End of Life Care (Nursing)

00:02 Hi, Today we are gonna be talking about End of Life Care.

00:05 My Name is Jill Beavers-Kirby.

00:09 So what are the ethical issues involved with end of life care? The first is the quality of life. It's important to try to maintain the patient's activities of daily living as independently as possible.

00:22 You want to try to maintain optimal functioning status for the patient.

00:27 Ethical dilemmas during end of life care may include [inaudible 0:00:32.000], insertion of feeding tubes, IV hydration and so on.

00:40 And what is an ethical dilemma? An ethical dilemma is a problem that is not have a satisfactory solution for both sides.

00:51 How to manage an ethical dilemma? First you need to examine the actions.

00:55 Examine your actions. The patient's actions. The family's actions.

00:59 The next you need to consider the consequences.

01:02 The consequences of your actions and of the patient's actions and of the family's actions.

01:09 You need to analyze and establish your own values and opinions of this ethical dilemma.

01:16 That's very important to main professionalism and professional competence during this time.

01:21 You can also ask your institution's ethics committee to step in and help resolve this ethical dilemma.

01:31 End of life care contains the dying Person's Bill of Rights.

01:35 The dying Person's Bill of Rights is a professional standard and include rights as: being treated as a living human being until the minute they die.

01:46 The right to be free from pain and a right to have a sense of purpose.

01:54 So what are the nurse’s responsibilities during end of life care? You want to the evaluate what the family understands about this time and what they actually expect.

02:06 Try not to use medical jargon. It’s okay to say "death" and "dying".

02:10 What are the patient's primary symptoms? You wanna focus on these.

02:14 Is the patient too cold? Too warm? Or they are in pain? You want to allow the caregiver or caregivers to discuss caregiver burden.

02:24 Better know that this is normal.

02:26 It can care somebody who's at the end of life is tough.

02:30 Help the family be prepared for the signs of imminent death and how to manage them such as the agonal breathing that can occur several hours before death.

02:40 But also want to give bereavement resources to the family and caregivers such as support groups.

02:48 Palliative care and Hospice Care.

02:50 Palliative care is made of health care providers and physicians and nurses.

02:56 This provides comfort measures to the patients.

03:00 They focuses on prevention, lessening, and respite of physical, emotional social, and spiritual signs of disease or therapies.

03:10 Hospice care is a Medicare benefit.

03:13 So if your patient has Medicare then they are available to sign up for hospice care.

03:18 Hospice care provides care for patients who have the short time to live such as a few months.

03:25 This focuses on relieving symptoms and encumbrance of the illness.

03:31 It also helps patients to live as fully as possible.

03:37 So what is the Nursing Assessment during end of life care? Are the patient's and family's treatment and care needs being met? Are they being met at their expectations? Are unwanted symptoms being addressed? Is the patient comfortable? Are they warm? Are they cold? Are spiritual and emotional needs also being met for the patient and for the family? Is grieving being addressed for the patient and the family satisfaction? These are all very important.

04:11 So some examples of nursing diagnosis can include comprise family coping related to impending death.

04:20 End of life care related to terminal cancer and palliation related to in state COPD.