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End Of Life Care: A Case Study

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There are great improvements through medicine, public health, and activities for elders. With excited expectations, elders deserve to be happy, confident, and hopeful for a joyful long life. Inside health promotions and disease prevention programs, there is an increasing priority for elders, their families and health care system that give encouraging, passionate, enthusiastic and a friendly atmosphere.
Living wills and advance directives detail a person’s choices for end-of-life care. These documents speak loud about a person’s needs and wants when someone is not able to speak for themselves. Doctor’s and caregivers can provide help for families with these legal documents, following with organ donation options, guidance on DNR and DNI orders, …show more content…

Suggestions to make ethical decisions should be taken serious through advanced directives. This allows the patient to maintain control over healthcare decisions in consoling situations. Even after they become insufficient by means of a sentimental living will that gives informative instructions. Accuracy and communication of surrogate decisions are important, because a lot of times families are not well-informed about medical decisions that need to be made. Many of these problems can be resolved by improved communication with regular family meetings and decisional aids. If a patient does not have documented treatment preferences, then decision-making should continue by substituted judgement, in which the surrogate is in questioning to make a decision the way a patient would of want, matter-of-fact, taking into account the patient’s explained choices and values. Under a caregiver contract and advantages, caregivers are able to provide detailed information about the reason of advanced care planning documents, such as what to expect when choosing a treatment option. Another important plan that should be completed by the patient is having a durable power of attorney set up for healthcare proxy. This allows another person to make medical decisions when the patient is not able to speak for themselves. It is also good to have estates and assets planned out accordingly, so that they are protected for the beneficiary and flexible for the individual prior to

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I spoke with the patient 's wife via phone, The wife states that she needs additional assistance for the patient. She states that she is aware that the patient 's health is declining and that she wants him to be comfortable at home. I discussed hospice services with the patient and the wife. The wife states that she would like hospice to evaluate the patient, the patient also agree for hospice to evaluate. Case reviewed with the patient 's nurse, the charge nurse, case management and hospice.

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In some cultures, family members make treatment decisions on behalf of their loved-ones. Provided the patient consents to this arrangement and is assured that any questions about his/her medical care will be answered, the physician may seek consent from a family member in lieu of the patient.”

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But painful scenario like this where patient cannot make decision. They would have filled substitute decision making document that allows capacitated patient to appoint a person on his or her place in making healthcare decision if the patient become incapacitated. Depending upon the state law designation may take proxy form, surrogate power of attorney, health care agent and allows physician to constant the decision with surrogate and implement the treatment decision (Johnson,

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Today in America the homeless account for almost 1.8 million with nearly 44 % of them being men. Disease and mortality are greatest in the homeless, there has “been a 51% increase in the number of patients age 50 or older between 2008 and 2014 (Healthcare).” With these increasing numbers, the growing need for advanced care planning in the homeless is becoming more relevant. The case study that was examined was Paul: No Surrogate.

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The ethical principle of autonomy provides for respect for the patient’s autonomy to make decisions and choices concerning their life and death. Respecting the patient’s autonomy goes against the principles of beneficence and non-maleficence. There also exists the issue of religious beliefs the patient, family, or the caretaker holds, with which the caretaker has to grapple. The caretaker thus faces issues of fidelity to patient welfare by not abandoning the patient or their family, compassionate provision of pain relief methods, and the moral precept to neither hasten death nor prolong life.

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The living will protects a person’s predetermined choices relating to how their physician carries out their health care or end-of-life care in the event that they become unconscious or mentally incapable. Write your living

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These decisions include those relating to future health care, end of life care, personal arrangements and living arrangements, but not financial matters. In the event of a serious health issue, if the person has signed the advanced care directive, dictating that they refuse health care and it is directly relevant to the situation, then it is legal binding. All other aspects of the advanced care directive are only recommendations to the nominated person and/or the health care team (Advanced Care Directives - SA

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The best interest need to be used for those resident who lacking mental capacity, according to the Act, for some significant decisions, which requires the contribution of opinions from their family members. For example, when it comes to the end of life care, the main concern for care staff in the home is to ensure resident is pain free and preserve their dignity. So one of the issues to be discussed between care staff and family at that stage of resident’s care is whether to have ‘Do Not Attempt to Resuscitate (DNAR)’ form in place. For those resident who did not have advanced decision regarding the issue or those who lacked the mental capacity to make the decision, their family member will be consulted. A best decision will be made based on resident’s best interest.

