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End-of-life care becomes an issue at some point for elderly patients

End-of-life care becomes an issue at some point for elderly patients. Discuss the difference between palliative care and hospice care programs. Discuss what you can do as a nurse to support your patients regarding end-of-life care in accordance with their wishes. Explain the use of advance directives versus Physician Order for Life Sustaining Treatment (POLST) and their legal implications when providing care for elderly patients.

Sample Answer

Palliative care and hospice care are both focused on providing comfort and support to patients with serious illnesses. However, there are some key differences between the two:

Palliative Care:

Can be provided at any stage of illness, even if curative treatments are still being pursued.
Aims to improve quality of life by addressing physical, emotional, and spiritual needs.
Can be provided concurrently with curative treatments.

Hospice Care:

Typically provided when a patient’s prognosis is six months or less.
Focuses on comfort and symptom management rather than curative treatments.
Provides comprehensive care, including medical, social, and spiritual support.

Full Answer Section

Supporting Patients’ End-of-Life Wishes

As a nurse, you can play a crucial role in supporting patients and their families during the end-of-life care process. Here are some ways to do so:

Open Communication: Establish open and honest communication with the patient and their family about their wishes and concerns.
Active Listening: Actively listen to the patient’s and family’s needs and concerns.
Empathy: Show empathy and compassion for the patient and their family.
Education: Provide information about end-of-life care options and the disease process.
Advocate: Advocate for the patient’s wishes and ensure they receive the care they desire.
Coordinate Care: Coordinate care among the patient, family, and healthcare providers.

Advance Directives vs. POLST

Advance directives are legal documents that express a person’s wishes regarding their medical care in the event that they are unable to make decisions for themselves. They can include living wills, durable powers of attorney for healthcare, and do-not-resuscitate (DNR) orders.

Physician Orders for Life-Sustaining Treatment (POLST) are specific medical orders that provide guidance for healthcare providers about the types of life-sustaining treatments that should or should not be provided in the event of a medical emergency. POLST forms are typically completed by a physician or nurse practitioner in consultation with the patient and their family.

Legal Implications: Advance directives and POLST forms can have significant legal implications. They can help ensure that a patient’s wishes are followed, even if they are unable to communicate them directly. It is important for healthcare providers to be familiar with the laws governing advance directives and POLST forms in their jurisdiction.

By understanding the differences between palliative care and hospice care, supporting patients’ end-of-life wishes, and being knowledgeable about advance directives and POLST forms, nurses can play a vital role in providing compassionate and effective care to elderly patients at the end of life.

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