how well informed were you regarding end of life care beforetaking this course?

Why do we need end of life care training?

The dying experience is forever carried in the life story of those for whom the nurse cares. Schools of nursing and continuing education have the vital role of providing the knowledge and skills needed to give the best care possible at the end of life. Alaniz J. (2000). Nurses recognize need for better training to deal with end of life issues.

What do we know about end-of-life care issues?

Exploration into end-of-life care issues is examined utilizing a historical context. Focus areas for improvement in today's education of nurses have been identified as spiritual-psychosocial health areas and physical health areas.

What is the certificate in end-of-life issues?

The Certificate in End-of-Life Issues represents a specialization in the field of caring for those who are experiencing a terminal illness. It is designed to enhance the knowledge and skills of individuals who work with dying patients by providing a multidisciplinary educational experience.

Are nurses educationally prepared for end-of-life care?

End-Of-Life-Care: Are Nurses Educationally Prepared? End-Of-Life-Care: Are Nurses Educationally Prepared? Submitted by Lisa Marie Chiplaskey, MSN, Ed., BSN This study identifies that nurses are educationally unprepared to offer quality end-of-life care to patients and families.

End of Life Timeline: Signs & Symptoms Of The Dying Process

Hospice care: Comforting the terminally ill - Mayo Clinic

Why is end of life care important?

End-of-life care decision making carries paramount importance due to the advancements in medical sciences. Since medical science has evolved over the time and now has a potentiality to reshape the circumstances during death and in turn prolong lives, various ethical issues surround end-of-life care. The purpose of this narrative review is to discuss issues such as autonomous decision making, importance of advance directives, rationing of care in futile treatments and costs involved in providing end-of-life care. Even though much progress has been made in this area continued advancement in medical science demands further research into this topic.

How can healthcare organizations help end of life care?

Healthcare organizations can work towards developing and implementing guidelines & policies for end-of-life care decision making , especially policies for withholding or withdrawing the treatment options so as to avoid the ethical dilemmas. There should be a proper disclosure mentioning the limitations of certain specific treatment options if there are any, so that the patients and families are well informed about their treatment options and make well-judged decisions. Healthcare executives can develop resources supporting palliative treatment care choices. They can additionally provide detailed information and knowledge about these palliative care options so as to facilitate patients and their families to make a competent end-of-life care preference. Healthcare organizations can provide effective support by appointing an interdisciplinary ethics committee and employee assistance facility available so as to address any ethical crisis [1]. A well-formed, consistent and integrated ethics committee can safeguard organization’s future by increasing patient satisfaction, increasing organizations productivity, avoiding unethical activities, restricting undue costs, and reducing the risk of lawsuits [11].

Why is it difficult for the general population seeking medical care to understand the concept of limited treatment in case of futile cases?

It is difficult for the general population seeking medical care to understand the concept of limited treatment in case of futile cases. The stewardship of limiting medical care is surrounded by ethical issues as the patients and their families do not understand the need to limit treatment in some cases where it is futile. Healthcare providers and physician are working towards this challenging task of making patients understand the need to refuse treatment as it may not benefit them and in some cases can cause harm.

What is compassionate care?

Compassionate care is another option seeked by the patients while considering end-of-life care which can be at times less costly and a good preference when medicine is unable to restore patient’s health.

What is the role of family in the end of life?

Families have a responsibility of putting forth the end-of-life care preference of the patient. Family members play the role of proxy due to the virtue of their relationship with the patient and may not be very good in guessing the patients preference for end-of-life decision making, in the case where explicit declaration of patients preferences is not clear. These proxies try to judge the medical situation as the patient may have evaluated but it is seen that they are not very good at taking end-of-life decisions for the patients.

How do healthcare executives manage ethical issues?

