Palliative Care as a Critical Exercise at the Last Days of Life - Essay Example

Running Head: Palliative Care Student’s name Institution Course Lecturer Date Introduction With the current focus on provision of good health care to all people, the mortality rate has increased. According to the 2009 statistics done by the World Health Organization (WHO), the percentage of persons aged beyond 65 years in Europe has steadily increased (Hall et al., 2011). It is estimated that 25% of individuals in Europe region will have attained an age of 65 years and above by 2050 (Hall et al., 2011). As a result of high prevalence rate of cancer cases, much focus has been put on provision of palliative care for cancer patients. Palliative care, also known as comfort care is a significant care given to people with terminal illnesses and it focuses on providing quality life and dignity to the affected (Hall et al., 2011: 1). It prolongs their life and relieve from pain affecting them and their intimates. Its goal is to prevent the symptoms and side effects of an illness besides treatment as early as possible. Palliative care is usually given systematically, putting into consideration psychosocial and spiritual needs of the patient and family. Routine for administration of palliative care should be provided by health care professionals. Currently, the life span of people from well developed nations is over 65 years while that of people from developing nations is less than this (Brereton et al., 2011: 982). Needs of people in Palliative Care Care of people above 65 years towards the end of their lives is something has become a challenge to many. Brereton et al., 2011 notes that little has been done to establish the actual needs of people within this age group (p. 982). Many of them have reported preference of death occurring at the hospital which implies that health care experts ought to be knowledgeable about the appropriate care to be given to these people. Notably, the physical environment provided to these people is a crucial aspect and the issue of environment provided by the health facilities turned out to be a subject of major concern (Boltz et al.,2010). As noted by one of the respondents in a research done by Boltz et al., the hospital ought to provide an enabling environment rather than a disabling environment to the patients (Boltz et al., 2010: 385). Three aspects are deemed pertinent in the physical environment. They include; privacy, proximity to intimates and home and satisfaction in the environment (Brereton, 2011: 985). Privacy of the Physical Environment With regards to privacy, health experts have noted that patients and relatives are depressed by exposure of secrets. privacy of the physical environment during palliation is therefore crucial. A study conducted revealed that a higher percentage of patients died when they shared a room with many other patients (Brereton, 2011: 986). The fact that patients who are on palliative care require privacy ought not to be confused with being left alone. On the side of relatives, the same study indicated that relatives were more comfortable to make a telephone call with much privacy (Brereton, 2011: 986). Rowlands & Noble (2008) noted that single bed rooms were crucial in providing privacy, reducing the levels of noise and rate of infection (Rowlands & Noble, 2008). This was in agreement with research done by Brereton. It therefore stresses the need to provide palliative care to patients in a private environment. Proximity to Intimates and Home Proximity to home environment and loved ones was also noted as the most important factor during the period of palliation for both the relatives and the patient. Proximity helps in enhancing accessibility of the health facility by the relatives. Relatives were found to be more willing to stay overnight to give the patient company which is very crucial at the time of palliative care (Brereton, 2011: 986). The presence of relatives to provide social support helps in the stress reduction and pain reduction (Rowlands & Noble, 2008: 768). Satisfaction with the environment It has also been noted that the physical environment surrounding the patient ought to be satisfy the patient and relatives. In particular, the environment should be clean and homely to mostly the relatives (Brereton, 2011: 986). Additionally, familiarity with that environment for the patients is deemed crucial towards their last days of life. Therefore, in as much as palliative care patients do require appropriate pain management, the physical environment is also a crucial aspect of their last stages of life. There is need to provide an environment which satisfies the needs of both patients and caregivers owing to the growing belief that it affects the quality of life (Rowlands & Noble, 2008). privacy, proximity and satisfaction of environment are the key factors to consider when planning and modifying an environment of a patient with terminal illness. Importance of Providing Palliative Care Palliative care is an important practice that helps both the patient and family. It is worth noting that when an individual is diagnosed of a terminal illness, both the family and the patient him/herself suffer emotionally (Payne & Froggatt, 2009). The situation is more worse for older individuals whose dying period is prolonged and complex. In addition to this, the complexity of dealing with older people is further worsened by the ambiguity of such cases