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To balance out the pros and cons of co-guardianship regarding life-sustaining treatment is not an easy task, and the law fails to provide any guidance for those that are lead into this type of situation. LIVING WILLS In New York, there is little guidance on the use of a living will, but it is used to express an individual’s wishes as to end of life decisions in advance. Similar to a health care proxy, it is a legal document whereby an individual sets forth their wishes regarding medical treatment. It provides directives if the individual becomes permanently unable to participate in decisions for their medical treatment, including life-sustaining treatment. Enacted by the Courts, rather than legislation, living wills have little guidelines for its use.

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It is nearly impossible for the patient to rely on another person to make the best decision that they would have made for themselves, particularly when it involves personal interests such as profiting from a will. If there is something to gain, the family members’ motives seem questionable. If the patient falls ill, then there lies a possibility that their heirs will hope for the patient’s death so that they could receive their inheritance. The inability to confirm whether the family actually has the patient’s best interest in mind supports the argument that any form of euthanasia is unethical. Moreover, health care costs for terminally ill patients, including nursing homes, prescription drugs, and home health care deserves consideration.

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In order for a patient to receive the prescription for medication, a physician must declare the patient to be terminally ill, which means they have an incurable and irreversible illness, and they must have no more than six months to live. Also, a second doctor must agree with the first doctor. In addition, the terminally ill patient has to be mentally competent and able to administer the medication themself (“Threat” A12). These rules act as safeguards to ensure that the patient requesting aid in dying is making an informed decision and is acting voluntarily (Gopal

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Life and Death in Assisted Living Facilities Assisted living facilities are one of the fastest growing industries in the United States. Unfortunately, assisted living facilities have a history of being problematic. Specific cases from the movie Life and Death in Assisted Living Facilities indicates that assisted living facilities are often under staffed, poorly trained, and often admit elderly patients who are not qualified candidates for their facilities (Byker and Thompson, 2013). When taking this in to account, it is important to consider why families may admit their loved ones in to assisted living facilities.

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When a patient is at the end of life it is very important to value the patients self dignity and their decisions at the mere end of their lives. The end of life care is to relieve the weight of the patient 's shoulders physically and mentally. I approve of end of life caring. Basic end of life care is summarized by improving the care of quality of life and dignity of the ill person. The important themes to good ethics of end of life care is a combination of human rights,respect,dignified care,and privacy.

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Some patients have to choose the so-called End of Life Option Act for them. Ronald Glasser, listed, that the system wasn’t meant to care for sick people; it was meant to make and manage money. The doctors won’t listen to us if we are in the hospital death bed, they will only listen to them self. Ronald Glasser, also mentioned, the physicians and nurses are being prodded by threats and bribes to abdicate allegiance to patients, and to shun the sickest, who may be unprofitable. Most doctors when they see a patient on the death bed they don’t ask the patient if they went to go; they ask family, friends, and themselves not the person that is actually dying from there life.

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Once the requests are made two doctors then must sign off stating the patient will die in 6 months or less (The Editorial Board, 2015, September). Witness are to oversee the patients written request and certify that he or she is of good mind (The Editorial Board, 2015, September). The patient must then receive counseling about hospice and palliative care (Thompson, 2015). A statement must be signed within 48 hours of self-inflicted death that they are still sound of mind (Thompson, 2015). They are reminded before the doctor writes the prescription that they do not have to fill the prescription nor take it the choice is solely theirs (Thompson,

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