Palliative care for patients with advanced progressive disease

Introduction
Caring for people with advanced progressive disease offers many challenges for both professional caregivers and family. The course of advanced progressive disease can be described as the gradual loss of patient’s independence. Zimmermann et al. (2014) argues that advanced progressive diseases are yet to receive an effective cure; however, efforts can be made to make the lives of these patients productive and meaningful. As such, the idea of palliative care emerged.

Palliative care is a holistic approach that incorporates professional caregivers as well as family carers in treatment of the patient. It handles the patient and carers from all angles of life including spiritual, emotional, psychological and physical. Each member of the family usually experiences a number of emotional reactions during patient care. According to Wong and SW-C Chan, there is a study conducted in 2007 showed that patient relative’s needs: emotional and informational support, communication support, Social and physical support. Moreover, Cultural beliefs played a part in influencing family emotions and concerns. Therefore, nurse’s role is to help these families to improve their quality of life by supporting them with the previous supporting domains to minimize their suffering.
Summary of the slides
Advanced progressive disease refers to any condition with live threatening diseases, irreversible and not cured(Laney et al. 2012). However, with certain medicines and palliative care can control the sign and symptoms. It affects a person’s psychological, physical, emotional and social life. According to Wong and SW-C Chan, there is a study conducted in 2007 showed that the patient and the family need emotional and informational support, communication support, Social and physical support. Through the years, nurses have been presented with many strategies and theories such as the last theory of palliative care, to support patient and their families. Palliative care is defined as an approach that improves the quality of life of patients and their families facing the problem associated with life threatening illness due to that, new research mentioned family most involved with care schedule (Polek et al. 2013).
Carer refers to anyone who regularly looks after patient with life threatening disease. It can be a friend, family member, multidisciplinary team or unpaid person. on the other hand, It’s difficult to define this term and it’s may be different to each person depending on his/her personal situation and cultural background . But in general the people you live for, laugh with and love. Those who continually show up, stay up and make up, who make you glad you never give up
Nursing interventions for advanced progressive diseases
Palliative care is gaining popularity as a vital aspect of quality care for patients with advanced progressive diseases.According to the WHO, palliative care is “an approach that improves the quality of life of patients and their families facing the problems associated with these life-threatening illnesses. This approach works through prevention and relief of suffering by means of early identification and treatment of pain and other problems such as physical, psychosocial and spiritual symptoms.Palliative care is a holistic approach, where relationships are built with professional skills and decision making (Laney et al. 2012). Also, advanced progressive diseases patients experience affective or psychological symptoms of fatigue including lack of motivation and energy, sadness, depression, and anxiety. As well as a lacking sense of willpower and fighting spirit, fatigue takes away the ability to achieve things that the patient and family want to achieve. There is a reduced control over life events, which further affects the patient’s quality of life. A vital component of palliative care is restoring this control (Laney et al. 2012). Providing information is a beneficial method of helping advanced progressive diseases patients restores their lives. Nurses could explain that the patient is not alone in the journey because fatigue is a likely occurrence in most advanced progressive diseases. The nurse discusses causes of fatigue, impacts and side effects of interventions. The nurse will also talk about the effect of depression and stress. This helps the patient to control the fatigue in an effective manner (Tuffrey-Wijne, et al. 2007).In advanced progressive diseases, radiotherapy seems to an indispensable tool (Wittenberg-Lyles & Sanchez-Reilly, 2008) (Altilio & Otis-Green, 2011).
Moore (2012) posits thatSocial support is the second approach to patients with advanced progressive disease and their carers. Access to quality social support enables the emotional adjustment needed to cope with advanced progressive disease, thus preserve their quality of life. The feeling of connectedness that nurses hold with these patients and their carers can lead to experiences of happiness and security, as well as a sense of belonging.
Steven and Raftery‏ (2009) indicate that information needs in people with advanced progressive disease and their carers is often unmet. As such, these patients and their families tend to have an incomplete understanding of the disease and its prognosis. The third approach suggests giving them a space to talk with the dying person about the importance of their relationship. As advocated in palliative care, an open communication approach seems relevant though not routinely applied. Under the area of oncology, health professionals, who are members of the multidisciplinary team, are now required to attend an acknowledged accredited communication skills program. Improved communication skills possibly benefit all patients struggling with advanced progressive disease.
Emotional support
Emotional support provides people with sense of love, reassurance and belonging when individuals feel they are being listened to and valued they develop a healthy sense of self-worth. Emotional support has strong and consistent relationship with health status. The professional caregiver engages in in discussion which allows the patient and carer to reveal the vital spiritual, social and emotional aspects in their lives. A systematic evaluation of these aspects allows the treater to acquire a sense of the patient’s and carer’s coping vulnerabilities and strengths. The treater may ask a number of questions. What are you proud of? Do think that God is happy with you? What are some of the most challenging moments you have gone through? How did you manage through such difficult time? Such questions tend to be therapeutic in nature and allow a person reflect on his/her relationships and achievements that have been important to her/him. Also, they enable some attention to the things that the patient would still want to accomplish interpersonally and emotionally in the end-of-life stage. Moreover, they may health professional caregivers understand a patient’s coping strategies, thus enabling for optimal care.
Conclusion
Advanced progressive diseases have become a key health concern for populations and medical practitioners across the world. Multidisciplinary team exists to minimize the risks and provide care. Through the years, many strategies and theories brought up such as the last theory of palliative care. Palliative care is defined as an approach that improves the quality of life of patients and their families facing the problem associated with life threatening illness(Sullivan et al. 2010). Therefore, new research mentioned family most involved with care schedule. Care givers must understand all the available intervention options afforded to these life threatening illnesses. The treating teams, patient and family ought to concentrate on ensuring people with advanced progressive diseases have quality of life in their end of life stages (Steven & Raftery‏, 2009). Additionally, the medical team must understand and communicate the risks of treatment, such as death and worsening of the symptoms. To monitor where treatment approaches are attaining success, follow-up is imperative. Also, there could be an evolution of illnesses so that alternative interventions are subsequently deployed (Denvir et al. 2015). Palliative care is offered by a committed team composed of ancillary staff, nurse, and doctor.
References
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Steven, A and Raftery‏,J.2009,Health Care Needs Assessment: The Epidemiologically Based Needs Assessment Reviews.2nd ed. New York : Radcliffe Publishing
Poor,B and Poirrier,J. 2011,End of Life Nursing Care .London: Jones & Bartlett Learning. [available at] https://books.google.com.sa/books?id=dmNYaM0Mc0IC&printsec=frontcover&hl=ar&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false
Altilio,T and Otis-Green,S. 2011,Oxford Textbook of Palliative Social Work. New York: Oxford University Press.
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Polek, B., Roach, M. J., Andrews, W. T., Ehling, M., & Salek, S. 2013. Burden of Friedreich’s Ataxia to the Patients and Healthcare Systems in the United States and Canada. Frontiers in Pharmacology, 4.

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