Nursing and Mid Wifery

  1. Home
  2. AllAssignmentHelp Samples
  3. Medical
  4. Nursing and Mid Wifery
575 58 14 3540

Requirement

1- Write a report of around 3000 words on " Nursing and Mid Wifery" with referenced to APA

Solution

INTRODUCTION:

In Australia the acute medical care prioritises diseases so that life can be preserved. Malignant diseases like cancer show considerably short period of decline which begins and ends in acute care but patients suffering from life limiting diseases like dementia show irreversible and gradual progression of disease. The Australian population is gradually ageing and there has been an increasing demand for end-of-life and palliative care across the entire continent. As the age of the population gradually increases, so does the need for caring for the aged in residential care settings and homes increases. The Australians feel it considerably important to support the older generation by providing them high quality end-of-life care in the settings they opt like their own home, residential aged care, acute care hospital or devoted hospice services. Acute care hospitals however sometimes lack the adequate and appropriate settings needed for providing dedicated end-of-life care and thereby ensuring better life and comfort. Dying is considered a normal part of life and not just medical or biological event. Recognising the moment when the individual is approaching the end-of-life is important so that timely, compassionate and appropriate end-of-life care can be provided. The individuals should be entrusted the power to decide their personal care as and when possible; since the goals, needs and wishes of the individual changes over time as he approaches his end. This report will discuss what palliative care and approach is and will also discuss the manner in which it has been applied in aged residential care. The advanced care planning and directives will be discussed along with discussing the strategies that can help improve the provision of palliative care in residential aged care. 

PALLIATIVE CARE AND APPROACH:

Palliative care is defined as an approach which helps in heightening the living quality of patients who are suffering from fatal illness along with their families. The patients are rendered help through relief and prevention of suffering with the help of early identification, treating pain and other psychosocial, physical and social problems along with impeccable assessment. Palliative care:

  • Helps the patient get relief from pain along with other distressing problems

  • Helps in affirming the value of life and refers to dying as a normal human process

  • The care is neither intended to postpone death or to hasten its arrival (Chin & Booth, 2016)

  • The care provides the patient a support system through which the patient can live an active life until his death

  • The care helps in integrating the spiritual and psychological factors of patient

  • The care will help in enhancing the standard of life and help in creating positive impact on the course of illness

  • The care system offers support to the families so that they can cope with the illness of their patient and tackle their personal bereavement

  • The care is provided through team work which caters to the needs of the patient along with the families; bereavement counsellors provide support if need arises

  • The care is initiated at an early stage of illness when other therapies intended to prolong life are applied like chemotherapy, radiation therapy. At this stage the care includes investigation related to better managing and understanding the distressing medical complications.

  • The palliative care to be effective requires a wider and multidisciplinary attitude involving the family of the patient along with utilising the community resources (Back et al., 2016)

Palliative care is provided in serious illnesses like chronic obstructive pulmonary diseases, heart failures, cancer, Parkinson’s disease and dementia. This care helps the patients to understand and identify their choices of clinical treatment. The care provides organized services which can prove immensely beneficial to the older people who are experiencing various disability and discomfort due to their ripe age. This care is not based on prognosis and can be provided along with curative treatment. This care can be provided in hospitals and nursing homes; specialized clinics, homes and outpatient palliative care clinics (Amblàs-Novellas et al., 2016). When the palliative care team realises that the ongoing treatment is ineffective, the palliative care can be transitioned to hospice care when the doctor believes that the patient is not responding to the treatment and can die within six months. The palliative care team comprises doctors and nurses specialising in palliative care along with nutritionists, social workers and chaplains. This multidisciplinary team works with the patient and its family along with the other attending doctors so that they can provide emotional, practical, social and medical support.
The main aim of palliative approach to care is improving the living standards of individuals with life limiting ailments and providing support to their families. The exact time for starting palliative approach is when the given treatment for curing the condition are not working any longer and the individual decides to stop the curative treatment(Amblàs-Novellas et al., 2016). The focus of this kind of approach is on the comfort level of the patient and ensuring that the patient is provided quality standard of life which is consistently maintained so that the individual can live properly as long as he survives and die in a care and supportive atmosphere.

Want to hire the best medical surgical nursing assignment help? The experts of Allassignmenthelp.com can provide you with the best and high-Quality Biomedicine assignment help. If you want to buy nursing assignment help from us, simply place your order on our website and our assignment experts will provide you with the best solution.

