End of life care is one of the notable types of care that focuses on individuals during the final months of their lives. The consideration of the end of life care arises in situations that involve deteriorating health condition even though he or she is receiving active treatment. In most cases, this is essential when dealing with incurable health conditions that may include cancer, among others. However, it is equally important to take note of the fact that end of life care is similarly essential in geriatric or gerontological care. Primarily, the adoption of end of life care for older patients seeks to provide health professionals with a well-structured plan to help in enhancing the quality of life of the patients.
The reason for having to select the end of life care is because it remains as one of the critical areas of responsibility that reflect on the essentiality of ensuring that patients are comfortable even though they are most likely to die. In geriatric nursing, end of life care is viewed as being rather remarkable, considering that it allows for an effective response to socio-demographic changes and challenges associated with dealing with older adults with life-limiting conditions. The adoption of the type of care serves as a guarantee of advancing overall effectiveness in dealing with older adults effectively. The main expectation is that this will help establish a front through which to make sure that the older adults remain comfortable while limiting their exposure to pain or other challenges that they are likely to encounter.
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Significance of the Problem
When focusing on the geriatric population, end of life care is considered as being rather significant, as it reflects on the commitment that seeks to involve both patients and caregivers. The provision of proper care during the end of life helps in creating an improvement in the quality of life of the older patients receiving care. The significance of the end of life care can be seen from the fact that it plays a critical role in reducing exposure of patients, who are battling incurable illnesses, to pain. Essentially, this means that health care facilities used in this case are expected to make sure that their patients are not exposed to any forms of discomfort that may affect the quality of their life irrespective of the fact that they may die within a few weeks or months. The idea is having to create a well-structured approach through which to create an environment that promotes the standard of health for the patients at all times.
The other notable significance associated with the end of life care is that it ensures that patients can overcome some of the fundamental problems or challenges that they are likely to encounter in their final months. One such example is when older adults find themselves dealing with issues such as depression and anxiety resulting from the changes associated with their age. In such cases, the health care facilities providing care are expected to come up with an effective plan that will help in delivering expected psychological care for the patients as part of improving the quality of lives that they lead. Additionally, this would also mean that the health care institutions would be in a much more viable position of having to manage such risks as the patient's age or illness progresses.
From a nursing perspective, end of life care is viewed as a critical approach through which to ensure that persons suffering from incurable illnesses or those experiencing old age live a life that reflects on dignity. End of life care is considered a critical area of nursing that seeks to ensure that patients, who are entitled to high-quality care, receive care personalized care depending on their illness or age to improve on their health outcomes. In most cases, this means having to ensure that every aspect associated with the patient's life is well managed to achieve the best possible results. Additionally, this would also mean that caregivers will also take into account what they consider as being most famous for the patient as part of improving the quality of life that they lead.
Literature Review
A review of literature touching on the end of life care concerning the geriatric population highlights the fact that this is a type of care that has, for a long time, been ignored. Johnson, Butow, Kerridge, Bell, & Tattersall (2018) indicate that health care systems around the world have failed to consider the type of care as part of their approaches to palliative care; thus, meaning a significant number of people find themselves missing out on this approach to quality of care. The challenge that this has had for patients is that most of those requiring end of life care, especially the elderly who suffer as a direct result of their health conditions.
According to Makaroun, Teno, Freedman, Kasper, Gozalo, & Mor (2018), one-third and two-thirds of people dying in developed countries die in hospital settings with approximately 20% dying while in intensive care units. From this point of view, it is clear that that the there is a high demand for the end of life care, considering that it allows for the development of a well-structured approach through which to improve the health standard for patients that are most likely to die in hospitals. Makaroun et al. (2018) highlight the need for having to ensure that end of life care is included as a significant aspect in providing quality care while ensuring that it is guided by patient-centred research. That means that the adoption of a plan to improve on the end of life care ought to be defined by the need to personalize care. Specifically, this would mean that the quality of care offered would be much more personalized as a way of ensuring that the patients remain satisfied at all times while improving on their comfort.
Lasater, Sloane, McHugh, & Aiken (2019), on the other hand, have indicated the need for having to ensure all stakeholders in the health care industry are included in the plans through which to create guidelines touching on how health institutions should provide end of life care. The demand for the purpose of life care for older adults indicates that most health institutions offer such type of care work based solely on intuition rather than using an evidence-based approach. The use of intuition means that the effectiveness of the care services provided cannot be guaranteed regardless of the extent to which such types of care are justified. Lasater, Sloane, McHugh, & Aiken (2019) point to the need for having to ensure that all stakeholders, who include service provided and government agencies are involved in a plan through which to define the plan of care adopted.
