Approaches to Palliative Care

Approaches to P tout ensembleiative C arPalliative approach refers to the proviso of a holistic grapple for tolerants who be no longer antiphonary to curative interposition and anxious(p)(p). The approach provides primary c be services to better the quality of life of the dying patients through acknowledgmenting bruise and opposite dingy symptoms and integrating physical, psychosocial and uncanny c ar to discipline a good close for the patients (Koutoukidis, Stainton and Hughson 2013, p. 865). It besides offers support for families of the terminally ill patients to cope with trouble and affliction in the end-of-life stage of the patients (ACT wellness 2014). In palliative allot, nurses are instanter involved in ensuring a holistic pity for the patients and liaising with the patients families. They deal with perturb relief, provide emotional support for both(prenominal) the patients and families and promulgate the patients disease tick offs with other tending specialists through regular team meeting and clinical discussion. They also carry out assessment, care plan and bereavement follow up with families and friends of the patients to help them cope with grief and freeing (Tasmanian Palliative Care armed service 2013, p. 9).An advanced care directing is a written statement just about the wishes of the patients regarding their medical treatment choices and future health care. It is a way that individuals, specially those who are in chronic or life-limiting condition like Mr. Guzman, communicate their wishes to the carers when they are un open to make decision on their health care choices, which can help avoid unwanted treatment and reduce family filter in any emergency situation (The Advance Care directional joining 2012). The advanced care directive is implemented within the legitimate framework of capital of Seychelles. The Medical Treatment Act 1988 allows the patients to ref function medical treatment that are not consis tent with their cultural or individualized beliefs in most of the circumstances, and The Guardianship and Administration Act 1986 enables the patients to appoint an enduring protector to make decision on their health care (capital of Seychellesn segment of Health 2014, p. 53). According to the capital of Seychellesn legislation, medical practitioners must usually seek for the patients go for regarding their health care choice in the advanced care directive before providing any medical treatment to the patients (capital of Seychellesn Department of Health 2014, p. 54).The accredited best practice regarding pain prudence for palliative care patients consists of both non-pharmacological and pharmacological approaches. The non-pharmacological approach in palliative care is primarily enabling the patients to regularly access to family members or religious leaders to ensure their psychological, spiritual and religious needs are met. This approach whitethorn help address the emotio nal components of pain and improve the psychological wellbeing and physical health of the terminally ill patients (Hughes 2012, p. 26). Pharmacological approach involves using drug therapies to in effect manage the pain. Hughes (2012, p. 25) suggests that the first attempt of analgesia may not be able to fully control the patients pain, and ongoing commitment to assess and adjust the pain control technique can give the patients confidences, which thereby reduces pain. Therefore, patient-centred care is outstanding as it enables health practitioners to assess and decide on specific doses and forms of analgesia that should be given to the patients. It is also mentioned that health practitioners do not normally use opioid analgesia to their full potential though they are safe and cost legal medications. For effective pain control management, does, duration of treatment and the patients current condition, such as renal and hepatic function, should be taken into account to ensure the patients receive adequate pain relief with less side effect ( study Institute for Health and Clinical Excellence 2012).Filipinos believe in bahala na, which performer leaving ones fate to God. They also believe that a persons suffering is the Gods will, and only ingathering can save the persons life. Families and friends of the dying patients should, therefore, pray for the patients alternatively than discussing advanced care directive and terminal prognosis with them as it frustrates the patients and makes them olfactory perception hopeless. Discussing end-of-life issue with the patients is also believed to bring unwanted outcome to the patients health condition (Mazanec and Tyler 2003, p. 54). Such attitude to dying conflicts with modern health practices in which the dying patients are provided with full disclosure of the fact of illness and treatment and are able to make decision on their future health care. Patients with Filipino decent may also want to die at nucleotide o r die in their home countries. Those who are catholic may require a priest to perform sacrament of the sick and may not allow the nurses to wash their dead bodies, making it backbreaking for health professionals to provide holistic care for the patients before and after stopping point (Mazanec and Tyler 2003, p. 54).When a person is dying, numerous common symptoms may occur in the exsert day or the last few hours before demolition. Confusion and furor may usually occur during the end-of-life stage due to metabolic and electrolyte imbalance, hypoxemia and toxin accumulation. The patient also demonstrates increased weakness, fatigue and drowsiness and requires more sleep. In improver to decrease oral intake including food and fluid, they are also presented with the symptoms of decreased cardiac output, cool extremities, cyanosis and decreased urine output due to decrease blood perfusion and renal failure. Breaths stimulate shallow and accessory muscle is use as the patient is struggling with breathing. They also rescue raised temperature and urinal and faecal incontinence (INCTR Palliative care 2009). Nurses know that patients are close to death as they become less interested in food, and their mouths become real dry. They have trouble swallowing pills and medicines and are