PALLIATIVE CARE PROVISION IN RESIDENTIAL AGED CARE:

Palliative approach in aged care settings emphasizes on health care which is not just based on diagnosis; in the aged care homes the aim of this kind of approach is maximising the living standards by providing appropriate care based on needs. In this approach a positive methodology is used which can help in reducing the personal symptoms and distress of the suffering individual. The patients residing in residential aged care facilities (RACF) include young patients who are suffering from illness that will reasonably cause death in the foreseeable future (Broad et al., 2015). A palliative approach aims to heighten the comfort and living standards of the residents and the main focus remains on the emotional, cultural, spiritual and social yearnings of the individuals along with their preferences for adopting specific care rather than depending on the aggressive clinical treatments. This type of care management involves preserving the good symptoms of the patient and attending to the spiritual and social needs of the residents in the aged care. 
The individuals suffering from life threatening illness and residing in RACF should be rendered standard living quality by giving palliative care at the initial level of diagnosis, as they progress in their illness and the final days when they are nearer to their death. A palliative approach in RACF should administer the patient with the following facilities:

  • Comfort, dignity, autonomy and respect

  • Their spiritual and cultural wishes should be respected

  • The team should openly discuss and be transparent in matters related to treatment option and the present condition of the individual

  • The team should effectively manage the pain and other distressing symptoms of the patient

  • The patient should be given the choice to select the treatment option based on available evidences

  • The care should give the patient the quality of life which he desires in the present circumstances (Frey et al., 2016)

  • The aged care should allow access of persons whom the patient desires to see

  • The staff should pay attention to the factors troubling the patient and report it back to the nursing staff

  • The team should minutely notice the changes in the condition of the resident and look for certain symptoms like loss of appetite, fatigue, pain, loss of mobility, confusion. These should be documented and reported back to the nursing staff

This type of palliative care treatment works wonders for the patient terminally ill and awaiting their last days. The multidisciplinary team supports the residents with the best possible care. The resident and their family are rendered care and support by the staff that they know and can trust easily. The team ensures early assessment of disease along with managing aligned symptoms and pain; they also openly discuss death and dying so that the patient can warmly welcome death in the desired place.

ADVANCED CARE PLANNING AND DIRECTIVES:

Advanced care planning is not just related to old age; medical crisis at any age can make the individual so ill that he fails to make his own health decisions; even though individuals are not sick they can plan their future health care for ensuring they get the medical care they desire if circumstances make them unfit to speak. The advanced care planning involves forming decisions about a particular care which the person desires to receive when he is unable to express (Booth &Lehna, 2016). These decisions are based on the preferences, personal values and suggestions of the loved ones. Advanced care planning comprises: 

  1. Acquiring information about the different types of available life sustaining treatments

  2. Sharing the personal values with the loved ones

  3. The individual can decide the type of treatment he desires to adopt or the treatment which he shuns from applying if he is diagnosed with life threatening illness

  4. The planning even involves completing the advanced directives by writing the type of treatment which the patient has desired and has rejected if circumstances arise where he is unable to speak for himself (Green et al., 2015).

The family and the health care providers should be made aware of the preferences of the individual; these preferences when documented from the advanced care directive.
The advanced care directive is a legal document which becomes effective when the patient is incapacitated or unable to speak for himself (the reason behind the inability could be either old age or severe injury or disease). The advanced care directive helps the medical team to know the treatment which the patient desires; the advanced directive also allows the patient to expresses his desires and values associated with end-of-life care. The advanced directive can be treated as a living document which can be adjusted according to the changing circumstances associated with change in health or some recent advanced information (Teixeira et al., 2015). The advanced care directives (ACDs) are known to show considerable difference since the people who document their preferences most likely get the care they had desired and opted at the end of their life than those who fail to document their preferences. The ACDs thus provides the patient a path to plan ahead of time when they lose their decision making capability so that they can live well and embrace death with dignity based on their personal values. 

