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End-of-life care becomes an issue at some point for elderly clients. Even with the emergence of palliative care programs and hospice programs, the majority of elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your clients in end-of-life care and in supporting their desires. Support your response with evidence-based literature.

End of life brought about difficulty to both patient and family not just emotionally but also the difficulty of decisions that came with it, from simple problems to extremely complex. According to the American Psychological Association, the focus of death and dying here in the United States focuses on autonomy, independence, self-control and individual choice. Choices made during end-of-life care is due can stem from many different factors such as: the dying individual is the primary decision-maker and wanted to remain in-charge of his life planning; the dying individual has a clear understanding of his/her diagnosis, prognosis and options; the dying patient is competent to make choices and value open communication to plan and discuss about impending death to the member of his/her family; or the dying individual has a spiritual orientation that influence his/her preference of where to die.

According to APA, some people suffer needlessly at the end of life and it is the care giver, in this instance, the nurses’ duty is to provide an effective palliative and supportive care to the dying individuals and their family; assist the patient  with appropriate treatment for pain and depression, pharmacological choices to help alleviate the suffering and help the dying patient family to find a the support they need and counselling about needs and expectations associated with end-of-life care. The nurse’s job is to advocate not just for the dying patient but for the whole family as well.

All end-of-life choices regardless of how simple they are have a complex psychological component, implications and consequences that affect not just the dying but also the living, and oftentimes, the medical end-of-life decisions are the most challenging for both. Interdisciplinary team compose of hospice nurse, physicians, social service and many others plays a vital role in the dying patient’s life and the life of those that are left behind.

 

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