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Palliative care is an approach that helps in improving the quality of life of the patients and their family members also who has been dealing with the issues that are related with life-threatening illness. This is done by preventing and providing relief from the suffering by detecting the pain and other issues be it physical, psychosocial or spiritual at early stage and doing impeccable assessment followed by the provision of treatment of pain and the other issues (Al-Mahrezi & Al-Mandhari, 2016). The main objective of palliative care is to mitigate the affliction of the patients along with their families by the inclusive evaluation and treatment of the physical, spiritual, and psychosocial symptoms that have been experienced by the patients. As the fatality approaches to a patient, its symptoms may entail more hostile palliation. The Palliative therapy is corresponded to the active care provided to the patients the nature of whose illness is such that it does not respond to the curative treatment. It is provided for the mitigation of the misery of the patient and to not affect the cure along with helping the individuals to address the people with their physical, social, spiritual, psychological, and practical issues along with preparing them for managing their life closure as well as their dying process. It also helps the patient’s family in coping with the loss and the grief at the time of illness and mourning (Hospice & Alliance, 2014).
This booklet will help the third year undergraduate students and the new graduate nurses as well in assisting them to understand the concepts of palliative care for end-of-life stage people. The booklet will help the care providers in developing the understanding for the challenges that may occur and the strategies that could be implemented in the provision of palliative care in end-of-life stage of the people.
1. Palliative care and hospice care
2. Principles of Palliative care for the individuals who are end stage of their life
4. Challenges or barriers faced in providing end-of-life palliative care
5. Potential Interventions
6. Core values of National Palliative Care Standards in end-of-life palliative care
Palliative care is an approach that helps in improving the quality of life of the patients who has been dealing with the issues that are related with life-threatening illness. The provision of palliative care is done by a team that includes nurses, clinical physicians, and other consultants who work in collaboration with the patient's other physicians for providing an extra stratum of support (Al-Mahrezi & Al-Mandhari, 2016). It is provided at any age of life and at any stage of any serious illness, and its provision can be done along with the curative treatment. While, Hospice is a program structured for providing the palliative care to the patients who have life expectancy of about six months or even less that and are at their residents. It has been covered by some medicare, Medicaid, private insurance plans that have enhanced home care benefits (Oechsle, 2019).
Palliative care plan entails:
(Bergenholtz et al., 2019)
The ultimate goal of palliative care at the end of life is to improve the quality of life during the last few months. for individuals who are suffering from severe diseases. This could be done by providing a miscellaneous array of support and care delivery to the patient (Davis & Hui, 2017). Apart from improving the quality of life some other goals are:
To overcome them, educating with various concepts and training the nurses with respect to the end of life palliative care would help in this. However, Physical barriers such as distance, poverty etc could be overcome by the implementation of government programs and providing cost effective care.
Given below are the potential interventions that are taken in case of any of the below issue faced during the care (Henson et al., 2020).
-Limiting the unnecessary painful procedures
-Administering anticipatory analgesia prior to the course of action
-Transcutaneous electric nerve stimulation if required
-Comfortable loose clothing
-Fan to provide cool air
-Limiting the volume of IV fluids
-Behavioural strategies, this include breathing exercises, relaxation, guided imagery, music
-Appropriate treatment for infection
-Managing the treatable lesions
-Moisturizing the skin
-Applying cold packs
Depression & Anxiety
Psychotherapy and behavioral techiques
The National Palliative Care Standards helps in evidently eloquent and endorsing the vision for the compassionate and proper specialist palliative care. The Standards will also helps in distinguishing the significance of person-centered and age-appropriate care. This helps to manage the end-of-life care to the patient efficiently. In scrupulous, the standards point to the choices and the need for the attention towards the needs of the people that is at risk (Dalal & Bruera, 2017).
The core values of the National Palliative Care Standards entails:
Al-Mahrezi, A., & Al-Mandhari, Z. (2016). Palliative care: Time for action. Oman Medical Journal, 31(3), 161–163. https://doi.org/10.5001/omj.2016.32
Dalal, S., & Bruera, E. (2017). End-of-life care matters: Palliative cancer care results in better care and lower costs. The Oncologist, 22(4), 361–368. https://doi.org/10.1634/theoncologist.2016-0277
Davis, M. P., & Hui, D. (2017). Quality of life in palliative care. Expert Review of Quality of Life in Cancer Care, 2(6), 293–302. https://doi.org/10.1080/23809000.2017.1400911
Getty, J. (2018). Principles of palliative care. InnovAiT, 11(12), 676–679. https://doi.org/10.1177/1755738018793921
Hawley P. (2017). Barriers to access to palliative Care. Palliative Care, 10, 1178224216688887. https://doi.org/10.1177/1178224216688887
Henson, L. A., Maddocks, M., Evans, C., Davidson, M., Hicks, S., & Higginson, I. J. (2020). palliative care and the management of common distressing symptoms in advanced cancer: pain, breathlessness, nausea and vomiting, and fatigue. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 38(9), 905–914. https://doi.org/10.1200/JCO.19.00470
Hospice, W., Alliance, P. C. (2014). Global Atlas on palliative care at the end of life. London: World Hospice and Palliative Care Alliance.
Karen, R. (2016). Palliative care improves quality of life, reduces symptoms, AJN: American Journal of Nursing, 117(4), 66. doi: 10.1097/01.NAJ.0000515237.74666.c3
Khoshnazar, T. A., Rassouli, M., Akbari, M. E., Lotfi-Kashani, F., Momenzadeh, S., Haghighat, S., & Sajjadi, M. (2016). Structural challenges of providing palliative care for patients with breast cancer. Indian Journal of Palliative Care, 22(4), 459–466. https://doi.org/10.4103/0973-1075.191828
Oechsle K. (2019). Current advances in palliative & hospice care: problems and needs of relatives and family caregivers during palliative and hospice care-An overview of current literature. Medical Sciences (Basel, Switzerland), 7(3), 43. https://doi.org/10.3390/medsci7030043
Schroeder, K., & Lorenz, K. (2018). nursing and the future of palliative care. Asia-Pacific Journal of Oncology Nursing, 5(1), 4–8. https://doi.org/10.4103/apjon.apjon_43_17
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