The Importance Of End-Of-Life Care

Mortality is one of the undebatable paths of life that one must undergo. Modern trends have given rise to a different view of aging and terminal diseases, not as a stage of life but rather some illness. The new point of view has led to shift from the past end of life care practices to more realistic services. More attention is currently emphasized by the health care experts. Involvement with individuals at the last years of life is a universal duty which we all have to play a role. My experience as a physician with patients and their families convincing them to end the life-sustaining intercessions has taught me a lot. I have called relatives to the hospital and watched them grieve at the death of their beloved. Although this is not a light duty, what comforts me is that I play a role in the patients and their families at the most critical point of their lives. Mourning, sadness, confusion, grief and all the emotions that every individual adopt after death is announced at times get me caught in the trap. This has made me adopt different viewpoints about death and life each time a person dies.  Reflections On End-Of-Life Care For Patients And Families Discussion Paper

Physicians have many discussions about the end of life to engage in some of which may be addressed through legislation. The development and funding of end of life in hospitals are highly regarded by the National End of Life Care Program. Health care homes are considered the best environments for the end of life care (Abhay, 2016). However, the public is still uncertain about the practices at the end of life care homes. The community knows little about how much care is given to their patients. The question about whether their needs are well met remains a controversy.

Experts at the end of life care departments often emphasize on the centrality of a personalized care (Butcher, 2010). The care homes staff may be knowledgeable of the primacy of personalized care to their clients but fail to sustain an individualized care. Sparing time to sit with the dying individuals and ensuring their comfort may not simply be met possibly because of the limited staff. Handling every patient individually could mean that some will stay unattended. Establishing informal relationships with the residents helps create a motivation and avoid withdrawal (Butcher, 2010). The building of personal relationships makes the staff more approachable which makes those on their way out more reassured.

Personalized Care In End-Of-Life Situations

The individuals living their last days need to maintain their dignity and respect (Duderstadt, 2013). Family, friends and the staffs in the health care facilities should help the patients sustain their self-respect by paying attention to their needs and their interests. This can be enhanced by helping maintain their cleanliness, assisting them in keeping their hair neat and offering other services such as pedicures, manicures and trimming their chin. Respect can also be shown by recognizing and acknowledging personal, ideological and cultural differences (Duderstadt, 2013). Care providers ought to put aside their own beliefs, faiths and ideological subscriptions in service of their clients.

Medicine has proved triumph in many instances of life: preventing and curing diseases, making births less painful and conquering related complexities (Morley, 2013, p. 616). However, the elephant in the house is curing old age and death. Mortality has overweighed the strength of any existing medicine. At times the medicine even tends to intensify the suffering. Although all the efforts made by medical practitioners in these critical periods are meant to lengthen one’s lives, not all have proven any success. When the medical attention offered does not bear the desired outcome, a crisis is bound to occur between the specialists and the affected families (Morley, 2013). Ideally, this is not the fault of the doctor. The uttermost goal of any medical practitioner is the satisfaction brought about by saving lives (O’Neill & O’Keeffe, 2010, p. 1282). Nobody delights at death. This then raises another controversy of whether those nearing their last days should be kept in the hospital or dismissed. However, the health centers mostly decide to take all blame but do the best to save lives.

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End life choices whether to withhold or to withdraw from the life-prolonging treatment for dying patients is a familiar dilemma (Ewegen, 2012). Ideally, people undergoing their last years or their last months of life should be given maximum care and helped to live as well as they require and with dignity until their last second. Care providers should be sensitive enough to their needs, wishes, and preferences. Identifying this will help them to adequately plan for the client’s care. This care is not only restricted to personal needs but also the external environment. The people who matter the most to the person should also be shown some concern. The family members who are most important to the client should also be supported. This support encompasses all physical and emotional needs. Many family members are literally not aware of how to react in the face of death. This may affect both their emotional and physical behavior especially when they recount their relationship and the experiences with the victim (Ewegen, 2012). This might be caused by either by a feeling guilt or remorse. The tension is likely to be heightened by a conflict among the family members either about a decision to be made or legal measures. This calls for an external intervention, particularly by the spiritual experts. The significance of pastoral care at the end of life is to help the involved cope up with the situation.

Maintaining Dignity And Respect For Patients

The duties I am usually attached to in my field of practice, have helped me learn how to conquer medicine related conditions regardless of their weight. I had long thought all been easy to accept especially due to numerous encounters with death and still births. It was until when I had a real experience with my grandfather that I realized that training and experience were not enough.

Living with grand parents can be an interesting experience, more interesting when you can share some experiences or even go for some walks together. However, it can be a great nightmare which you would want to escape by all means. Everyone would love to see their beloved ones happy. When lives move them violently them to the point of non-contentment, we pity them and even pray that God can give them a rest. Death, though undesirable becomes the best rescuer. When the encounters turn to be unbearable, and beyond our intervention, the comfort we previously had disappears. In the recent past, I had an experience with my grandfather battling with his old age.

Old age is an enemy who comes forth with much more shortcomings: loss of hearing, sight, memory and best friends. It is also attached some chronic illnesses such as diabetes, some forms of dementia and heart failure.  The experience with my grandfather has never been the best. It has taught me a lot about aging and death. Although I have always been his favorite, old age deprived him the intimacy we once had. When he hit a hundred years, he could not recognize anyone, not even his sons. He had lost most of his senses. The once active, independent and jovial grandfather was unable to see. He could not maintain substantial conversations. He had to be carried from place to place. He lost his ability to touch and had to be fed, washed and dressed up. He was always emotionally disturbed and constantly claimed to have all sorts of physical pain. Though we tried as much as we could to make him comfortable, this could not amount to any significant change. His suffering and physical pain were heightened by the poor life he had lived in his past years. He had had a series of accidents breaking his joints and weakening his muscle. He had also been an aggressive smoker and drug addict. This would have robbed him his life much earlier if the doctors had not discouraged him from such habits. This did not stop immediately; we had to practically keep him off from using drugs.

