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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 Orders for Life-Sustaining Treatment (POLST)
and their legal implications when providing care for elderly patients.
Include an introduction and conclusion, and use a heading for every topic to be discussed.

Sample Answer

As individuals age, end-of-life care becomes a topic that necessitates thoughtful consideration. While both palliative and hospice care involve supporting patients with terminal illnesses, they offer distinct approaches and serve different purposes. Understanding these distinctions empowers nurses to advocate for their patients’ wishes and guide them through this sensitive phase of life.

Palliative Care vs. Hospice Care:

Palliative care: Aims to improve quality of life for individuals with serious illnesses, regardless of their stage. It can be initiated alongside curative treatment, focusing on managing symptoms like pain, anxiety, and fatigue. This holistic approach encompasses physical, emotional, and spiritual well-being.
Hospice care: Tailored specifically for patients with a life expectancy of six months or less who choose to forego curative treatment and prioritize comfort measures. It emphasizes pain management, emotional support, and patient autonomy in their final days.

Full Answer Section

Supporting Patient Wishes:

As nurses, upholding patients’ autonomy in end-of-life care is paramount. Here are key ways to achieve this:

Open communication: Initiate honest and compassionate conversations about their preferences, fears, and values regarding end-of-life care.
Education: Inform patients about available options, explaining the differences between palliative and hospice care, and empower them to make informed decisions.
Respect for advance directives: Familiarize yourself with their advance directives (e.g., living wills, POLST) and ensure their wishes are followed diligently.
Collaboration: Work closely with families, physicians, and other healthcare team members to provide holistic and coordinated care that aligns with the patient’s wishes.

Advance Directives vs. POLST:

Advance directives: Legal documents expressing an individual’s preferences for future medical care if they become incapacitated. Examples include living wills and healthcare power of attorney.
POLST (Physician Orders for Life-Sustaining Treatment): Medically-approved forms outlining specific preferences for life-sustaining treatments (e.g., CPR, mechanical ventilation) based on the patient’s individual condition and prognosis.

Legal Implications:

Both advance directives and POLSTs are legally recognized documents. When properly completed and communicated to healthcare providers, they become legally binding, ensuring patient autonomy and preventing unwanted interventions. Nurses play a crucial role in ensuring these documents are valid, completed, and readily accessible to guide care decisions.

Conclusion:

Navigating end-of-life care requires sensitivity, expertise, and respect for patient autonomy. By understanding the nuances of palliative and hospice care, actively engaging in patient-centered communication, and honoring their wishes through advance directives and POLSTs, nurses can provide invaluable support and ensure a dignified and comfortable journey through this crucial stage of life.

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