The task of healthcare executives to manage ethical issues surrounding end-of-life care is challenging. Healthcare executives can address these ethical dilemmas ensuring certain policies to be followed during managing this task. They can guide the patients and their surrogates to make informed treatment preferences by providing them trustful information, appropriate prognosis and available options regarding the case specific treatment choices. They can assist the patient and their families to make a well judged end-of-life care decision and document their preferences. In case there is a disagreement between the healthcare provider and the patient or surrogate end-of-life care choices, then they can take appropriate steps by appointing an ethics committee to address this ethical or legal issue and document its proceedings. Healthcare executives can compile policies, so as to introduce, promote, and discuss the use of advanced directives as an admission procedure [1]. This can motivate the patients to make a living will (advanced directive) about their end-of-life care preferences which in due process can facilitate families to make appropriate decisions in case of incapacitated patients.

How does technology affect end of life care?

The technological advancements and innovations are reshaping the decisions and treatment preferences surrounding end-of-life care. These technologically advanced treatments have a capability to prolong the life of a patient rather than allowing the natural dying process. The end-of-life decisions to sustain life are considered on the basis of patient centered care, quality of life after these advance treatments and have to be weighed along with shared decision-making process [1]. These new medical treatments and technologies are increasing the number of people seeking long-term care. It is challenging to provide long-term advanced treatment and care to the population considering the increase in older population and assessing the projected increase in this population, especially when the baby boom (a cohort born between 1946–1964) reach old age by 2030 [4]. It is assumed that people will adapt to healthy lifestyles and thus, this will reduce disabilities, diseases and injuries. This advancement will lower death rate and increase people living longer and needing long term care in their later life [4].

How to prepare for end of life care?

1. Recognize dynamic changes in population demographics, health care economics, and service delivery that necessitate improved professional preparation for end-of-life care. 2. Promote the provision of comfort care to the dying as an active, desirable, and important skill, and an integral component of nursing care. 3.

How to improve quality of life at the end of life?

10. Assess and treat multiple dimensions, including spiritual-psychosocial and physical needs to improve quality at the end of life. 11. Assist the patient, family, colleagues, and one's self to cope with suffering, grief, loss, and bereavement in end-of-life care. 12.

Why are nurses uncomfortable with EOL decisions?

Unfortunately, most nurses are uncomfortable counseling patients and families around EOL decisions because of barriers identified including: lack of knowledge, lack of practical experience, mistaken belief of emotional distress for patients and families associated with a discussion, and time limitations.

What are the recommendations for EOL nursing?

Recommendations for improved EOL nursing care outcomes have been identified as improvement in curricular content and continuing education utilizing care competencies, and revision of texts, which incorporate current research, to enhance EOL care. Achieving these objectives will take the collective effort of publishers, researchers, educators, and nurses. Tremendous opportunity exists in the next decade to change EOL care. The strengthening of nursing education certainly is an essential step toward meeting that goal. This will provide a more comprehensive and compassionate approach in the delivery of EOL nursing care.

What is EOL care?

One of the basic tenets of EOL care is the treatment of patient and family together. Death in acute care institutions has caused many families to come apart. EOL care helps to make death a coming-together. Approaching death can be a spiritual and psychosocial growth-filled experience for families.

What are the barriers to EOL care?

Healthcare professionals’ inadequate knowledge of physical health including: pain management, symptom control, and other dimensions of terminal-illness care have been cited as a key barrier to good EOL care. Nurses cannot practice what they do not know, and basic knowledge is contingent upon accurate, current, and comprehensive information provided through textbooks. Although most of the content present in the texts was relatively accurate and current, most EOL topics simply were not covered in texts (Schlegel 2000). Overall, nurses considered their basic nursing education inadequate preparation for EOL care. The vast majority rated their basic nursing education inadequate in all areas, but especially, pain relief (Ferrell, 2000). Clearly, changes in basic nursing education and more continuing education are keys to improving EOL care.

How many nurses care for dying patients?

A current study identified 87% of nurses stated that they care for dying patients in their current role; 28% said they never cared for a dying patient during nursing school. Most respondents (89.5%) believe that end-of-life content is important for basic nursing education.

What is the end of life care?

End of life care begins with advanced planning, it is essential that family members discuss what is important to them before they need end of life care. Putting these wishes in writing can help the family during this most difficult time. There are two similar but different services available to the dying patient.

Why is compassionate care important?

