Palliative Care in Nursing

Introduction

Palliative care refers to specialized care given to people suffering from terminal illnesses in order to improve their quality of life and reduce suffering. Generally, people suffering from terminal illnesses are incapable of supporting themselves, either physically or psychologically, thus tending to require a lot of support from family and professional care providers. Indeed, they are at the last stages of their life, and as such, professional caregivers including nurses, physicians, and other medical personnel make supportive efforts to provide relief from stress and pain, as well as enhance positive attitude to patient and family. The effect of palliative care is to reassure the patient that he/she is not a burden to the family and to reduce the stress that the family may have in relation to the patient’s suffering.

The trend in Palliative Care

In recent years, there has been increasing demand for palliative care, especially in the US, mainly due to the increasing number of people suffering from chronic illnesses such as cancer, diabetes, and HIV/AIDs-related illnesses. The current trend indicates that in the future palliative care services will be needed more than they are today due to several factors. First, most developed nations are facing the challenge of population aging, and older people are likely to suffer from chronic diseases that normally come with age. Secondly, there are changing patterns of diseases that require palliative care, some of which are brought about by lifestyle; apart from cancer, other diseases such as hypertension and diabetes are highly affecting the health condition of many people, and they, therefore, require palliative care. Therefore, a combined effort of the patient, family, and carers would be instrumental in the successful implementation of palliative care programs.

Importance of Palliative Care

The trend is likely to continue in the future as many people become aware of the importance of palliative care. Indeed, embracing palliative care would significantly contribute to cost-saving in relation to medical expenses incurred by patients and their families in the treatment of such serious illnesses. Unroe and Meier (2013) emphasize this by claiming that, palliative care that resonates around the needs of a patient suffering from chronic illness tends to improve the quality of life of the patient as well as reduce the cost of hospitalization. Nevertheless, palliative care would be sustainable when there is effective policy formulation and implementation about skills, research, and accessibility to patients.

People suffering from serious and chronic illnesses, both malignant and non-malignant, need support from professional caregivers who should work hand-in-hand with the private physician of the patient; this would reduce the burden of care from family members. According to Ivany and While (2013), clinicians must offer end-of-life care to heart failure patients who may have various palliative care needs such as “education, communication, symptom management, and psychosocial needs” (p.441). Proper communication between patients and caregivers is important in order to reassure patients that they are not a burden to society despite their physical or psychological incapacitation. Lundberg, Olsson, & Fürst (2013) suggest that palliative care becomes successful and beneficial when it is carried out in an environment that is convenient to family members and patients, such that it creates a home-like atmosphere. Moreover, effective interaction would be intended to serve various roles including “emotional, informational, supportive encounters, professional focus of staff, a supportive environment, and bereavement support,” all of which enhance positive feelings of family in relation to security, comfort, and strength (Lundberg, Olsson, & Fürst, 2013, p. 282).

It should be noted that when patients who are in their last stages of life develop the feeling that there are people taking care of them unconditionally and with dedication, their satisfaction level tends to improve. In addition, palliative care improves not only symptoms control but also the quality of life, thus prolonging the life of the patient, which could otherwise have been deteriorated by stress. Nevertheless, Rabow et al. (2013) conducted research on the impact of palliative care on lung cancer outpatients and established that it reduces health care utilization and enhances chances of patients living a longer life than they could have lived if support from palliative carers was not present.

One important healthcare principle is that, people should not be discriminated against when accessing palliative care based on their age, type of illness, or any other distinguishing feature; rather, they should be treated equally (Wallerstedt, Sahlberg-Blom, Benzein, & Andershed, 2012). Indeed, terminal illnesses affect anybody regardless of age or any other affiliation, although the aged tend to be highly vulnerable to terminal illnesses such as cardiovascular disease, diabetes, cancer, and dementia due to declining capacity and immunity. Nevertheless, in order to ensure discrimination is eliminated in palliative care, especially against the aged, patients should be cared for based on need and not a diagnosis.

Conclusion

National health policies should take into consideration the importance of palliative care. Health promotion initiatives should therefore seek to sustain health, create supportive environments, and enhance collaboration among all stakeholders in palliative care services. This would involve enhancing education and awareness programs in order to allow people to understand their health care needs, empowering the workforce with skills to improve palliative care in hospitals and nursing homes, and establishing frameworks that support palliative care in a home environment. All in all, palliative care should be diversified to include the provision of care from diagnosis, through potential curative treatment, and until the patient reaches the end of life.

References

Ivany, E., & While, A. (2013). Understanding the palliative care needs of heart failure patients. British Journal of Community Nursing, 18(9), 441-445.

Lundberg, T., Olsson, M., & Fürst, C. (2013). The perspectives of bereaved family members on their experiences of support in palliative care. International Journal of Palliative Nursing, 19(6), 282-288.

Rabow, M., Kvale, E., Barbour, L., Cassel, J. B., Cohen, S., Jackson, V…. Weissman, D. (2013). Moving upstream: A review of the evidence of the impact of outpatient palliative care. Journal of Palliative Medicine, 16(12), 1540-1549.

Unroe, K., T., & Meier, D., E. (2013). Research priorities in geriatric palliative care: Policy initiatives. Journal of Palliative Medicine, 16(12), 1503-1508.

Wallerstedt, B., Sahlberg-Blom, E., Benzein, E., & Andershed, B. (2012). Identification and documentation of persons being in palliative phase regardless of age, diagnosis and places of care, and their use of a sitting service at the end of life. Scandinavian Journal of Caring Sciences, 26(3), 561-568.

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