End of Life Care: Providing for Terminal Patients

Paper Summary:

This paper studies how hospitals and, in particular nursing staff, provide care to terminal patients at the end of their lives. The paper begins by examining the current beliefs and practices concerning the end-of-life patient and his family as compared to the beliefs and practices of 100 years ago. Next, the paper assesses the concerns that patients have regarding end-of-life issues. Then the paper turns to an analysis of the policies and laws that affect nurses and physicians when they provide end-of-life care. The paper concludes with a discussion about the implications for the future of end-of-life care, particularly if patients' concerns are not adequately addressed.

From the Paper:

"The first component, receiving sufficient pain and symptom management, is one which has been the subject of numerous articles, books, and research studies in many countries. In an article entitled, "Dying Patients in the USA Often Suffer Too Much" (Fackleman, 11/19/02), it is reported that nearly half of the 1.6 million patients living in nursing homes suffer from untreated pain. Last Acts, a coalition of health care groups, conducted an extensive survey about end-of-life issues in all 50 of the United States and in the District of Columbia. They found that living without pain and dying with dignity were the two wishes that end-of-life patients had. Sadly, there are many instances in the U.S. and in Canada when these wishes are not granted. In an article she wrote for RN Journal of Nursing, Lisa Schiff states, "In a recent study of over 2300 nurses - most of whom worked in oncology - more than half said that their nursing education had not adequately prepared them to provide end-of-life care." (Schiff, September, 2000)."

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