CRITICALLY DISCUSSING AND APPLYING ADVANCED CARE DIRECTIVES IN RESIDENTIAL AGED CARE:

Advanced care planning discussion involves discussing the personal beliefs, values and preferences of the individual which will help in guiding the future decision making process and can result in a written advanced care plan. Advanced care directive is a special form of official advanced care plan which is expressed in writing, recognised by legislation or common law and duly signed by competent adult. The clinical care, resuscitation plans and treatment along with clinical care prescribed by the medical team for guiding the clinical care should be documented in the ACDs and the advanced care plans (Dixon, Matosevic& Knapp, 2015). The ACDs can record any of the factors like life goals, desired outcomes and values of the patient, directions of the patient related to treatment refusal and care, decision associated with appointing substitute decision maker (SDM). 
However there are various problems associated with ACDs; problems may arise when the ACDs contain clinical directions which are not informed earlier or are too specific leaving very little scope for changing the line of treatment. Sometimes the clinical directions are too non specific and fail in guiding the decision making process. Problems even arise when the substitute decision makers are confused about their role in the whole process and fail to provide support in the decision making process. Again there are situations when people change their preferences but forget to update the ACDs; sometimes the clinicians are reluctant to follow the directions mentioned in the ACDs and do not honour the decisions of the substitute decision makers (Combes et al., 2019). The SDM nominated by the patient should be capable of forming decisions best suited for the individual and similar to his preferences. The alternative decision should be based on what the person knows about the preferences of the patient including the patient’s values, goals, views and beliefs which are relevant to the situation and match with the medical advice. 
There are several barriers in the formation of advanced care directives; sometimes in cases of imminent death the doctors are reluctant to discuss the end-of-life matters with the patient which causes delay in the discussion process. It is very important to normalise the discussion procedure; the National Framework for Advanced Care directives has suggested that ACDs and advanced care planning should become an integral part of the procedure when the patient contacts the medical practitioners and health care. The important part of the advanced care planning discussion should be honouring the background and cultural values of the patient. Patients belonging to backgrounds having minority language and culture fail to complete the ACDs as compared to the majority population. In some cultures again the individual decision making process and the principles of autonomy on which the ACDs are based are considered hostile(Combes et al., 2019). A major barrier in forming ACDs is the time factor; the discussions related to comprehensive and effective advanced care planning are not conducted in the standard consultation period. However by conducting appropriate discussion and planning with the patient, appointments can be rescheduled so that the ACDs can be completed. If the issue of forming the ACDs is raised in timely manner there does not arise the need for completing it urgently. The places where nurses assist in management plans and health assessment; they should be provided training in areas of ACDs for facilitating their participation in management planning and routine assessment. 

STRATEGIES TO APPLY PALLIATIVE CARE IN RESIDENTIAL AGED CARE:

The older generation at the end of their life desire complex and unique health support which are provided in varying settings by different health professionals. Occupying everyone associated with the health and support needs of the client on the same platform can sometimes become quite impossible. Applying strategies so that the service providers can be united will help in improving the care which the patients desire and need at the end of their life. Collaborating with various services ensures easier sharing of information which can prove extremely beneficial (Chan, Webster & Bowers, 2016); it increases the constant care given to the patients through skilled and confident palliative care staff. The strategies which can be applied so that the palliative care can be heightened in residential aged care and effective result can be gained are:

  • The confidence, skills and knowledge of the staff associated with palliative care and advanced care planning should be increased 

  • Communication and awareness within the local services and resources should be increased

  • Constant and improved care should be provided in between the services

  • The documentation of advanced care planning of the residents should be completed in proper period

  • The residents living in palliative care should not be transferred from their place in the last week of their life

  • The workplace and personal practices should be changed immediately according to the needs of the patient

  • Appointing a key worker who will be responsible for providing the care and services, improving cooperation between services and maintaining the continuity of services

  • The roles and responsibilities of each practitioner should be clarified which will boost the communication within the care system(Chan, Webster & Bowers, 2016).

The palliative care support system should position the patient, families and the care givers at the centre of the support system; the system should render support and service to the families of the patient. Providing this will help the palliative care to differentiate itself from other service providers since majority of the service providers just focus on the needs of the patient. People tend to have varying needs in the residential aged care centre; based on the complexities of the patient’s needs specialist palliative care services should be provided for rendering utmost services (Harstäde et al., 2018). The work force of the residential aged care should be developed by giving training and education so that they can provide support to the health professionals involved in the palliative care. A robust and efficient work force will ensure that the patients are provided the much needed support in the residential aged care. Culturally appropriate and clear communication is important in rendering palliative care(Harstäde et al., 2018). Provision should be made for ensuring that the families get involved in communication and care related decisions; the families and the patients should be encouraged to participate in ongoing discussions related to palliative care and in the decision making process. 

