Hi, Today we are gonna be
talking about End of Life Care.
My Name is Jill Beavers-Kirby.
So what are the ethical issues
involved with end of life care?
The first is the quality of life.
It's important to try to maintain
the patient's activities of daily
living as independently as possible.
You want to try to maintain optimal
functioning status for the patient.
Ethical dilemmas during end of life care
may include [inaudible 0:00:32.000],
insertion of feeding tubes,
IV hydration and so on.
And what is an ethical dilemma?
An ethical dilemma is a problem
that is not have a satisfactory
solution for both sides.
How to manage an ethical dilemma?
First you need to
examine the actions.
Examine your actions. The patient's
actions. The family's actions.
The next you need to
consider the consequences.
The consequences of your actions and of the
patient's actions and of the family's actions.
You need to analyze and establish
your own values and opinions
of this ethical dilemma.
That's very important
to main professionalism
and professional competence
during this time.
You can also ask your
institution's ethics committee
to step in and help resolve
this ethical dilemma.
End of life care contains the
dying Person's Bill of Rights.
The dying Person's Bill of
Rights is a professional standard
and include rights as: being
treated as a living human being
until the minute they die.
The right to be free from pain
and a right to have
a sense of purpose.
So what are the nurse’s responsibilities
during end of life care?
You want to the evaluate what the
family understands about this time
and what they actually expect.
Try not to use medical jargon. It’s
okay to say "death" and "dying".
What are the patient's
You wanna focus on these.
Is the patient too cold? Too
warm? Or they are in pain?
You want to allow the caregiver or
caregivers to discuss caregiver burden.
Better know that this is normal.
It can care somebody who's
at the end of life is tough.
Help the family be prepared for
the signs of imminent death
and how to manage them
such as the agonal breathing that
can occur several hours before death.
But also want to give bereavement
resources to the family and caregivers
such as support groups.
Palliative care and Hospice Care.
Palliative care is made of health care
providers and physicians and nurses.
This provides comfort
measures to the patients.
They focuses on prevention,
lessening, and respite
of physical, emotional
social, and spiritual signs
of disease or therapies.
Hospice care is a Medicare benefit.
So if your patient has Medicare then they
are available to sign up for hospice care.
Hospice care provides care
for patients who have
the short time to live
such as a few months.
This focuses on relieving symptoms
and encumbrance of the illness.
It also helps patients to
live as fully as possible.
So what is the Nursing Assessment
during end of life care?
Are the patient's and family's treatment
and care needs being met?
Are they being met
at their expectations?
Are unwanted symptoms being addressed?
Is the patient comfortable? Are
they warm? Are they cold?
Are spiritual and emotional
needs also being met
for the patient
and for the family?
Is grieving being addressed
for the patient and
the family satisfaction?
These are all very important.
So some examples of nursing
diagnosis can include
comprise family coping
related to impending death.
End of life care related
to terminal cancer
and palliation related
to in state COPD.