Abstract
The paper discusses how research regarding hospitalized end-of-life experience is limited and studies that do exist have been done retroactively and focused on certain subjects. The paper describes how terminally ill patients and their families have participated in surveys rating their trust in physicians, forbearance of unwanted life support, effective communication, care continuity, and life completion (Spichiger). The paper relates that staff is expected by families to attend the patient's needs without delay and provide as much comfort as possible, patients believed that good communication skills were extremely important for health care providers, and family members believed their family member's dignity was compromised when personal needs were disregarded, yet when timely maintenance was available, bedside visits were much easier. "

From the Paper
"Research regarding hospitalized end-of-life experience is limited and studies that do exist have been done retroactively and focused on certain subjects. Terminally ill patients and their family's have participated in surveys rating their trust in physicians, forbearance of unwanted life support, effective communication, care continuity, and life completion..."

Tags:terminally, ill, hospital

Abstract
This paper discusses the difficulties that may be associated with having a terminal disease, in terms of a patient's contentment with life. It describes the resources and support that Canadian patients with terminal disease are fortunate in possessing. It discusses how these resources of a well-trained, empathic health force and modern facilities support social well-being. The paper provides examples from the literature.

From the Paper
"Quality of life in patients with terminal illnesses such as terminal cancer is no doubt a large concern for nurses. Unlike acute disease processes, terminal diseases in patients, while therapeutic relations between nurse and patient can strengthen over time, must also be evaluated to determine the effectiveness of treatment. In this case, it is the preparation of the patient and family in body, mind and spirit for that inevitable transition from life to death. Interventions to improve the quality of life of these patients have significant value as portrayed in the previous articles."

Tags:palliative cancer, quality of life, treatment death

Abstract
The paper discusses how the environment in a home where there is a terminally ill parent is often significantly different than a "well" household. This is not only because this home has the paraphernalia associated with the ill, such as sick beds, pharmaceuticals, wheel chairs and the like. These factors cause tense situations that make all family members more stressful. The paper then discusses how children of terminally ill parents experience other frightening daily occurrences. The paper concludes that youth need assistance in dealing with death and grief in order to help them cope with the changes occurring in their lives.

From the Paper
"Many children and families go this situation. According to national statistics, by the age of 15, over a million children in the United States will lose a parent to a terminal illness (Mahoney, 2005). Although numerous programs and resources are available to help those children who are grieving the death of a parent, there are few organized interventions to help families cope with their children's emotional needs during the parental illness and treatment, when help is especially needed."

Tags:terminal, illness, parental, illness

Abstract
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)."

Tags:patient, ill, sick, cancer, life, dying, doctor, nurse, hospital, hospice, pain, management, nursing, home

Abstract
The paper examines the study "Living with Incurable Cancer at the End of Life--Patients' Perceptions on Quality of Life" by Johnasson et al., that explores the quality of life in terminal situations and specific methods of providing proper and quality-improving end-of-life care to terminally ill cancer patients. The paper discusses the study's descriptions, the methodological congruence, the precision in the analysis and interpretation of the study's results, the theoretical and philosophical connections of the study to the larger practice of medicine and the general applicability of this study. In this writer's opinion, this study helps to promote better medical practices and greater levels of care.

Outline:
Introduction
Descriptive Vividness
Methodological Congruence
Analytical and Interpretative Preciseness
Philosophical and Theoretical Connectedness
Heuristic Relevance
Conclusion

From the Paper
"It is often assumed that in the instance of terminal illnesses such as certain cancer cases, this process would be made even more difficult by the prolonged reduction in quality of life resulting from both the symptoms and/or the care needed to mange symptoms. This view, however, is challenged by evidence that improvements in symptom management of terminally ill patients has led to a shift in perception of end of life care. Perhaps more importantly, a more comprehensive understanding of the factors that contribute to quality of life has led to a reassessment in the methods of measuring this essential aspect of patient care. The study examined addresses both this overall reassessment of the quality of life in terminal situations, and specific methods of providing proper and quality-improving end-of-life care to terminally ill cancer patients.
"Specifically, five terminal cancer patients in the final stages of their diseases participated in repeated focus groups, and through their discussions certain themes and other patterns were developed. Assessing what factors to measure in making a quality of life determination and obtaining accurate measurements of these factors has always been a somewhat difficult and subjective process, and this study, rather than attempting to quantify this subjectivity, instead exploits and expands upon it in order to come to a more accurate and individualistic approach at improving the quality of life during end-of-life care for cancer patients."