Consideration Of End-Of-Life Choices

Although I was a training medical practitioner, I was unable to cater for all his needs. He grew more demanding as days passed. Hospital visits multiplied as the days passed. The charges heightened day by day though no much change was evident. Relatives and friends continued draining their bank accounts to cater for the huge hospital bills. Despite the fact that we were sure that medical attention would not cure the condition, we had to remain loyal to our community. However unfixable the matter was we had to show some commitment. The modern societies highly denounce neglect to the aging. Mishandling them may attract severe legal measures. The families and societies attached to the old person have a responsibility to ensure that their rights and freedoms are observed and their dignity preserved. After a long battle with grandpa, he finally passed away. The reactions were very different from each family member. Women wailed while men tried to keep some calmness in their faces. We were greatly pained by his demise but gained comfort from the fact that he had rested. In my opinion, we should not put a lot of pressure to the old. We should not coerce them into living as this may cause them more pain than death. I do not see any sense in holding them back in their suffering.

The transitional challenges attached to patients, caregivers, health providers and families are as a result of the organization’s practices and cultural attitudes (Samaraweera1 & Maduwage, 2016). The ethical dilemmas we are faced with in life call for a series of questioning ideologies to come up with the most appropriate. According to Abraham Maslow in his hierarchy of human needs, the highest level is self-actualization/self-fulfilment. He suggests that the greatest need of any individual is the passion to help other people achieve their full potential. This can result in a more complicated controversy. Do those people who live beyond their independence attain their self-actualization? The answer could be definitely no. Hypothetically, people who live beyond their nineties become some form of loads to their loved ones. They are fully dependent on them in all aspects ranging from financial assistance to the most basic personal chores.

End of life care homes may or may not be the best places to face death (O’Neill & O’Keeffe, 2010). Personally, I would recommend that if one has to face death, let it be with dignity. If the patient gets adequate care and services, I can recommend them. The greatest trouble comes in when these stations are flooded, and the patients’ needs cannot be met at a personal level. In the cases where the care homes do not work to one’s satisfaction, alternatives such could be adopted. Keeping patients at the hospitals might be considered as an option but only in areas with adequate infrastructure to accommodate the clients (Han, 2012). In many cases, family and friends opt to keep the victims at home. If adequate care and attention is assured, this has no harm. End of life care does not necessarily require specialists. Training and experience at this juncture in life are of limited importance. The most basic ingredient is the devotion and dedication in the service of others. In this event, the medical practitioners can hardly be termed as the only superior beings.

Challenges Of Caregiving For End-Of-Life Patients

The medical specialists in the face of mortality undergo numerous dilemmas. A slight error in the medication could cost the life of the patient (Yousif, Hussain, & Mhakluf, 2010).  The professional ethics require them to safeguard human life at all costs. At the same time, the interests of the clients must be safeguarded. The lack of autonomy amongst the elderly and the terminally ill in our societies may attract different perspectives on how they should be treated. We may wish the past a hundred happy birthdays without considering whether our sentiments please them or not. Why don’t we consider if their life is appealing to them? We might be happy about their life not considering their comfort.

Conclusion:

In conclusion, collaboration should be established between the patients, the relatives, and the healthcare providers. At times, the physicians and the family members are faced the responsibility to make decisions which might affect the patient’s life to a great extent. Such includes deciding on where the patient should spend their remaining part of life. The most appropriate decision has to be reached, and the patient must be comfortable with it. This bond enhances the openness amongst the parties helping to get the best outcomes from the relationship.

References:

Abhay, M. (2016). Elderly Care in India: Way Forward. Journal of Gerontology & Geriatric, 5 (5), 2-3.

Butcher, L. (2010). Health Reform May Push End-of-Life Discussion Forward; ‘End-of-Life Planning Shouldn?t Happen at the End of Life.’ Oncology Times, 32 (3), 12.

Duderstadt, K. G. (2013). Affordable Care Act: States Move Forward With Health Care. Journal of Pediatric Health Care, 27 (2), 158-168.

Ewegen, S. M. (2012). Being Just? Just Being. Philosophy Today, 56 (3), 285-294.

Gilewski, M. J. (2010). Aging Successfully in Each Generation. PsycCRITIQUES , 50 (38), 124-142.

Han, M. (2012). Health care of the elderly in Myanmar. Regional Health Forum, 16 (1), 23-28.

Morley, J. E. (2013). Aging successfully. Aging Health, 9 (6), 615-618.

O’Neill, D., & O’Keeffe, S. (2010). Health Care for Older People in Ireland. INTERNATIONAL HEALTH AFFAIRS, 51 (9), 1280-1286.

Samaraweera1, D., & Maduwage, S. (2016). Meeting the current and future health-care. Journal of Public Health, 5 (2), 96-100.

Yousif, N. a., Hussain, H. Y., & Mhakluf, M. D. (2010). Health Care Services utilization and satisfaction among elderly in Dubai, UAE, and some Associated Determinants. Middle East Journal of Age and Ageing, 4, 26-32.  Reflections On End-Of-Life Care For Patients And Families Discussion Paper