Quality of Life and Functioning - Essay Example

Health care is extremely important if patients’ lives have to improve. Health promotion and quality of life practices are important when dealing with patients suffering from chronic diseases like cancer. Negative perceptions have negative consequences to the health of a dying patient as in the case of Mr. and Mrs. Thomas. Three strategies that can be used in improving the quality of life of patients suffering from chronic ailments include activities of daily living (ADLs), instrumental activities of daily living (IADLs), and active grief and bereavement counseling for families and patients. A holistic nursing plan is vital when caring for patients as in the case of Mr. and Mrs. Thomas. Among other things, the nurse as a care giver should work together with health facilities and community members in the promotion and maintenance of health, illness care and rehabilitation of patients. Quality of Life and Functioning Good health is desirable for all people whether they are reasonable or not. However, in some instances, human beings end up being affected by chronic diseases, such as cancer, that have grievous implications on the life of an individual. Chronic diseases like cancer can lead a person to experience grave depression as he/she tries to deal with the effects of the disease. Individuals with chronic diseases often experience challenges in their social life as they are not able to enjoy life as expected (Aldwin & Gilmer, 2004). It is important to note that persons with chronic diseases need to be given adequate care. They should be assisted to meet their personal needs, such as bathing, toileting and dressing. In addition, they should be given the necessary assistance in performing their daily tasks like shopping, paying bills, using telephone, as well as navigating physical and social environments. Health promotion services should be able to optimize health and healthy behavior of individuals suffering from chronic diseases. These services should also help patients improve their condition and, therefore, decrease the effects of the illness. Quality of Life program is being done to ensure that the patient achieves optimal health and is able to live independently without any external help. In addition, Quality of Life also involves the use of effective cognitive components (Aldwin & Gilmer, 2004). Dangerous diseases, such as breast cancer affecting Mrs. Thomas, have serious effects in life. They can interfere with quite a lot of everyday activities of an individual. The disease may affect the senses making it difficult for the patient to see or hear, thereby affecting personal mobility. The disease also has diverse effects on the social life of the individual. Such patients should be assisted to achieve their normal body functioning as suggested by Aldwin and Gilmer (2004). Health care is extremely necessary since it enables the improvement of patients’ lives. Caregivers should consider nutrition, dental care, exercise and physical activity when attending to patients. Care givers should also ensure that patients suffering from cancer stop smoking cigarette. The main aspects that must be addressed in the life of the patient that should be managed effectively include the physical, psychological, and social components. Health promotion and quality of life practices are very important in ensuring that patients suffering from chronic diseases such as cancer get necessary support from their care givers. Without health promotion tips, the patient risks suffering from depression; they may even succumb to the disease easily (Aldwin & Gilmer, 2004). Personal perceptions affect Mrs. and Mr. Thomas in several ways. The two see their heath status to bee too serious that they will eventually succumb. Patients who have personal perceptions that they can never get well are very difficult to treat. The nurse can provide the best possible care but without change in perception, there can never be change. Personal perceptions lead to more depression. Secondly, Mr. and Mrs. Thomas believe that friends have stayed away from them because of poverty and their health status. Perceptions like these have negative consequences to the health of a dying patient. In addition, Mrs. Thomas believes that it is her situation that is affecting her husband. Perceptions like these only lead to more depression. The husband may as well be affected by the feelings of his wife towards his health status. There can never be progress if personal perception are negative, patients must at all time remain positive. Three strategies that can be used in improving the quality of life of Mr. and Mrs. Thomas include activities of daily living (ADLs), instrumental activities of daily living (IADLs), and Active grief and bereavement counseling for families and patients. Activities of Daily Living (ADLs) The activities that will have to be undertaken under the activities of daily living include helping the patients bath, dress, toilet, eat, and moving them from one bed/place to another. These measures enable the care giver and health professional to determine the current status