Tags:methodological, congruence, precision, medicine

Abstract
The following paper provides understanding of the organization, "Alive Hospice", an organization that provides care while the patient enters end stages of disease and then goes through the process of dying. The writer examines what its volunteers provide for the terminally ill patients that it serves.

From the Paper
"In recent decades, medical science has advance to the point that people are living longer than ever before, and with that life comes a quality of life that is enjoyed well into the golden years. For those who are among the living the world is a beautiful place. However, for those whose lives are ending, the world can be a place filled with fear and uncertainty as one goes from doctor to doctor in search of hope and miracles. Then, when they announce the final curtain, that the patient is all out of options and the only path now is death, there are decisions to be made. Many people are afraid of dying in the clinical setting of a hospital, but they are not sure there are options. There are."

Tags:caregiver, client, nurse, terminally, ill, fear, pain, modern, medicine

From the Paper
"Ethical Issues Of Home Health Care
Introduction
Long-term care is becoming a main component of American health care. Long-term care takes place in hospitals, single-family or group homes, nursing homes, housing with linked services, and specialized day centers; patient populations include children with developmental disabilities, elderly people with physical disabilities and those with Alzheimer's disease, and adults with AIDS. Kasper cites Evashwick's definition of long-term care and home services to include intravenous administration of medicine, devices for mechanical ventilation, meal preparation, and bathing. Providers of health care include skilled nurses, technicians, therapists, family members, and others. Home health care legal and ethical issues pertain to all..."

Abstract
In this paper, the writer contends that assisted suicide is not only a humane option for suffering patients but for the families as well. The writer discusses how the laws and procedures to become accepted for assisted-suicide are extremely detailed to prevent the misuse of the procedure. The writer asserts that each individual should be allowed to determine his or her own fate, and his or her own death, if the situation permits. The writer argues that physician-assisted suicide should not become a religious, moral or ethical issue; it is about the terminally ill, long suffering, person whose final wish is to leave on his or her own terms, to die with dignity.

From the Paper
"Two patients, the same age and the same gender, have been diagnosed with advanced brain cancer. Each has been given six months to live. Their doctors have informed them the last six months of their lives are likely to be filled with pain and suffering, and both patients will become bed-ridden. Two months go by. Each patient finds himself in extreme pain, and feels he is a burden on friends and family. Life is starting to become unbearable. Each one's memories are fading. Both patients begin to forget friends and family, and just want the pain to stop. Both feel they and their families would be better off if death was on their own terms. Fortunately, for one patient, he lives in Oregon. Unfortunately, for the other, he lives in California."

Tags:physician-assisted, suicide, living, wills, terminal, illness

Abstract
The paper discusses end-of-life decisions, advance directives and patient advocacy that are issues within the scope of the health care social worker. The paper shows how the complexity of legal and medical issues involved in the creation of a living will and/or providing surrogate instructions is beyond the medical or legal training of the social worker.

From the Paper
"A social worker acts as a patient advocate. Social workers are charged with promoting patient respect and respect in treatment in end-of-life situations. The National Association of Social Workers was one of the first professional organizations to actively participate in support of the ethical dilemmas inherent in caring for individuals during end of life circumstances by issuing the formal policy statement "Client Self-Determination in End-of-Life Decisions in 1993 (Luptak, 2004). In the area of living wills, the social worker should only be part of a team that can help you address end-of-life issues and decisions and the member of the team to assure that other healthcare providers such as doctors and other facility staff know of your decisions ("How social workers," 2004). In the health care social worker's job, no task is more important than advocating for patients' wishes in end of life decisions."

Tags:patient, advocacy, end-of-life, issues, terminal, illness, physicians, lawsuits

Abstract
This paper describes the moral and ethical issues surrounding euthanasia or assisted suicide and analyzes the current U.S. law. It distinguishes between the two types of euthanasia -passive euthanasia, withdrawal of life support and active euthanasia, the right of a patient to request for a doctor to perform. It investigates the concept of a living will which allows one to specify the circumstances under which you wish to receive particular types of life sustaining treatment should you become terminally ill and unable to convey your decisions to your physician and examines their legalities in different States.

From the Paper
"The State of Maryland have laws that permit you to appoint a health care agent or Power of Attorney, someone who makes decisions for the patient if they become incompetent or can no longer speak for themselves. The appointment of these health care agents is most often accomplished through filling out the forms known as health care proxies. Some health care proxy forms allow you to direct your agent to make specific medical treatment decisions in particular situations. These health care agents have the power to make all medical decisions for incapacitated persons, including decisions concerning life-sustaining medical interventions."

Tags:death, power, of, attorny, assisted, suicide, coma, painless, death, terminally, ill