The approach to End of Life Care
The disquieting patterns of end of care life in the U.S have been well studied. According to a research by American Centers, one in three Medicare beneficiaries are admitted to the intensive care Unit, one in two visits to an emergency department, and one in five has inpatient surgery (Morton, Hudak & Gallo, 2017). However one of the sobering facts is that there is no current practice or policy to promote care of dying Americans supported by a fraction of evidence that the Food and Drug Administration would want to approve even a moderately innocuous drug. Private and public sectors are now involved in an unprecedented array of virtuous efforts to promote end-of-life care. In this paper, I will discuss how I would approach end-of-life care using evidence-based practice for a patient taking into consideration their physical, psychosocial, and spiritual needs.
How I would Approach End-of-Life Care
First, I would conduct rapid conduct quasi-experimental studies and randomized trials to help to determine whether the novel and current interventions improve outcomes which are important to terminally ill patients and society in general. End-of-life care is founded on three pillars: physical, psychosocial, and spiritual care. These practical pillars of hospice and palliative care help to meet the needs of terminally ill patients (Brinkman-Stoppelenburg & Rietjens, 2014). Delivering adequate palliative care requires caregivers and patients be met. When possible, these needs should be accomplished above and beyond the management of pain.
Observational studies have shown that patients who engage in complete advance directives or advance planning are less likely to die in a hospital than patients who do not engage in complete advance directives (Morton, Hudak & Gallo, 2017). The surrogates for patients who engage in advance complete directives and care planning report fewer concerns about communication and in some religions they benefit from less costly care. Physical needs are considered inclusive in supporting the emotional and spiritual journey of terminally ill patients and caregivers. Prospective studies have shown that addressing patients’ psychosocial needs of terminally ill patients helps to moderate their physical symptoms. Being free from the spiritual burden and emotional burdens such as fear of dying is important in ensuring that a patient’s end-of-life days are ‘mentally’ free from pain (Morton, Hudak & Gallo, 2017).
Second I would seek to reach a consensus regarding the outcome measures to use to quantify the implications of interventions near the end of life. Special measures in place of death, survival, or cost of providing care are essential but limited. Technological advancements such as the use of electronic health records facilitate the evaluation of the process of care that are important to patients and family members. Such technologies will enable small and large-scale cost evaluation of whether interventions for end-of-life complications including palliative care consultations promote rates of documents of patient’s goals of care and management of pain. Addressing the patient’s physical needs involves management of pain and symptoms with aim of ensuring the patient at all times. Physical discomfort among terminally ill patients terminally impacts the quality of life of a patient (Brinkman-Stoppelenburg & Rietjens, 2014).
End-of-life care is often described as a journey with various stages where in each stage is characterized by different care needs and challenges. Care providers are therefore required to understand the aspects of end-of-life care as well as the needs of patients. Equally important is the aspect of treating terminally ill patients with dignity, compassion, and respect while providing the necessary support which may be required.
Brinkman-Stoppelenburg, A., & Rietjens, J. A. (2014). The effects of advance care planning on end-of-life care: a systematic review. Palliative medicine, 28(8), 1000-1025.
Morton, P. G., Hudak, C. M., & Gallo, B. M. (2017). Critical care nursing: a holistic approach (p. 1056). Lippincott Williams & Wilkins.