Place Order For A Top Grade Assignment Now

We have some amazing discount offers running for the students

Place Your Order

CONCLUSION:

The residential aged care facility are structured and equipped in such a manner so that they can support the medical practitioners to provide efficient service to the patients and their families. Palliative care is provided to patients suffering from chronic ailments so that they can properly spend the last days of their life. The end-of-life care should be considered part of normal practice of the residential aged care; staff giving palliative care should acknowledge that the facilities provided in the residential aged care are home for many individuals towards the end of their life. The mental health needs of the individuals in the residential aged care should be assessed and documented so that the palliative care rendered to them relieves them from depression and anxiety hovering over them. This report has discussed the meaning and approach of palliative care and how it can be applied in the residential aged care. Palliative care when adopted for patients residing in residential aged care can help the medical practitioners and staffs involved in the process earn maximum benefits from their services. The residential aged care staff and services should ensure adopting appropriate measures for acknowledging and recognizing the life and contribution of the consumers after their death. The advanced care planning and directives along with the barriers involved in it are also discussed in the report. Strategies related to palliative care are recommended so that maximum support can be rendered to the patients residing in residential aged care. 

Reference:

  • Amblàs-Novellas, J., Murray, S. A., Espaulella, J., Martori, J. C., Oller, R., Martínez-Muñoz, M., ... & Gómez-Batiste, X. (2016). Identifying patients with advanced chronic conditions for a progressive palliative care approach: a cross-sectional study of prognostic indicators related to end-of-life trajectories. BMJ open, 6(9), e012340.

  • Back, A. L., Steinhauser, K. E., Kamal, A. H., & Jackson, V. A. (2016). Building resilience for palliative care clinicians: an approach to burnout prevention based on individual skills and workplace factors. Journal of pain and symptom management, 52(2), 284-291.

  • Booth, A. T., &Lehna, C. (2016). Advanced Directives and Advanced Care Planning for Healthcare Professionals. Kentucky nurse, 64(2).

  • Broad, J. B., Ashton, T., Gott, M., McLeod, H., Davis, P. B., & Connolly, M. J. (2015). Likelihood of residential aged care use in later life: A simple approach to estimation with international comparison. Australian and New Zealand journal of public health, 39(4), 374-379.

  • Chan, R. J., Webster, J., & Bowers, A. (2016). End?of?life care pathways for improving outcomes in caring for the dying. Cochrane Database of Systematic Reviews, (2).

  • Chin, C., & Booth, S. (2016). Managing breathlessness: a palliative care approach. Postgraduate medical journal, 92(1089), 393-400.

  • Combes, S., Nicholson, C. J., Gillett, K., & Norton, C. (2019). Implementing advance care planning with community-dwelling frail elders requires a system-wide approach: An integrative review applying a behaviour change model. Palliative medicine, 0269216319845804.

  • Dixon, J., Matosevic, T., & Knapp, M. (2015). The economic evidence for advance care planning: systematic review of evidence. Palliative medicine, 29(10), 869-884.

  • Frey, R., Boyd, M., Foster, S., Robinson, J., &Gott, M. (2016). What's the diagnosis? Organisational culture and palliative care delivery in residential aged care in New Zealand. Health & social care in the community, 24(4), 450-462.

  • Green, M. J., Schubart, J. R., Whitehead, M. M., Farace, E., Lehman, E., & Levi, B. H. (2015). Advance care planning does not adversely affect hope or anxiety among patients with advanced cancer. Journal of pain and symptom management, 49(6), 1088-1096.

  • Harstäde, C. W., Blomberg, K., Benzein, E., &Östlund, U. (2018). Dignity?conserving care actions in palliative care: an integrative review of Swedish research. Scandinavian Journal of caring sciences, 32(1), 8-23.

  • Teixeira, A. A., Hanvey, L., Tayler, C., Barwich, D., Baxter, S., &Heyland, D. K. (2015). What do Canadians think of advanced care planning? Findings from an online opinion poll. BMJ supportive & palliative care, 5(1), 40-47

AllAssignmentHelp Logo

Give your grades a boost

Just share your requirements and get customized solutions on time.

  • 1,168,768 Orders
  • 4.9/5 Overall Rating
  • 5,052 Experts
Citation Generator

Best Online Citation Generator Tool

Eliminate writing errors with AllAssignmentHelp

Try Now

Grammar Checker

Instant Grammar Checker

Check Spell & Sentence Correction with AllAssignmentHelp

Try Now

Plagiarism Checker

Plagiarism Detection

Check Your writing for plagiarism and correct grammar.

Try Now

Word Counter

Word Counter

Stay within the word limits of your homework

Try Now

Get Quality Assignment Without Paying Upfront

Hire World's #1 Assignment Help Company

Place Your Order