Palliative, Rehabilitation and Continuing Care

Introduction to Palliative, Rehabilitation and Continuing Care

End-of-life care is an approach in which the care is provided to the patients suffering from the illness of an incurable health problem and is on the verge of their death or very close to it (Westerhoff, 2017). The demonstration of respect and care for the patients, carers, and his/her family members is the core values of the National Palliative Care Standards that are focused in this study.

This review focuses on the analysis and critiques of the current studies on end-of-life care or palliative care. The increased realization has made end-of-life care a major topic for concern for the health carers, patient’s family members, and also for the patients. The themes may include patient-centered care, are important as it helps the carers to know more about the patient’s beliefs, cultures, and their involvement in decision making enables them to form a better plan to treat the patients.

Literature Review of Palliative, Rehabilitation and Continuing Care

  • Theme – Shared decision making

According to Sandsdalen et al. (2015), patients prefer high levels of participation in shared decision making. Some wanted to get their families involved in the health care team, whereas, some patients prefer their involvement in developing their treatment plans. According to Brenner et al. (2016), in some cases, the parents of the ill child want the participation of some related family members in decision making.

The involvement of the patient’s family members in health care teams and decision making is very difficult because they do not understand the clinical standards and importance of specific surgeries and treatments for well being of the patient.

  • Theme - Communication

According to Hajradinovic et al. (2018), the ability to talk to family members and friends about everyday topics and treatments play a major role in improving the situation of the patient. According toEriksson et al. (2016), communication with health caregivers or family members or friends about the pain and suffering during the end stage of life makes the patient that he/she is not alone.

For making the availability of friends or family members to the patient, hospital staff needs to prepare a room for their stay and manage the visiting hours accordingly, this increases their work pressure. Moreover, the involvement of the patient and his family members in decision making gives insights about the patient’s beliefs, values and needs that in improved treatment of the patient.

  • Theme – Consistent care

According to Hughes et al. (2019), found that the efforts of the caregivers were highly appreciated by the patient and his family members because in the life of terminally ill patients the role of primary care physicians is of high importance. According to Brenner et al. (2016), the interviews showed that parents highly appreciate the efforts and consistent care by the hospice staff that resulted in a high improvement in their ill child at his life ending phase.

For providing full-time surveillance and care, it is required to assign caretakers to the patient all day long, such facilities are more effective in home facilities than in hospitals.

  • Theme – Comfort services

According to Aghdash (2015), end-of-life care services include taking full care of the patient’s comfort and support. According to  Chiang et al. (2017), end-of-life care services are available at home also for the patient’s comfort but yet they are being hospitalized at an increased rate.

The home served patient shows an increase in the rate of being hospitalized so the quality of home-based end-of-life care needs to be improved.

The table summarises the commonalities found between authors and themes and is used as a correlation between the literature review.

Table: Common themes in selected articles.

 

Authors Names and Date of Publication

Common Theme

1. Sandsdalen et al (2015)

2. Aghdash (2015)

3. Eriksson et al (2016)

4. Brenner et al (2016)

5.  Chiang, Lee, & Kao (2017)

6. Hajradinovic et al (2018)

7. Hughes et al (2019)

Shared

Decision-Making

v

   

v

     

Communication

   

v

   

v

 

Consistent care

     

v

   

v

Comfort services

 

v

   

v

   

Discussion on Palliative, Rehabilitation and Continuing Care

This review reveals that formulation of end-of-life care faces many barriers like financial barriers, family-related issues, patient-related issues, these are needed to be considered majorly while implementing any strategies end-of-life care (Aghdash, 2015). If there is a lack of staff members then this leads to the need for availability of at least one family member for communication so that they do not feel lonely. This is because they cannot undergo the painful story of their critically ill child again and again and this helps in reducing the stress of the parents up to some level.

The study also revealed that end-of-life care helps in enabling the patients to live a happy and stress-free life for the remaining part of their life. When the patient is very close to his/her death, effective care provided by the health care team enables the patient along with their family members to accept the fact of near death. The planning of decisions for the patient with the involvement of the patient in his/her decisions results in improved results (Hajradinovic et al., 2018).

Therefore, communication, consistent care, and a few more are important themes under the demonstration of respect and care for the patient, carers, and his/her family members as a core value of the National Palliative Care Standards that are focused in this study. The encouragement of effective communication, peer support, and friendship comfort services prevent the feeling of loneliness among the patients.

Conclusion on Palliative, Rehabilitation and Continuing Care

The need to build effective end-of-life care or palliative care is felt in such a world where most of the population at least once get hospitalized in their old ages with health issues, like diabetes, cancer, and many others. Sometimes the lack of experience in delivering the care impacts the effectiveness of end-of-life care. The social, cultural, and behavioral aspects of the patient and their family members create barriers in the execution and planning of delivery of care and treatments to the patient. It is important to meet the general ideology of code value related themes so that the patient can live the rest of their lives happily and meaningfully.

Reference List for Palliative, Rehabilitation and Continuing Care

Aghdash, S., A., Ghojazadeh, M., Aghaei, H. M., Behzad, M. N., & Asgarlo, Z. (2015). Perspective of patients, patients’ families, and healthcare providers towards designing and delivering hospice care services in a middle income Country. Indian Journal Of Pilliative Care, 21(3), 341–348. DOI: 10.4103/0973-1075.164898

 Brenner, M., Connolly, M., Cawley, D., Howlin, F., Berry, J., & Quinn, C. (2016).  Family and healthcare professionals’ perceptions of a pilot hospice at home programme for children: A qualitative study. BMC Pilliative Care. https://dx.doi.org/10.1186%2Fs12904-016-0161-0

Chiang, J. K., Lee, Y. C., & Kao, Y. H. (2017). Trend analysis of end-of-life care between hospice and nonhospice groups of cancer patients in Taiwan for 2002-11. Medicine, 96(34). https://doi.org/10.1097/MD.0000000000007825

Eriksson, H., Milberg, A., Hjelm, K., & Friedrichsen, M. (2016). End-of-life Care for Patients Dying of Stroke: A Comparative Registry Study of Stroke and Cancer. Plos One11(2). https://doi.org/10.1371/journal.pone.0147694

Hajradinovic,Y., Tishelman, C., Lindqvist, O., & Goliath, I. (2018). Family members´ experiences of the end-of-life care environments in acute care settings – a photo-elicitation study. International Journal of Qualitative Studies in Health and Well-being ,13(1). https://dx.doi.org/10.1080%2F17482631.2018.1511767

Hughes, N. M., Noyes, J., Eckley, L., & Pritchard, T. (2019). What do patients and family-caregivers value from hospice care? A systematic mixed studies review. BMC Palliative Care18(1), 18. https://doi.org/10.1186/s12904-019-0401-1

Sandsdalen, T., Hov, R., Høye, S., Rystedt, I., & Wilde-Larsson, B. (2015). Patients’ preferences in palliative care: A systematic mixed studies review. Palliative Medicine. doi: 10.1177/0269216314557882

Westerhoff, D. M. (2017). End-of-life care. Canadian family physician63(5), 351–352. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429047/#:~:text=Palliative%20care%20is%20an%20approach,pain%20and%20other%20problems%2C%20physical%2C

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