Palliative care is critical in the care of the critically ill patients. The comprehensive provision of care to the seriously ill and dying patients forms the principles underlying palliative care perspectives.
WHO describes its core principle as integral to improving the quality of life of patients and their families facing life-threatening illness through prevention, assessment, and treatment of pain and other physical, psychological, and spiritual problems. Although this has evolved from independent hospice, its approach is disease specific and holistic. Global differences in the health care systems account for the variation in children and adults. Therefore, this paper focuses on the perspectives enhancing the quality of life.
Even though life is precious, death forms a part of the human experience. Death and dying to be a natural process, it is often associated with the rapid deterioration of ill health. However, varied scholars tend to question; why, when, what and how that causes death. The disease-specific approach argues that death may occur as a result of a progressive advance in disease. As a result, the staging of the disease is crucial in determining the specific management of a patient. Other health status determinants such as healthy lifestyle, an individual’s age, preventive medications and medical interventions can cause continuous unresponsiveness for relief medication. Persistent symptoms associated with the chronic illness and a sudden change in health status trajectory lead to death. This death and dying perspective emphasize on a biomedical revolution in the health system, failure to which chronic illnesses will be a disaster.
Terminally, the outcome is death. Since curative measures are not of importance, symptoms and pain have to be managed and relieved respectively. These are a major concern for the clinicians since methods for assessing and treating pain require reviewing and establishment. End of life rates of pain has been usually high, requiring effective management among people receiving palliative care consequently posing fear in life-limiting disease. Several factors lead to improper management of pain including; addiction to opioid drugs, concern about the cost of drugs, side effects related to the drug, anxiety and future dependence on opiates. Communication between the clinician, patient and the relatives wholly influence symptom and pain relieve perspective. Consistency in continuous education and open communication, encourage honesty, independence of addictive drugs and expression of fears evoking the mind. The principle of symptom relief and pain management is crucial in a multi-disciplinary approach.
Patient-centered psychosocial care is supportive at the moment of diagnosis. The spiritual aspect of care focuses on survivorship in contrast to the spiritual distress during the prognosis. It comprises issues of “ self-esteem, insight into an adaptation to the illness and its consequences, communication, social functioning and relationships. ” An individual’s psyche in terminal illness is affected by several factors, amongst is stigmatization. Stigmatization grossly affects own evaluation, reducing both the patient’s and family’s self-worth to the extent of rejection and abandonment. Other factors include denial of cancer diagnosis, unveiling of truth related to disease progression and delivering unsettled family issues and conflicts. For instance, Cancer patients need psychological support in the staging of the disease and course of treatment. In spite of these interpersonal and patient life encounters, integrating spiritual care in decision-making solves related fear and distress in search of meaning and purpose in life.
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