nurses must help family members understand this thought and help the family to understand that death is a "life affirming" and "meaningful" experience. Psychological Care Patients and relatives feel more relaxed when they are reassured by the nurse that she is available to help. Just the presence of experienced staff is as important as anything doctors or nurses say. When relatives feel comfortable with the nurse, "intimate family connections can be discussed with the nurse in a non-threatening, respectful manner and in a way best suited to each family's needs" (Tritschler and Yarwood, 3) In hospital care relatives visiting dying patients often experienced difficulty in knowing which nurse they should approach and were anxious to not be seen as a nuisance. The stress relatives experience is intensified when they are unsure of what to expect. As nurses we have duty of care to our patients and their relatives in giving lots of support. We also need to be responsible for communicating what the treatment of drugs and effect on their pain levels. Nurses want to reassured patients and their families that the patient is receiving the best treatment possible and that the individual is a comfortable as possible. As things get more complex the family can stay calmer when they know the nurse is competent and wants what is best for the family. Spirituality and Multicultural Issues Spirituality becomes particularly important in times of distress and change because it is part of a person’s philosophy. It is important for the nurse to understand that spirituality is an issue that is different for many. Some people will believe in a higher power, where others will not. It is important that the nurse has an understanding of the family's spiritual beliefs in order to assist. As Sampson (1982) pointed out "tradition, local and religious custom make up a person’s background". In death faith becomes more important because of the fear of the unknown.. As nurses in practice if the person is in palliative care we can recognise spiritual needs, we can communicate, listen and maybe get in touch with the spiritual leader who is willing to contribute. According to Bushinski and Cummings, "timing is critical to the success of a therapeutic conversation. The nurse needs to take cues from the client's behaviour to determine emotional readiness and available energy" (6). This is very important in any phase of the death experience. In contrast if it is sudden death, if a nurse is versed in the cultural beliefs of the patient, they can help to carry out the wishes of the patient as they relate to religious and cultural activities. There are things to consider as to whether a body is moved, or the right religious figure is brought in. Nurses must also understand that cultures may grieve differently so, they must recognize the family's grief and help them go back to the normal family routine when they can do so. It is also important to note that many elderly people would rather die at home than in a hospital, and the individual may be entering into palliative care. This will cause a disruption in the regular routine for the family. At this point, the nurse must work closely with the family to help them recognise the various stages that their family member may be going through as they move into their death. End of life issues When death is expected it means a patient has time to prepare and opportunity to reconcile life choices. For the patient it gives them an opportunity to create a Will, plan their own funeral and know that the family won’t have to stress about things once they are gone. There is time for the family to come to terms with the idea of their death. It is a time to talk to friends and family who may have been estranged in the past. When death comes quickly as in a sudden death, a nurse may be able to help the family understand that the individual's death was relatively quick and painless. Sudden death can be more devastating to the family. Also, suicide can be more devastating because the individual committing suicide may not leave a note. In both of these situations, the family is left without closure. Sudden death often can coincides with tragedy such as a fatal accident, stroke or heart attack. Expected death can seem to be easier as there is time say goodbyes and the family and friends are able to have closure. The nurse's role here is to make the patient comfortable with the knowledge they are dying and help the family (and sometimes the patient) come to terms with the death. Death in old age is difficult for patients and most prefer to die at home. If they have to live in a residential home or the hospital for a long time, the family may experience a gradual deterioration from the patient. Care of the dying patient in palliative care is primarily the nurse’s responsibility. Nurses deal with the day to day role of supporting and helping the families with psychological, social, physical and spiritual consequences of their illness. Palliative care neither hastens nor postpones death; it provides relief from pain and other distressing symptoms. It integrates the emotional, social and cultural aspects of care and offers support to the family to cope during patients’ illness and bereavement. My experience The first death I witnessed as a nurse was with a patient that I a woman I had become close to and my goal was to help her accept her death. She was very brave and high spirited throughout her process. She was put on a liver care pathway . My role was to care and support the patient as she was dying. Other roles for nurses In the final stages of life, nurses become very close to the family and help them through the transition. In palliative care, they are interacting with the family longer and sometimes over a period of time. If there is a family gathered around the dying person, relationships can change amongst family members. Sometimes there is fighting as children and other relatives begin to examine their grief. One of the reasons for this is because the past and the present collide, and adults sometimes revert back to remembering childhood incidences. The nurses role in this situation may be to help the family reflect on a "sense of achievement rather than one of loss" (Tristler and Yarwood, 7). Through gentle communication, nurses can guide some families to become more connected with each other, oftentimes more than they were before the death. This is also a time for nurses to be involved with the various medical interventions if they are necessary. Conclusion Life transitions are very complex and they change as people age. Death and dying are different for everyone, and often can be difficult for families and the individual who is dying. The nurses role is to comfort the family, communicate about care, and help them understand the dying process. In working with the dying patient, the nurse's role is to help them relax and make an easier transition. Works Cited Bashinski, Robin and Cummings, Kathleen. "Practices of effective end-of-life communication between nurses and patients/families in two care settings". Creative Nursing, 2007, Vol. 13 Issue 3, 9-12. in Academic Search Premier, Read More