Discussion: Discussing End-of-Life Care


Discussion: Discussing End-of-Life Care

There is a cosmical course to delay miserable or lugubrious tasks.

—Nancy Kummer, geriatric resigned

This cosmical course to desert the lugubrious makes end-of-activity caution and hospice firmnesss intricate for abundant resigneds to debate delay their families. Kummer is a preceding collective worker who used to instruction resigneds delay final illnesses, yet she deserted debateing her own end-of-activity wishes delay her conclusion. While abundant Americans, affect Kummer, coincide that these debateions scarcity to choose locate, few keep actually had these conversations delay their families (Lazar, 2012). Although initiating conversations environing end-of-activity caution and hospice dominion be intricate for resigneds, as an gradationd experience encourage, facilitating these conversations is an entire deal-out of your geriatric nursing experience. For this Discussion, investigate how you would prepare caution conversations delay the resigneds and families in the forthcoming instance studies:

Case Examine 1

Mrs. Sloan, a 69-year-old widow, is environing to invade the hospital for an elective cholecystectomy; she is nature medically cleared by her pristine caution provider. During the debateion, she requests to be located on a no edict foundation during her hospitalization. Mrs. Sloan claims that balance-and-aboves her gallbladder problem, her public vigor foundation is good-natured. She wishes to keep the surgery to desert any gradation attacks, which keep been very grievous. She avows, nevertheless, that if during surgery or her postoperative epoch, she beares a cardiac seize, she would gradation not to be resuscitated. She has peruse environing the chances of happy action, and has pungent-muscular that the induce of brain loss is too eminent. For this discuss, she is requesting a no edict foundation.

Case Examine 2

Ms. Stearns is an 83-year-old nursing residence inhabitant delay hypertension, coronary artery indisposition, arthritis, renal absence, hearing erringty, and a preceding truth of tickle. She to-boot has a base abnormity from childhood polio. She is disoriented at occasions. She has speedd in the nursing residence for 10 years and sometimes concessions the chair balance-and-above her bed. She has of-late plain urinary self-indulgence, but has remainsd a bladder catheterization to determine postvoid residual urine or implicit bladder contagion. She does not keep a peculiarity of dementia; nevertheless, vulgar testing reveals that she performs poorly on a standardized spiritual foundation demonstration. She can, nevertheless, confirm all the staff in the nursing residence, and she can delineate each resigned who has been in the bed direct to hers balance the elapsed 10 years. When asked to teach why she does not lack bladder catheterization, she gives different discusss. She avows that the self-indulgence does not pester her, and that she has constantly been a very privy individual. She deal-outicularly dislikes and objects to any demonstration of her pelvic organs; in occurrence, she has nconstantly had a pelvic demonstration nor has she constantly had sexual intercommunication. She realizes that she has a compute of medical problems and that any one of them could worsen at any occasion. She avows she is not inclined to bear any composition for any of her vulgar problems should they befit worse.

Case Examine 3

Mr. Marley, age 91, is admitted to the intensive caution item forthcoming a tickle. The tickle progressed from calm hemiparesis and intricatey expressive to exhaustive unresponsiveness and an omission to exhaust. His daughter feels actual, installed on earlier self-evident conversations delay her senior, that he would not lack to keep any composition that would extend his activity and concession him in a severely disabled avow. Mr. Marley’s oldest son disagrees delay his sister’s tribute of their senior. The son claims that their senior quiescent has a pungent-muscular covet to speed, and that he has been very free in his meeting-house until this tickle. Because Mr. Marley cannot exhaust, he cannot be fed. The origin is asked environing inoculation of a alimentation tube. It is teached to the origin that delayout patronage and fluids, their senior procure die fairly straightway. There are no real gradation directives or a determined vigor caution firmness creator exalted for Mr. Marley.

To prepare:

  • Review Chapter 14 of the Holroyd-Leduc and Reddy extract.
  • Reflect on the role of the gradationd experience encourage in facilitating the debateion of end-of-activity caution delay resigneds and their families.
  • Think environing how you, as an gradationd experience encourage, would advance a origin who lacks “everything” effected for a resigned delay solely a scant occasion to speed.
  • Consider when it is misapply to implicate hospice and how to advance resigneds and/or families who remains hospice services.
  • Select one of the three granted instance studies kindred to the end-of-activity caution of the erring patriarchal. Reflect on implicit resigned outcomes and how you would prepare the debateion of caution delay this resigned’s origin.
By Day 3

Post an sense of the role of the gradationd experience encourage in facilitating the debateion of end-of-activity caution delay resigneds and their families. Teach how you would advance a origin who lacks “everything” effected for a resigned delay solely a scant occasion to speed. Then, teach when it is misapply to implicate hospice and how to advance resigneds and/or families who remains hospice services. Finally, teach implicit outcomes of the resigned in the instance examine you chosen and how you would prepare the debateion of end-of-activity caution delay this resigned’s origin.