Death and Dying Are Part of Life

January 23rd, 2012


By , BSN, RN

Death and dying—these are topics people still whisper about in public or prefer to not discuss at all. However, as nurses we are faced with these issues frequently and it is our responsibility to help our patients and their families deal with end of life realities. Palliative care and hospice are programs focused on care of the dying and their special needs. They are specialties that many nurses find rewarding—not depressing, as you may think.

Hospice and palliative care nurses believe everyone has a right to die with dignity, as comfortable as possible, pain free, and with the knowledge that their loved ones support their decision. Hospice is focused on caring, not curing and, often patients stay in their own home until the end. There are hospice care facilities and hospice programs in hospitals and nursing homes. According to the World Health Organization palliative care is the the active total care of patients whose disease is not responsive to curative treatment. It is an extension of hospice that starts earlier in the disease process, and the care plan is often re-evaluated as patients' health status continues to change.

Hospice Care

In hospice a team approach is used to support and monitor all the patient's needs, physiological, psychological, and even spiritual. The team may include any combination of family members, nurses, doctors, social workers, other therapists, clergy, home health aides, and volunteers. This team will:

  • Coordinate patient and family care.
  • Control symptoms including pain.
  • Make medical and nursing services available around the clock.
  • Provide bereavement follow up after the client's death.

Hospice providers help their dying patient and offer family support throughout the process, from the initial diagnosis to the end of life and beyond.

Palliative Care

Palliative care is not just about dying. Palliative care also provides treatment and support for those suffering from a serious illness or injury and those afflicted with chronic disease process. The goal of palliative is much the same however—the achievement of the best possible quality of life for patients and their families during these times of illness, high stress, and worry. A team approach is also taken in palliative care with doctors, nurses, and other specialists working together to provide an extra layer of support. Palliative care is appropriate at any age and stage of illness and can be provided along with curative treatment.

Palliative care is based on five major principles laid out by Drs. Kathleen Foley and Alan Carver in 2001. Palliative care:

  • Respects the goals, likes, and choices of the sick or dying person.
  • Looks after the medical, emotional, social and spiritual needs of the client.
  • Supports the needs of the family members.
  • Helps gain access to needed health care providers and appropriate care settings.
  • Builds way to provide care at the end of life.

Hospice and palliative care can provide a better quality of life during serious illness and at the end of life for both the patient and the patient's family. It is about not just the technical and scientific side of medicine and nursing, but about being part of the patient's emotional and spiritual health all the way to the end.

If you are interested in learning more about hospice and palliative care tune in to RN.FM Radio tonight at 9 pm EST and listen to an interview with Laurel Lewis, RN, with Hospice Partners of Southern California. She will be talking about her own career path into hospice nursing and her new path hosting "Death and Dying Dinner Parties." It's not as morbid as it sounds. If you can't make the interview in real time check out the recordings at the RN.FM Radio website.

Also, come back to later this week. Lewis is taking a few minutes out of her schedule to leave some "Notes" at the "Nurses' Station."

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