Remember, you are important. You need to be cared for, and care for yourself, during these most difficult moments of your career and life.

What is the goal of end of life nursing education?

A goal of end-of-life nursing education is to produce nurses who are comfortable with death and dying and who have had the opportunity to reflect on their thoughts and feelings about end-of-life care. This article reviews the history, development, and teaching methods of end-of-life care, offering recommendations for future education.

What is the role of nursing schools in the end of life?

Schools of nursing and continuing education have the vital role of providing the knowledge and skills needed to give the best care possible at the end of life.

What was the impact of the 1960s on hospice?

The 1960s brought imperative changes in the care of the dying. A prime motivating force for change was to reestablish the important connection between spirituality and end-of-life care ( Puchalski & Ferrell, 2010 ). The founding of St. Christopher's Hospice in 1967, by Dame Cecily Saunders in the United Kingdom, heralded the modern hospice movement ( National Hospice and Palliative Care Organization, 2014 ). The philosophy that emanated from St. Christopher's was a focus on pain and symptom management and a focus on the emotional and spiritual experiences specific to the dying.

What is the support study?

The well-known SUPPORT study (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments ) was a controlled trial in the mid-1990s to improve care for seriously ill hospitalized patients ( Connors et al., 1995 ). Researchers identified poor communication between patients and their healthcare team at the end of life with respect to wishes and choices. The majority of Do Not Resuscitate orders were being written as little as 2 days before death. The study also identified high levels of pain during a large part of the dying process for most patients, and the location of death was taking place in an intensive care unit or hospital, rather than at home, where most patients preferred. The 1997 Institute of Medicine report, Approaching Death: Improving Care at the End of Life also found that many patients were unnecessarily dying in pain, and significant knowledge deficits among healthcare providers were common. As recent as 2002, the Last Acts Report affirmed these findings and added that finding good end-of-life care was not likely, while access to hospice and palliative care was occurring in too few situations ( Pace & Lunsford, 2011 ).

What did the 1997 Institute of Medicine report on the end of life find?

The 1997 Institute of Medicine report, Approaching Death: Improving Care at the End of Life also found that many patients were unnecessarily dying in pain, and significant knowledge deficits among healthcare providers were common.

How does an online community board help end of life students?

The online discussion board provides a link between courses and gives students a place to reflect on issues specific to end of life ( Todaro-Franceschi, 2009 ). Kavanaugh et al. (2009) successfully designed a blended course. The first class session was a face-to-face meeting that involved viewing a video. Subsequent classes entailed online reflection and discussion of the text, journal articles, books and websites. The last class was again, face-to-face, where each student presented an evaluation of an evidence-based resource.

When did nursing education advance?

NURSING EDUCATION ADVANCES. These dire reports of the late 1990s and early 2000s regarding care of the dying in the U.S. spurred nurses into action. An important response came from the American Association of Colleges of Nursing (AACN) in 1997, in the development of competencies and curricular guidelines.

How to comfort someone who is dying?

Some ways caregivers can provide comfort are as follows: Keep the person company - talk, watch movies, read, or just be with the person. Allow the person to express fears and concerns about dying, such as leaving family and friends behind. Be prepared to listen. Be willing to reminisce about the person's life.

Who can verify a patient's death?

If the patient is in a hospice program, follow the guidelines provided by the program. A caregiver or family member can request a hospice nurse to verify the patient's death.

What is hospice care?

The care focuses on making the patient comfortable. The patient receives medications and treatments to control pain and other symptoms, such as constipation, nausea, and shortness of breath. Some patients remain at home during this time, while others enter a hospital or other facility. Either way, services are available to help patients and their families with the medical, psychological, and spiritual issues surrounding dying. A hospice often provides such services.

What does it mean when a caregiver is overwhelmed?

The patient is very depressed or talking about committing suicide; The caregiver has difficulty giving medication to the patient; The caregiver is overwhelmed by caring for the patient, or is too grieved or afraid to be with the patient; or. At any time the caregiver does not know how to handle a situation.

What are the symptoms of a patient close to death?

