End of Life Care: Ensuring Needs are Met
Suzan Miller-Hoover DNP, RN, CCNS, CCRN-K
"You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die."
— Dame Cicely Saunders, nurse, physician and writer, and founder of the modern-day hospice movement (1918 - 2005).
"Life is pleasant. Death is peaceful. It's the transition that's troublesome."
– Isaac Asimov, American science fiction novelist & scholar (1920 - 1992).
These two quotes sum up end of life. How we deal with our patients and family at the end of life may make a difference in how we live the rest of our lives; without regret, without anger, with peace and hope.
Most people want to die at home, surrounded by loved ones and free of pain (National Hospice and Palliative Care Organization (NHPCO), 2016). However, many of these people do not have advanced directives, nor have they spoken about their wishes to their family.
End of life care begins with advanced planning, it is essential that family members discuss what is important to them before they need end of life care. Putting these wishes in writing can help the family during this most difficult time.
There are two similar but different services available to the dying patient. Both services provide comfort measures and pain control to the patient and support to the families.
Palliative Care: Patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information and choice (NHPCO, 2016)
Hospice Care: The model for quality compassionate care for people facing a life-limiting illness; providing medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes and support for the family (NHPCO, 2016).
It is important to the healthcare provider to know and recognize when these services are needed by their patients. Identifying the various symptomology that might be present at end of life will ensure the patient receives the symptom relief s/he needs.
Knowing how to care for a patient at the end of life is a skill that is learned. Compassionate care is an essential element. Remember, you are important. You need to be cared for, and care for yourself, during these most difficult moments of your career and life.
Would you like more information about end of life care? The RN.com course Palliative Nursing: Caring for The End of Life Patient can provide you with symptom identification and treatment techniques.
References
National Hospice and Palliative Care Organization (NHPCO). (2016). Hospice care. Retrieved from: https://www.nhpco.org/about/hospice-care NHPCO. (2016).
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