The Final Stages: A Journey through the Dying Process - Term Paper Example

? The Final Stages: A Journey through the Dying Process It is usually a very sad experience to see and keep watch of a close intimate or relative behaving in a way that signalizes death. It is worth admitting that death of a relative or a close friend marks the saddest moment ever shared between the deceased and the relative. Journey through the dying process frustrates the patient as well as the close intimates and associates. It is with particular importance that a dying patient be provided with end of life care giver to whom the patient can talk to during his/her last breaths. In that case, this paper will discuss and analyze various points of the journey through the dying process and the relevant care required. The Final Stages: A Journey through the Dying Process Sonya L. Hicks Paradigm case study This case study explores how health care personnel received urgent and uncalled request to attend to a dying patient at wee hours of the night in a distant admission home. The patient in question was actually at his very last stages of the dying process. On arrival at the patient’s home, the health care profession got frustrated on seeing several family members of the patients seated and making watch of their sick. More frustrations spurred the health care provider on discovering that the patient suffered from metastatic lung cancer. Worth to mention was the great exasperation that fell upon the health care personnel on discovering unique damage on the back of the patient who was actually 40 year old. It happened unfortunately that the health care personnel never encountered a similar situation in his life time experience as a health professional. the family members of the patient more so the younger sibling were dismayed and showed little hope on the recovery of their loved brother. To worsen the situation, was the fact that the health care personnel had no medical tool. However, the determined health care professional held his professional hopes and vow to focus only on the patient and attend to his desires and needs. Reflected from his professional determination, the health care personnel made further efforts and called his physician to bring him medicines and diagnostic materials. With undistinguishable desire to catch up with life, the older sibling of the patient recognized one of his friends who operated drug shop. It therefore occurred that the pain relieving drugs were present at the drug shop. Fortunately, the health care personnel was in perfect need of the pain killers that he believed could calm the patient and let him die peacefully and silently. Good enough for professional health care personnel to do, the medical administrator held back for hours while checking on the patient until he passed on. The patient in mention in the paradigm case study suffered from metastatic lung cancer that had reached its mature stage. Going by the presence of lesions on the back of the patient indicated that the disease reached its critical point at which palliative therapy would not much effective. The patient had moved very close to death and only needed concentrated end of life care. At this level neither chemotherapy nor radiation therapy would produce effective results. Surgery as well could not be appropriate in managing the disease at this critical stage of development. The only solution to the unrest of the family concerning the patient was the administration of pain killer drugs to reduce the pain alongside intensive rehabilitation and encouragement to the patient. Level of proficiency & competencies-paradigm case The health practitioner in the paradigm case study had a good understanding of health care practices and the initiatives of end of life care. This can be seen from his/her noble judgment of diagnosing the patient with pain relieving medicines to calm the patient while dying slowly. The judgment made in this case was viable considering the production of lesion from the body of the patient, which was a good indicator that the disease had matured beyond cure. Worth to acknowledge was that the health practitioner understands of the feelings accruing to the family members from the distress of their dying relative. The help practitioner also displayed particular elements of proficiencies when he/she took issues by their ways and offered standard end of life health care services (Benner, 1984). The health care practitioner in the paradigm case study outlay signs of confidence and brevity in an environment surrounded by mourning and furious individuals. Heath practitioner in this paradigm case study had great competitive values as can be viewed from his/her perfect application of the recommended knowledge obtained from the field of nursing. Despite lacking certain critical diagnostic materials and equipment, the health practitioner in this paradigm case study used the least item within the vicinity to accomplish a challenging task. Being a competent medical professional, the nurse in the paradigm case study resolved to reputable analysis of the disease and set reasonable planning strategy with the mission of achieving goals that reflects professionalism (Benner, 1984). Pathophysiology of Metastatic Lung Cancer Metastatic lung cancer develops from another organ of the body after which the cancerous cells spread to attack the lung. Mazzone (2011) indicates that most of the lung cancers are results of spread of certain cancerous cells from the breast. According to