A member of the patient's health care team can give family members and caregivers more information about what to expect. Drowsiness, increased sleep, and/ or unresponsiveness.

How to help a patient who is unable to respond?

Speak to the patient directly. Let the patient know you are there for them. The patient may be aware and able to hear, but unable to respond. Professionals advise that giving the patient permission to "let go" can be helpful.

How to calm a patient who is agitated?

If the patient is agitated, do not attempt to restrain the patient. Be calm and reassuring. Speaking calmly may help to re-orient the patient. Decreased socialization and withdrawal (caused by decreased oxygen to the brain, decreased blood flow, and mental preparation for dying). Speak to the patient directly.

What is caregiving at the end of life?

Caregiving at the End of Life – Issues and Considerations. Caregivers are individuals who provide care to an individual who needs assistance. Caregivers can be professionals but are often unpaid individuals who support a loved one through an illness or the last phase of life.

What is end of life certificate?

The Certificate in End-of-Life Issues represents a specialization in the field of caring for those who are experiencing a terminal illness. It is designed to enhance the knowledge and skills of individuals who work with dying patients by providing a multidisciplinary educational experience.

What is ANCC in nursing?

ANCC—American Nurses Credentialing Center - ALLEGRA Learning Solutions, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

What is the American Board of Managed Care Nursing?

American Board of Managed Care Nursing - The American Board of Managed Care Nursing recognizes all of ALLEGRA Learning Solutions' ANCC accredited courses for continuing education credit for Certified Managed Care Nurses (CMCNs).

What are the ethical issues in end of life care?

This course provides health care professionals with the tools necessary to make ethical decisions when providing care for patients at the end of their lives. Key ethical issues related to end-of-life care, including advance directives, euthanasia, medical futility, do-not-resuscitate (DNR) orders, pain management, terminal hydration, organ donation, and considerations for the neonatal and pediatric patient are examine d. In addition, guidelines for dealing with ethical dilemmas are also provided.

What is hospice care?

Using a multidisciplinary team approach, the primary goals of hospice and palliative care are to provide symptom control, psychosocial and spiritual care, and optimal quality of life. The role of hospice and palliative care is rapidly expanding due to a better understanding of end-of-life issues by health care professionals.

What is the dying experience?

The dying experience is a profound, individual experience. The experience of loss and grief are as individual and unique as the persons involved. During this time, people often raise questions about the meaning of life.

What is the goal of end of life care?

The goal of end of life care is to enable and facilitate the clients' and the family members' ability to effectively cope with the end of life and all the physical, psychological, social, and spiritual stressors associated with it . Nurses and caregivers have highly important roles at the end of life.

What are the needs of a client at the end of life?

These needs include physiological, psychological/emotional, social, spiritual and cultural needs.

Why do electrolytes and fluids lose at the end of life?

Simply stated, electrolytes and fluids are lost at the end of life as the result of a client's refusals of oral fluids, the specific disease or disorder that the client has, and the lack of fluid and electrolyte replacements. More information about fluids and electrolytes, and fluid and electrolyte imbalances is fully described in detail later in ...

Why are electrolytes lost?

Simply stated, electrolytes and fluids are lost at the end of life as the result of a client's refusals of oral fluids, the specific disease or disorder that the client has, and the lack of fluid and electrolyte replacements. More information about fluids and electrolytes, and fluid and electrolyte imbalances is fully described in detail later in this NCLEX-RN review with the section entitled " Fluid and Electrolyte Imbalances ".

What resources do caregivers need?

Caregivers need the support of the nurse and community resources including self-help groups, respite care, other methods of social support as well as other interventions which are based on the caregiver's needs.

What are the symptoms of dehydration at the end of life?

The signs and symptoms of mild to moderate dehydration at the end of life include, among others, constipation, headache, thirst, dry skin, dry mouth and oral membranes, orthostatic hypotension, dizziness, and decreased urinary output.

What is hospice care?

According to the National Board for Certification of Hospice and Palliative Nurses, "Hospice and palliative care is the provision of care for the patient with life-limiting illness and their family with the emphasis on their physical, psychosocial, emotional and spiritual needs.