of the patient, for instance, whether they are making progress or are deteriorating in health. Activities of daily living also ensure that the patients achieve independence while at home; they should always be helped with bathing and eating. In general, the main objective of activities of daily living is to ascertain whether or not the patient can perform normal daily activities with or without assistance (Aldwin & Gilmer, 2004). Instrumental Activities of Daily Living (IADLs) Another strategy applied in patient care involves instrumental activities of daily living (IADLs). The management of Mrs. And Mr. Thomas requires the assessment of their physical and mental abilities to do daily activities as well as the level of their motivation in life. The main activities that should be undertaken in this respect include assistance in areas of making telephone calls, shopping, preparing food, housekeeping, laundering, independent travel, taking scheduled medication; manage their finances, however little they might be. There are several reasons why patients may not be able to undertake a given task (Miller, 2008). In most cases, the patient should be helped with their physical limitations, environmental factors that affect them, and social constraints. Mrs. and Mr. Thomas should be helped to achieve stable psychological well being through counseling. Instrumental daily living and activities of daily living are not only important to the physical ability of the patients, but also in ensuring that the patients achieve normal functioning in respect of their mental abilities and social life. Active Grief and Bereavement Counseling For Families and Patients This strategy helps in making the families, friends as well as patients deal with the consequences arising due to the illness of their friends and family members. There are very serious consequences arising from a dying patient to the survivors of the illness. It is not always easy to prepare a family member for the death of their loved ones. Mr. Thomas needs adequate counseling to avoid any further consequences on his health. Mrs. Thomas should be made to learn how detach herself from the husband so that she die peacefully in case her condition worsens. Families should always be informed of the health condition of their members on a constant basis so that they are able to prepare for any eventuality. Family members can be very important in healing the dying patient since they provide human touch. Acknowledging and accepting the condition of dying patients as well as sharing in their feelings and emotions is very important. Counselors and therapists should consider Mr. and Mrs. Thomas’s thoughts and feelings about their life before coming up with an appropriate counseling approach (Lubkin, 2011). Holistic Nursing Plan Nursing refers to the service given to an individual that helps him/her gain and maintain a healthy state of body and mind and in case this does not happen, the individual’s pain and discomfort is relieved. Holistic nursing is defined as the philosophy of nursing practice that is concerned with total patient care, in regard to the patient’s cognitive, social, financial, and spiritual requirements. It also considers the patient’s attitude toward the illness and the impact it has on his/her capacity to meet self-care needs. The care facilitates patient healing by creating a caring, interactive environment, facilitating patient encouragement, scientific intervention and individual cooperation to help them become whole, and esteemed individuals. Holistic nursing requires the understanding of the patient’s history and current social, psychological, physiological and spiritual needs. The current emphasis on holistic and patient centered care involves the patient and family members in designing and implementing an individualized plan of care. The nurse only provides primary support in providing resources, promoting healthy lifestyle and facilitating the learning and healing process as noted by Daniels and Nicoll (2011). Physical activity during cancer treatment contributes to the improvement of quality of life. The exercise needs to be done in a supervised setting, and appropriate caution taken in monitoring blood counts and cardiac pulmonary status. Physical exercise reduces some negative side effects of the cancer treatment, such as reduced physical functioning. Pain caused by cancer can be intensified by psychological stress which requires psychosocial interventions. Also, education about cancer will help the patient overcome barriers to the treatment of pain and stress. To optimize Mrs. Thomas’ functional ability, the nurse must be able engage in activities that include helping the patients bath, dress, toilet, eat, and moving them from one bed/place to another. These measures enable the nurse determine the current status of the patient, for instance, whether they are making progress or are deteriorating in health. These activities also ensure that Mrs. Thomas achieve independence while at home; she should always be helped with bathing and eating. In general, the main objective of the nurse is to ascertain whether or not the