Supporting End-of-Life Decisions- Palliative and Hospice Care Considerations for Thomas and His Family
Palliative care involves providing specialized medical care for individuals living with severe medical conditions like heart failure or cancer. Patients receiving palliative care receive healthcare for their symptoms. The primary objective of palliative care is to enhance the patient and their family’s quality of life (Krakauer, 2019). Accordingly, palliative care can be given at any stage of illness. It also helps patients understand their treatment options (Krakauer, 2019). On the other hand, hospice care focuses on the end of life care. The goal of hospice care is to provide comfort and improve the quality of life of individuals approaching the end of life (Oechsle, 2019).
The end of life looks different depending on choices, preferences, and needs. Some individuals may want to stay at home, while others may prefer to seek treatment in a healthcare facility. Individuals at the end stages of life have four critical areas where they need care. They include practical tasks and mental, emotional, and spiritual needs (Hughes et al., 2019). The patient’s caregivers require support since the end of life is associated with emotional distress (Nguyen, 2018). Discomfort from end-of-life may come from different sources. The main include fatigue, pain, breathing problems, and digestive issues. The patient can be given pain medications to relieve pain associated with end-stage renal failure.
The other support that can be provided to the patient and his family is helping them manage their emotional and mental needs. Individuals at the end of life may feel depressed or anxious (Wajid et al., 2021). It is thus critical to treat emotional suffering. The patient does not want to continue with dialysis, but the family wants him to continue. The family can be advised to accept the patient’s wishes and referred to social support groups. In addition, the patient will be encouraged to share what they feel with the counselor.
References
Hughes, N. M., Noyes, J., Eckley, L., & Pritchard, T. (2019). What do patients and family caregivers value from hospice care? A systematic mixed studies review. BMC Palliative Care, 18(1). https://doi.org/10.1186/s12904-019-0401-1
Krakauer, E. L. (2019). Palliative care, toward a more responsive definition. Textbook of Palliative Care, 105-109. https://doi.org/10.1007/978-3-319-77740-5_1
Nguyen, L. M. (2018). Palliative care in end-stage renal disease. Hospice and Palliative Medicine and Supportive Care Flashcards. https://doi.org/10.1093/med/9780190633066.003.0035
Oechsle, K. (2019). Current advances in palliative & hospice care: Problems and needs of relatives and family caregivers during palliative and hospice care—An overview of current literature. Medical Sciences, 7(3), 43. https://doi.org/10.3390/medsci7030043
Wajid, M., Rajkumar, E., Romate, J., George, A. J., Lakshmi, R., & Simha, S. (2021). Why is hospice care important? An exploration of its benefits for patients with terminal cancer. BMC Palliative Care, 20(1). https://doi.org/10.1186/s12904-021-00757-8
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Question
Thomas is an 85-year-old Caucasian male who has been admitted to the hospital for the past two weeks related to his end-stage kidney disease. Thomas’ medical doctor has requested you, as the social worker, to be present as he discusses end-of-life planning with the patient and his family. Thomas has stated he no longer wishes to continue with dialysis, though his family has tried to encourage him to continue as they don’t want him to die.
For this assignment, please complete a paper and discuss what information you would need to know about palliative and hospice care and end-of-life issues in working with this patient and family. How would you support the patient and family during this time?