End of Life Care Process
Health care providers perform a critical role in different health phases of a patient, with the most challenging, arguably being the actively dying period. When patients are transitioning from an actively dying phase to the imminent stage during which a patient’s death may occur at any time, the body experiences multi-organ failure and eventually shuts down (Hebert, Moore, & Rooney, 2011). While care providers have the necessary expertise to understand the transition and the needs of a patient who is not cognitive, family members often wish to hold on and attempt measures to save the patient. Providers should foremost advocate for the patient’s best interest while continually assisting the family in understanding the process.
Although health care teams are focused on preventing and eradicating disease when death is imminent, providing comfort and relieving suffering becomes their central goal. Physicians usually cease to assess a patient’s vital signs in the imminent stage unless under the family’s request (Marthone, 2016). A nurse should then explain the measuring rationale gently and clearly to the family alongside describing whether the overall process will be helpful to the patient. Additionally, the nurse should teach family members to continually touch and talk gently to the patient during the unresponsive stage, especially during hospice care. However, in situations when the family prefers to be distant instead of directly observing their loved one’s suffering, nurses should reserve judgment and continually support the family (Marthone, 2016). The provider’s responsibility is enhancing the patient’s quality of life alongside providing empathetic support to the family.
Providers must practice effective communication and coordination of care when responding to changes in a patient’s health. For instance, the family must be made aware that death is near calmly and sensitively so that they may prepare effectively (Hebert, Moore, & Rooney, 2011). Caregivers must educate the family on the patient’s signs during the dying phase while openly disclosing that death may occur quickly. Moreover, nurses should respect the family’s religious affiliation, as some may require the presence of pastoral care before death occurs. Providers should respect a patient’s final wishes, irrespective of the family’s demands (Marthone, 2016). For instance, if the patient had signed a do not resuscitate order, then CPR is not typically performed. The family should be educated on how to observe a patient’s dying wishes irrespective of their preference.
The end of life care process for a dying child directly involves the parents as the decision-makers. It is painful to observe the suffering of one’s child hence, providers should balance the medication administered to control pain and consciousness to allow efficient time for the patient and parents to interact (Weidner, Cameron, Lee, & McBride, 2011). Although caregivers should provide factual messages regarding the process, they should be sensitive, timely, and use clear language that is easily understandable by the parents and child. When parents are sufficiently educated on the expected changes in their child during the imminent phase, they can understand the need to withdraw life-sustaining treatment. Consequently, caregivers must maintain a balance between their responsibility towards the dying child and the parent’s duty as the child’s primary caregiver. For instance, the former should provide parents with necessary guidelines on the best care measures to the latter’s preferred extent without significantly interfering with their space. Providers should respect the parent’s preference for spiritual care by withholding their opinions and offering support when requested. As a whole, care providers should respect the parent’s role as the central decision-makers during the patient’s care process.
The patient’s best interest, regardless of age, should be the focus of providers during the end of the life care process. Physicians should respect an adult patient’s dying wishes alongside continually educating and communicating with the family members regarding the most robust care solutions. In a child’s case, caregivers should observe the parent’s requests while ensuring that they offer empathetic and consistent support aligned with providing comfort for the patient.