patient can perform normal daily activities with or without assistance. Education devices include videos, tutorials, coaching and didactic lessons. Training on coping skills is important to the patient and care givers. In summary, management of pain and stress for cancer patients is both multimodal and multidisciplinary. This means that both pharmacologic and non-pharmacologic measures are helpful in the treatment of breast cancer patients and survivors (Daniels & Nicoll, 2011). Patients suffering from terminal cancer experience significant stress in their attempt to cope with anxiety, lack of acceptance in respect of what happened to them, physical pain and fear of death. Patients in the terminal stage of the disease display rational and irrational anger towards their family, the care givers, and society in general. Once self care is no longer possible, group therapy is recommended for Mrs. Thomas and her family so as to manage chronic depression. Group therapy is an accepted psychiatrist treatment that utilizes therapeutic forces within the group, constructive interactions between members and the intervention of a trained leader to change the patient’s negative attitudes. Chronic depression group therapy has stood out as the most supportive intervention when it comes to increasing the length and quality of patient life of Mr. Thomas. The group experience will provide Mrs. Thomas with a sense of purpose in life as they share their life experiences. The group experience assists Mr. Thomas get a deeper meaning of life, and accept death as something that will occur to everyone since human beings are mortal. The helpful information reduces depression levels, and helps patients to deal with self-neglect, guilt, and anger. Staff and caretaker support groups enable individuals to provide better patient care and smoother functioning in their surroundings through improved staff wellbeing. The groups are headed by a facilitator instead of a group therapist whose goal is to assist members in reducing the levels of stress instead of resolving personal conflicts or attempting personal change. The groups meet on regular bases and benefit from the sessions in various ways. First, participating in group activities helps reduce anxiety, minimizes the feeling of isolation, improves intrapersonal communication between caregivers, heightens self esteem, and improves the patient’s adaptation in working with family members, greater group interaction, and cooperation. The patient’s goals become more realistic and significant improvement witnessed in the tolerance of pain and suffering. In short, group therapy is an effective treatment for acute and chronic ailments that are accompanied by stress. It provides a platform where members learn from one another, and increases trust and confidentiality. Role of Community Health Nurse Stress is perceived as disruptive, or a threat to the person’s psychological, psychosocial and spiritual wellbeing. Mr. and Mrs. Thomas require a quick response. The work of the nurse is to identify the patient’s strengths and weaknesses, provide necessary equipment, devices and facilities, make appropriate interventions, and support the patient in achieving stability. The nursing process in respect of self care helps the nurse identify and evaluate self care deficits, determine the availability of internal and external resources, and establish a course of action. The case of Mr. Thomas requires attention by encouraging him to evaluate his surrounding stressors and the environment. After this, the patient will be assisted to accept the need to understanding his level of control over current circumstances. Further encouragement should be done to help Mr. Thomas carefully follow the suggested stress management methods (Fink, 2000). The roles of a nurse care giver are to work together with health facilities in the promotion and maintenance of health, illness care and rehabilitation of Mr. Thomas. They provide health care education in the process of helping Mr. Thomas cope with his current situations as well a in performing their duties normally. Education incorporates diet, exercise, stress management, safety measures, and self care. Patients’ questions regarding their condition and misconceptions on the same are clarified by nurse care givers. Positive teaching and reinforcement will be provided to Mr. Thomas to help him assume self care management. The education process will be individualized to the patient’s level of understanding. The information will improve his acceptance of his wife’s situation to effectively continue assuming his role as the breadwinner (Fink, 2000). References Aldwin, C. & Gilmer, D. (2004). Health, illness, and optimal aging: Biological and psychological perspectives. New York: Sage. Daniels, R. & Nicoll, L. (2011). Contemporary medical-surgical nursing. Vol. 1. London: Cengage Learning. Fink, G. (2000). Encyclopedia of stress. New York: Academic Press. Lubkin, P. (2011). Chronic illness: Impact and intervention. New York: Jones & Bartlett Publishers. Miller, C. (2008). Nursing for wellness in older adults. New York: Lippincott & Wilkins. Read More