that can lead to either overtreatment or under treatment thus delaying referral to palliative care (Payne & Froggatt, 2009: 219). A number of factors are usually considered on whether a condition can proceed to the palliative care. On many occasions, it is the complexity of the situation that normally determines if the condition is to proceed to palliative care or not. Palliative care involves helping the patient relieve the suffering and making their families understand the conditions for change in patient. Patients and family members do experience changes in the; social, spiritual, emotional and bodily dimension at this period of end of life (Payne & Froggatt, 2009: 223). The effects of these changes should be made clear to them, and this will assist in the future care. For this to succeed, attention is required together with exceptional communication skills to both the family members and the patient. Payne & Froggatt (2009) highlights the fact that communication and interaction is a crucial factor in the period of palliative care. similarly, Rowlands & Noble (2008) note the fact that findings have shown that good communication is key in the period of palliation as it helps in anxiety reduction and the improvement of outcomes for both the family and the patient. Misunderstandings are a common phenomenon when dealing with such cases and they usually occur as a result of poor communication and for the fact that is normally difficult to satisfy all the needs of patients and their families. Confidence and appropriate communication are the key factors that have been highlighted to be very crucial when dealing with patients undergoing palliative care (Payne & Froggatt, 2009: 223). Health professional need to understand the needs of these people and their families in order to provide an appropriate end of life care to patients. The basic elements of palliative care are pain, and symptom assessment and advanced care planning management. Treatment should be stopped when the condition of the patient is complicated and irreversible. Advancement to palliative care can also occur if the treatment given to the patient is not working and causes a lot of pain to the patient.. Pain is a common symptom of any sickness (Borda et al., 2013). pain could result from bodily reaction to prevent further tissue damage or treatment administered to manage the prevailing condition. Terminal illnesses' patients usually experience pain resulting from either bodily reaction to prevent further tissue damage or progressive treatments administered to manage the condition. Pain usually affects the quality of life of patients adversely (Hughes, 2012). While pain adversely affects the quality of life of a patient, some of them can manage well. Health professionals need to assess the magnitude of pain that and place it on a rating scale. This will help in ensuring that they receive appropriate and effective management. Advanced care planning on the other hand is that process of preparing a plan for the future health and care of an individual putting into consideration the values and preferences in a situation when an individual may not have that ability of communicating what he or she needs. Advanced care planning is critical because it helps in ensuring quality life is provided irrespective of whether a patient has the ability to communicate or not. Conclusion In conclusion, palliative care is a critical exercise at the last days of life. There is need for health professionals to understand the needs of patients putting age into consideration if they are to provide an appropriate care. Physical environment is an overall factor in this case and it is normally depended upon by other factors. The fact that little has been done with regards to palliative acre to be provided to older people stresses for the need to conduct more research. This will guarantee an improvement in the quality of life provided to older people dying beyond 65 years. References Boltz M., Capezuti E., Shabbat N. & Hall K. (2010). Going home better not worse: older adults’ views on physical function during hospitalization. International Journal of Nursing Practice 16: 381–388. Borda, A. P., Charnay-Sonnek, F., Fonteyne, V. & Papaioannou, E. G. (2013). Guidelines on Pain Management and Palliative Care. European Association of Urology 2013. Brereton, L., Gardiner, C., Gott, M., Ingleton, C., Barnes, S. & Carroll, C. (2011). The hospital environment for end of life care of older adults and their families: An integrative review. Journal of Advanced Nursing, 68(5): 981-993. Hall, S., Petkova, H., Tsouros, A. G., Costantini, M. & Higginson, I. J. (2011). Palliative Care for Older People: Better Practices. Copenhagen: World Health Organization (WHO). Hughes, L. D. (2012). Assessment and Management of Pain in Older Patients Receiving Palliative Care. Nursing Older People, 24(6): 23-29. Meie, Diane E., Isaacs, Stephen L. & Hughes, Robert. (2010). Palliative Care: Transforming the Care of Serious Illness. London: John Wiley & Sons. Payne, S. & Froggatt, K. (2009). Global Exchange: Improving Palliative and End -of-Life Care for Older People in Ireland: A new Model and Framework for Institutional Care. Journal of Palliative Care, 25(3): 218-226. Rowlands J. & Noble S. (2008). How does the environment impact on the quality of life of advanced cancer patients? A qualitative study with implications for ward design. Palliative Medicine, 22(6): 768-774. Read More