Shulman et al. (2018), in the analysis of the viability of end of life care, take note of the fact that health institutions often ignore palliative care departments, which, in turn, limits funding and resources to such departments. The limitation of funding and resources means that palliative care departments, which are responsible for the provided end of life care, find it much harder to adopt well-structured strategies. The challenge arises from the fact that these departments require funding to allow them to acquire machinery and medication that improves on the best quality of care. Shulman et al. (2018) indicate that providing funding to palliative care departments would mean that processes associated with improving the quality of life would be considered, as well as, developing necessary tools that would aid in providing such quality of care. For the hospitals involved, the ultimate outcome is that patients may experience a higher sense of satisfaction with the care services offered.
Action Plan
As a geriatric nurse, I would focus on several key strategies through which to ensure that practical approaches are taken as part of providing health facilities to undertake the importance of end of life care. The strategies include:
Stakeholders Education
The first plan of action would involve education of stakeholders on the value that ought to be placed on the end of life care as an essential aspect of consideration in palliative care. The education of the stakeholders will be evidence-based, which means that I will provide the stakeholders with viable information regarding end of life care. The main intention of having to consider stakeholder education as a critical factor in the adoption of end of life care is to ensure that this type of care is normalized as part of the health care setting. The idea is that this will establish a clear front through which health facilities understand that end of life care is one of great importance when caring for the elderly. Additionally, this would also mean that the health care facilities will be on the forefront towards ensuring that they improve on the quality of life for the older adults as part of the stay in the hospital setting.
Advancement of Quality Standards in Hospitals
One of the critical areas of consideration in geriatric nursing is how to advance quality standards that would ensure that older patients are safe and comfortable at all times. As a nurse in this field, it is within my expectation to come up with quality standards that hospitals ought to adopt or implement. The standards will be inclined towards improving the processes of care for patients during the last few weeks or months, depending on the impacts associated with their age or illnesses. Additionally, the quality standards will also take into account the importance of having to improve on mental health services provided to patients as part of the end of life care. By advancing these quality standards, managements in hospitals will be in a better position of having to appreciate the end of life care. That would also mean that the hospitals would also capitalize on the demand for this type of care when dealing with older patients as part of improving patient satisfaction.
Recommendations
From the analysis, it is clear that majority of health care institutions have failed in implementing different strategies regarding the end of life care as part of dealing with older patients, which creates the need for having to consider several notable recommendations. These include:
Provision of funding and resources to palliative care departments
The first recommendation is for hospital managements to provide the necessary funding to various departments as a way of ensuring that they improve on their capacities to provide end of life care. Basically, this means that the management may need to allocate funding to palliative care as one of the ways through which to ensure that patients receive the best possible end of life care.
Training of nursing staff on end of life care
The second recommendation is for managements in health institutions to ensure that their nursing staff go through training and development with the focus being on end of life care. The role of nurses in providing end of life care cannot be ignored, as they have an essential role in ensuring that the patients remain comfortable at all time while in hospital. The training provided will be targeted at giving the nursing staff vital information and knowledge on how to provide end of life care.
Conclusion
End of life care is one of the notable types of palliative care that focuses on patients during the final months of their lives. The reason for having to select the end of life care is because it remains as one of the critical areas of care that reflect on the essentiality of ensuring that patients are comfortable regardless of the fact that they are most likely to die. The significance of the end of life care can be seen from the fact that it plays a critical role in reducing exposure of patients, who are battling incurable illnesses, to pain. From a nursing perspective, end of life care is viewed as a critical approach through which to ensure that persons suffering from fatal diseases or those experiencing old age live a life that reflects on dignity.
References
Johnson, S. B., Butow, P. N., Kerridge, I., Bell, M. L., & Tattersall, M. H. (2018). How well do current measures assess the impact of advance care planning on concordance between patient preferences for end-of-life care and the care received: a methodological review. Journal of Pain and symptom management , 55 (2), 480-495.
Lasater, K. B., Sloane, D. M., McHugh, M. D., & Aiken, L. H. (2019). Quality of End‐of‐Life Care and Its Association with Nurse Practice Environments in US Hospitals. Journal of the American Geriatrics Society , 67 (2), 302-308.
Makaroun, L. K., Teno, J. M., Freedman, V. A., Kasper, J. D., Gozalo, P., & Mor, V. (2018). Late transitions and bereaved family member perceptions of the quality of end‐of‐life care. Journal of the American Geriatrics Society , 66 (9), 1730-1736.
Shulman, C., Hudson, B. F., Low, J., Hewett, N., Daley, J., Kennedy, P., ... & Stone, P. (2018). End-of-life care for homeless people: a qualitative analysis exploring the challenges to access and provision of palliative care. Palliative medicine , 32 (1), 36-45.
