END OF LIFE STRATEGY

National End of Life Strategy

National End of Life Strategy

Core Competency 1

Question 1

In relation to end of life care, evidence the ability to communicate 1A 5A with a range of people on a range of matters in a manner that is appropriate to them and the situation.

Public debate has yet to resolve the question of whether individuals have a corresponding “right to die.” Relativism, or the “quality of life” ethic, takes into consideration an individual's life expectancy, medical prognosis, and level of functioning in activities of daily living as well as the risk and benefit levels of treatment options. Health care professionals must make quality-of-life judgments in order to act in their patients' interests. The American emphasis on individualism has reinforced the perspective of relativism in U.S. public policy. Attempting to balance the benefits and burdens of quality-of-life considerations takes social policy onto a slippery slope, as reasonable choices in some circumstances might lead to unreasonable and unethical outcomes in other situations.The time at the end of life is different for each person. Each individual has unique needs for information and support. The patient's and family's questions and concerns about the end of life should be discussed with the health care team as they arise.

The following information can help answer some of the questions that many patients, their family members, and caregivers have about the end of life. Patients and their family members often want to know how long a person is expected to live. This is a hard question to answer.

Question 2

Reflect on their ability to discuss significant news, such as death is 1B imminent, with patient and/or their family members providing support where appropriate.

When caring for a patient at home, there may be times when the caregiver needs assistance from the patient's health care team. A caregiver can contact the patient's doctor or nurse for help in any of the following situations:

The patient is in pain that is NOT relieved by the prescribed dose of pain medication;

The patient shows discomfort, such as grimacing or moaning;

The patient is having trouble breathing and seems upset;

The patient is unable to urinate or empty the bowels;

The patient has fallen;

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.

Everyone has different needs, but some emotions are common to most dying patients. These include fear of abandonment and fear of being a burden. They also have concerns about loss of dignity and loss of control. 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 ...