Medline Plus (2011), lung cancer can also metastasize from bladder cancer, colon cancer, prostate cancer and sarcoma. Upon spreading to the lungs, the cancerous cells divide and develop to form tumors. Mazzone (2011) reports that developed tumors absorb body oxygen and nutrients. These actions of tumors in the body lead to further death of otherwise healthy cells. Mazzone (2011) confirms that lung cancer metastasizes to form primary tumor, which is the tumor in the lungs and secondary tumor that survives in other parts outside the lungs. Mazzone (2011) ascertains that lung cancer comprises of two different types of tumors as reflected on the type of cells that results into the cancer and the specific size of the tumor when viewed by a microscope. The two divisions of lung cancer are the non-small cell lung cancer (NSCLC) and the small cell lung cancer (SCLC). The SCLC forms small cases of lung cancer and have high growth and metastasis rates. Mazzone (2011) confirms that SCLCs are often dangerous in that they readily spread to other parts of the body at the time of diagnosis. Mazzone (2011) cites that adenocarcinom that is a component of the NSCLC forms the greatest case of lung cancer in the human body. Mazzone (2011) unveils that lung cancer manifests in various ways such as chronic coughs and short breaths. Lung cancer also manifests by swelling of the neck and chests of the victims. In addition, lung cancer can be manifested through spontaneous weight loss and decline in appetite of the victim. Mazzone (2011) discloses that recurrent pains in the chests, shoulders and back are other identifiable manifestations of lung cancer. Moreover, abnormal fatigue and weakness of the body constitutes symptoms of lung cancer. Furthermore, Mazzone (2011) elucidates that coughing of mucus containing blood and difficulty in swallowing constitutes the elements of cancer infection in the lungs. It is also worth of noting that bulging of nails of the toes and fingers are likely to be indicators of lung cancer infection. Treatment of Metastatic Lung Cancer The treatment process of cancer starts with thorough analysis and examination of the historical stages of development of metastatic lung cancer. According to Yoder (2006), before actual treatment of the detected cancer is done, it is of great essence to carry confirmation through cytology. Yoder (2006) provides that treatment for Non-small cell lung cancer (NSCLC) involves surgery when at early stages of development. Surgical treatment for NSCLC only applies to patients’ co morbidities and the level and duration of pain in the pulmonary vessels. Yoder (2006) adds that patients with a positive response to surgery will at times be subjected to radiation and chemotherapy or other extensional surgery. According to Yoder (2006), radiation therapy should be applied only on patients with cardiac diseases and those who have poor surgery response. Treatment of small cell lung cancer (SCLC) at its initial stages may involve synergy of chemotherapy and radiation therapy (Yoder, 2006)). Combination of chemotherapy and radiation therapy can also be used as curing mechanism for the metastatic lung cancer. However, chemotherapy is sometimes considered toxic in that it leads to transfer of the metastatic cancer to the nervous system and eventually the brain. According to Yoder (2006), it is recommended that every patient of metastatic lung cancer who undergoes successful chemotherapy treatment be offered prophylactic cranial irradiation in order to lower the risks of spreading to radiation spreading to the central nervous system. Yoder (2006) elutes that radiation therapy can be appropriate for patients with extensive diseases when applied as palliative therapy. Yoder (2006) discloses that surgical resection may also be applied in the treatment process of metastatic lung cancer. Eldridge (2011) elucidates that metastatic lung cancer can be treated through chemotherapy, which is given as palliative therapy destined to increase survival of the victim as it also reduce the symptoms. According to Eldridge (2011), there are some cases of metastatic lung cancer that can be cured simply through chemotherapy. Psychosocial aspect of metastatic lung cancer Austin and Boyd (2010) demonstrate that patients suffering from metastatic lung cancer are likely to face isolation from the members of the society. In addition, patients suffering from metastatic lung cancer do have poor concentration in everything that they do in life. Victims of metastatic lung cancer do have the feeling of unworthiness in the society especially when they realize that their energy levels are degenerating. Furthermore, patients suffering from metastatic lung cancer do face sleep disturbances and spends most hours awake. According to Austin and Boyd (2010), the entire psychological problems faced by cancerous patients only leads to great depression and anxiety about life. With the chronic nature of the disease, most patients of metastatic lung cancer undergoes through hard moments of stress and mental illness as they feel unable to participate in societal activities. The fact there is no clear treatment of the cancer has spilled great fear and feeling of discomfort among the patients of metastatic lung cancer. Patients of the metastatic lung cancer are always hopeless and interpret their situations as the end of their life (Capana & Jasmin, 2005). The use of chemotherapy in the diagnosis of metastatic lung cancer has potential and long term effects on the