end-of-life care


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end-of-life care

multidimensional and multidisciplinary physical, emotional, and spiritual care of the patient with terminal illness, including support of family and caregivers.

End-of-life care has received increasing attention in recent years. The pioneering studies of Elisabeth Kübler-Ross on death and dying, begun in the the 1960s, have afforded valuable insights into the evolving emotions, experiences, and needs of the dying person. Health care professionals have formally recognized the importance of rendering humane and competent care at the end of life in ways that preserve the dignity and autonomy of the patient. Physicians, particularly oncologists, who treat patients with terminal illness have focused on the need to distinguish clearly between aggressive and palliative forms of treatment and to establish guidelines for the care of patients for whom further cure-oriented treatment will be of no benefit. In particular, they have recognized the importance of providing adequate pain relief to patients with advanced cancer. Increased attention has also been given to the control of fatigue, anorexia, cachexia, nausea, vomiting, and dyspnea, which often occur in terminal illness. Studies have shown that pain relief in terminal patients is often inadequate because physicians are afraid of inducing narcotic addiction or of being accused of hastening death. Wider use of opioid analgesics and development of patient-controlled analgesia and anesthesia systems have improved control of pain in terminal cancer and AIDS. Professional nurses have embraced the obligation to provide relief of suffering, comfort, companionship, and, when possible, a death that is congruent with the dying person's wishes. The hospice movement has established programs and facilities within the organized health care system that focus on the special needs of dying patients for comfort and care rather than efforts at cure. These programs include support of caregivers and family members during and after the patients' final illness. There is general ethical consensus that the withholding or withdrawal of life-sustaining treatments in terminal illness is not euthanasia but rather a decision to allow the disease to follow its natural course. End-of-life care emphasizes the importance of frank, timely, supportive discussion of such matters as preferences for life-extending care, including cardiopulmonary resuscitation, mechanical ventilation, artificial hydration and nutrition, renal dialysis, and surgery before decisions about the use of such measures become necessary. Legislatures have sought to preserve the dignity and independence of people nearing the end of life by allowing them to enact advance directives for their care in the event that they become incompetent or comatose. The integrity of the relationship between patients and health professionals has been threatened by growing social and legal toleration of physician-assisted suicide. The American Medical Association and the American Nurses Association have issued official position statements opposing assisted suicide. see also advance directive, physician-assisted suicide, living will.

end-of-life care

n.
The network of medical and support services, including palliative care, hospice, psychological counseling, and legal assistance, provided to individuals in the last stages of a terminal illness.

end-of-life care

(end līf kār)
Multidimensional and multidisciplinary physical, emotional, and spiritual care of the patient with terminal illness, including support of family and caregivers.

end-of-life care

Supportive care for the dying. Such care includes invasive interventions such as advanced cardiac life support, or supportive interventions, such as educational, emotional, physical, or social assistance to the terminally ill and their families and significant others.
See also: care
References in periodicals archive ?
* Improved my understanding of the ethical and legal aspects of end-of-life care? 78.9% of students strongly agreed and 21.1% of students agreed.
As noted, end-of-life care composes a large proportion of services funded by Medicare.
Over time, new nurses mentored by an experienced nurse gradually learn these protocols and other aspects of end-of-life care, such as what equipment stays connected, how the withdrawal process will proceed, what the patient will look like as death nears, as well as the messages to give to families and the timing of them.
Anita Hayes, deputy director of the National End-of-Life Care Programme, said: "New healthcare commissioners will doubtless face a full in-tray but there are compelling reasons for prioritising end-of-life care."
The nurse informed the daughter of this and contacted the on-call physician to involve her in the discussion of clarifying the end-of-life care wishes.
A recent nursing textbook study revealed only 1.4% of the chapters mentioned the topic of end-of-life care. A study of nurses themselves found a majority reporting the importance of end-of-life content within nursing curricula but only slightly more than half rated their undergraduate preparation as adequate.
They must encourage professions and institutions involved in end-of-life care to keep uprooting myths--often based in liability fears--that perpetuate suffering by conflating the relief of pain and suffering with PAS/PAD.
7 (Palliative Care Isn't Just End-of-Life Care), Oct.
The Medicare hospice benefit is specifically designed for end-of-life care but is an elected benefit for individuals who have a terminal diagnosis with a prognosis of 6 months or less if the disease runs its normal course.
Changes in the causes of death and advances in medical technology are leading nurses today to become more involved with end-of-life care than previously.
Welby had indeed become an advocate for the right to refuse treatment, recently writing a book, Let Me Die (Rizzoli), in which he asked the Italian government for what he called "euthanasia." The questions he asked, however, echo those of many facing difficult decisions about end-of-life care: "What is natural about a body kept biologically functional with the help of artificial respirators, artificial feeding, artificial hydration, artificial intestinal emptying, of death artificially postponed?"
Abstract: This descriptive study evaluated concepts relating to end-of-life care addressed in Journal of Neuroscience Nursing during a 10-year period.