unable to cooperate with caregivers. Their skin become dark or pale, and heart rate is fast and irregular. Nurses also visualise that they become confused, disoriented and restless (American Cancer Association 2014).Last offices are performed as soon as Mr. Guzman passed away. Though different hospitals may have different policies regarding this procedure, the dead persons system is usually straightened, coat of arms are sayd at the side of the form, pillows are removed, eyes are closed, denture is placed in the mouth if available, and a rolled towel is placed under the jaw to prevent sagging. All jewellery and personal stuffs are removed and kept at a safe place unless the f amilies wish to keep it with the patient (Funnell and Koutoukidis 2008, p. 175). Nurses also apply a starchy pressure on the lower abdomen of the body to drain all the fluid and prepares the death body for removal to a hospital mortuary or holding area by removing all tubes and drainage, washing, dressing, wrapping and labeling the body appropriately. Other specific cultural or religious practices concerning how to care for the body after death must be adhered to as fully as possible. If there is no specific requirement, two nurses should carry out a post-mortem care, and the body is subsequently taken to the hospital mortuary (Funnell and Koutoukidis 2008, p. 175). affliction has a negative effect on families and friends of the dead person though the death is anticipated. Some families may become shock, while others may become angry, anxious and resentful. They may also feel a whirlwind of emotions from intense grief and loss to relief and comfort from the fact that someone they l ove will no longer be suffering (Koutoukidis, Stainton and Hughson 2013, p. 873). mourning also affects health professionals, especially nurses, who provide direct care for the dead person. Stress, loss of motivation to plow providing health care for other terminally ill patients and social climb-down may be commonly seen, which negatively affect their work implementation and socialization (Wilson and Kirshbaum 2011, p. 560). Some recommendations for nurses to deal with grief and loss include lecture to someone they trust about how they feel and the difficulty of trying to manage with the problem, discussing it with other carers and health professionals at the facility or contacting the National Carer counsel to gain advice on how to deal with grief and loss effectively (Carer Victoria 2005).The sense of loss and grief may not ease with while for some families and carers. Prolonged grief can be a just concern and require further support to prevent negative consequences from happening. Supports that are available for families and health professionals to cope with grief and loss include rede and bereavement support services provided by the Australian Centre for Grief and Bereavement in Victoria, which offers a range of bereavement support programs and experient counselors including social workers, psychologists and psychotherapists to help individuals cope with grief and loss (Australian Centre for Grief and Bereavement 2014). Hospital and community health care center, palliative care agencies, volunteer groups and church and religious organizations are also available sources from which families and health professionals can seek support. National Association of Loss and Grief Victoria also offers supports for families, clinicians and stakeholders in the health and community service sectors to deal with grief and loss such as providing a package of loss and grief resources and making a discussion with counselors, psychologists and general practitioners available for those who find it difficult to deal with grief and loss (National Association for Loss and Grief Victoria 2011).Word count 1530ReferencesACT Health 2014, Palliative care, viewed 12 whitethorn 2014, http//www.health.act.gov.au/health-services/palliative-care/.American Cancer Association 2014, When death is near, viewed 13 whitethorn 2013, http//www.cancer.org/treatment/nearingtheendoflife/nearingtheendoflife/nearing-the-end-of-life-death.Australian Centre for Grief and Bereavement 2014, Counselling, viewed 15 may 2014, http//www.grief.org.au/grief_and_bereavement_support/counselling_services.Carer Victoria 2005, Dealing with grief when your family member dies, viewed 15 May 2014, http//www.survivingthemaze.org.au/bcfc/PDFS/GEN-04-15.pdf.Funnell, R Koutoukidis G 2008, Tabbners nursing care Theory and practice, 5th edn, Elsevier, NSW.Hughes, LD 2012, Assessment and management of pain in older patients receiving palliative care, Nursing aged People, vol. 24, no. 6, pp. 23-29.INCTR Palliative Care 2009, Signs and symptoms at the end of life, viewed 13 May 2013, http//inctr-palliative-care-handbook.wikidot.com/signs-and-symptoms-at-the-end-of-life.Koutoukidis, G, Stainton, K Hughson, J 2013, Tabbners nursing care Theory and practice, sixth edn, Elsevier, NSW.Mazanec, P Tyler, MK 2003, Cultural consideration in end-of-life care, Australian diary of Nursing, vol. 103, no. 3, pp. 50-58.National Association for Loss and Grief Victoria 2011, National Association for Loss Grief Annual Conference 2011, viewed 16 May 2014, http//www.nalagvic.org.au/ab-currentwork.htm.National Institute for Health and Clinincal Excellence 2012, Opioids in palliative care safe and effective prescribing of strong opioids for pain in palliative care of adults, viewed 13 May 2014, www.nice.org.uk/nicemedia/live/13745/59285/59285.pdf.Tasmanian Palliative Care benefit 2013, Information booklet, viewed 12 May 2014, https//www.dhhs.tas.gov.au/__data/assets/pdf_file/0005/8987/ta s-palliative-care-info-booklet.pdf.The Advance Care Directive Association 2012, What is advance care planning?, viewed 12 May 2014, http//www.advancecaredirectives.org.au.Victorian Department of Health 2014, Advance care planning Have the conversation, a dodge for Victorian health service 2014-2018, viewed 12 May 2014, http//docs.health.vic.gov.au/docs/doc/C1BEDB926ED9A6E7CA257C9A0005231A/$ send/Advance%20care%20planning%20-%20strategy%202014-18.pdf.Wilson, J Kirshbaum, M 2011, Effects of patient death on nursing staff a literature review, British ledger of Nursing, vol. 20, no. 9, pp. 559-563.