patients. According to DeBellis (1987), patients passed through chemotherapy face spontaneous hair loss, vomiting, changes in the color of skin and deprived appetite. In addition, cancer patients who get diagnosed through chemotherapy undergo retard sexual responses, diarrhea, hot flashes, constipation and chest congestion. Lilenbaum (2011) indicates that chemotherapy at times may lead to drop in the volume of blood in the body, which can always increase chances of one catching infections. Whittington illustrates that end of life care offered to the patients by clinicians help in safeguarding patient’s dignity without necessarily letting him/her suffer pain and discomfort the family members. End of life care ensures strategic discussion between the doctor and the patient regarding financial issues and management of symptoms linked to the metastatic lung cancer. Whittington presents pieces of advice to patients to make advanced registration in hospice coverage plan. Whittington mentions that hospice plan provides ideal strategy for patients to save before they are struck down by degenerative disease. Hospice plan caters for health care bills of the patients straight from prognosis to the stage of death or recovery. In the views of Whittington, ideal end of life care involves palliative care that focuses on comfort and reduction of symptoms while strengthening psychological and spiritual well being of the patient until death approaches. It is during end of life care that health personnel extracts slight wishes of the patients on how they would like their wealth be divided among the family members after death. Whittington indicates that doctors use the best of their profession to distinguish the appropriate time and point when to grill the patent concerning the patient’s wish. End of life care process avails ample opportunity for the medical practitioner to enquire from the patients about whom they would like to make decisions on their health in circumstances that they are unable to cooperate with doctors. End of life care process as offered by medical officers prepares the field for the health practitioner to get views of the patient concerning their funeral arrangements. Whittington indicates that at this level of end of life care, medical practitioners require to call funeral directors to help prepare budget according to the patient’s desire. In addition, Whittington demonstrates that end of life care enables doctors gather preferences of the patient on whether he/she be criminated or buried. Having prior experience on the death process of metastatic lung cancer patient enables care giver to provide maximum care in correlation to professionalism. The main aim of the end of life care for any patient is allowing peaceful and comfortable death of the patient under minimal pain. Prior exposure to the dying process of a patient expels fears and frustration from the care giver thus enabling one to gather confidence that is essential in avoiding suspicious behaviors that may affect the patient. Lamers (2011) disclose signs that relate to an individual who approaches death. Lamers (2011) indicate that most dying people face reduction in the body activity in the final hours and days. Dying people have retard appetite and do little speaking with low recognition of the surrounding. Dying people will be discovered by analysis and examination of blood pressure. Lamers (2011) unveils that blood pressure of dying people falls below normal and this reduces the rate and amount of blood circulation thereby resulting to fall in body temperatures. Dying people make short and quick breaths accompanied by periods of no breath. In addition, dying people encounters changes in skin color normally from pink to duller and darker. Sometimes the finger nails of the dying people changes in color from pink to blue while at the same time they bend. References Austin, W. & Boyd, M. (2010).Psychiatric and mental health nursing for Canadian practice. 2nd Ed. Olde City, PA: Lippincott Williams & Wilkins Publishing. Benner, P (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley Publishing. Capana, R. & Jasmin, C. (2005).Textbook of bone metastases. Hoboken, NJ: John Wiley and Sons Publishing. DeBellis, R. (1987).Psychosocial aspects of chemotherapy in cancer care: the patient, family, and staff. Madison, NY: Routledge Publishing. Eldridge, L. (2011). Metastatic Cancer to the Lungs. Retrieved October 29, 2011 from http://lungcancer.about.com/od/typesoflungcancer/a/metlungca.htm Lilenbaum, R. (2011). Patient information: Non-small cell lung cancer treatment; stage IV cancer. Retrieved October 30, 2011 from http://www.uptodate.com/contents/patient-information-non-small-cell-lung-cancer-treatment-stage-iv-cancer Mazzone, P. (2011).Lung Cancer. Retrieved October 30, 2011 from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/pulmonary/lung-cancer/ Medline Plus. (2011). Metastatic cancer to the lung. Retrieved October 30, 2011 from http://www.nlm.nih.gov/medlineplus/ency/article/000097.htm Whittington, E. A Patient’s Guide to Metastatic Cancer. Retrieved October 30, 2011 from http://media.curetoday.com/downloads/documents/pocketguide_metastatic_forweb.pdf Yoder, L. (2006). An Overview of Lung Cancer Symptoms, Pathophysiology, and Treatment. Retrieved October 29, 2011 from http://www.medsurgnursing.net/ceonline/2008/article08231235.pdf Lamers, W. (2011). Signs of Approaching Death. Retrieved October 30, 2011 from http://www.hospicefoundation.org/pages/page.asp?page_id=62884 Read More