Palliative Care for Elderly Patients and Their Families
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This essay illustrates the palliative measures that are being taken to the relieve suffering of elderly patients together with their families. It discusses palliative care provision, residential health care, the palliative approach, aged care issues, advanced care planning, and advanced care directives.
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AGED CARE1 AGED CARE Student’s Name Institutional Affiliation
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AGED CARE2 Aged Care World health organization (WHO) defines palliative care as a methodology that aims at improving the lives of aged patients and their families at large facing the complications that are linked to illness that is life-threatening. These can be made possible through the mitigation and respite of griefthrough early recognition and impeccable appraisal by management of the pain. The symptoms that are experienced by the patient and submitted to treatment include psychosocial, physical, and spiritual illness. Aged patient’s symptoms may need better palliation as death approaches (Burkett & Scott, 2015). Support should be provided to the dying patient’s family as comfort measures are being intensified. This essay illustrates the palliative measures that are being taken to the relieve suffering of elderly patients together with their families. Palliative Care Provision In cases of the worst scenario the elderly patient dies, the palliative care will shift its entire focus on bereavement and providing support to the family that has lost its love one (Fitch, Fliedner, & O’Connor, 2015). Palliative upkeep has proven to be more beneficial in various ways. Therefore, it aids the family to make significant medical decisions. Moreover, it aims at anticipating, preventing, diagnosing, and treating signs and symptoms that the patients may have experienced. The focal target of the palliative care system is to improve the quality of life of both the patient and the family as well regardless of the patient’s diagnosis (Martin, Hayes, Gregorevic & Lim, 2016). Palliative care reduces pain, fatigue, nausea in the aged patients that suffer from chronic illness as well progresses quality of patient’s life, which is a long term beneficiary effect. The palliative home care measure is fundamental to the aged since it gives them the chance to stay at home in a more familiar environment as compared to the hospital environment (Frey, Boyd, Foster, Robinson & Gott, 2016). This type of environment reduces
AGED CARE3 their rate of depression; as a result, they will visit the emergency rooms a few times. Families, at times, find it challenging to take care of the elder members of their families who have chronic illness due to commitments and engagements. Thus, professional caregiving can relieve them from that duty and pressure for their loved ones during the final month. Research has proven that the majority of elderly patients who are nearing the end of their lives spend their last moments in the hospital, which makes them feel lonely and helpless. Palliative home care provides them emotional and physical support to prolong their lives (Smedbäck et al., 2017). Residential Health Care Residential health care is a type of care that has been established to take care of the aged people who can no longer take shelter at their homes and are always regarded as a vulnerable group. This facility provides them progressive support care that comprises of aid with routine activities and individual care to 24 hours of treatment care. The residential aged services in Victoria are being overseen by the Commonwealth Government. The Aged Care Act 1997 (the Act) governs the residential aged care in Australia. An approximate of 200 000 Australians stay or live in residential aged care due to the growing population of older people. In Australia, there is an estimate of 2,672 residential aged care facilities (Broad et al., 2015). Residential care services can be provided under respite or permanent basis. The residential respite is short care that is provided to the elderly during emergencies in aged care facilities, and approval has to be made before the services are offered to them. The residential elderly care provides accommodation and amenities to the aged population that require continuing nursing and health care as a result of lack of self- independence in daily activities and critical impairments (Chapman, Johnston, Lovell & Liu, 2018).These facilitiesoffer a varietyof servicesthat constitute supervision, nursing, or any other additional care that the patient may be in need.
AGED CARE4 They are some of the challenges that the residential elderly care faces during the administration of palliative care. Therefore, the permanent inhabitants occasionally have difficulty during communication or dementia and comorbidities (AIHW 2015). Majority of the permanent residents diagnose chronic degenerative diseases as compared to patients in hospice that often diagnose cancer (Gribich et al. 2005). Discussion The Aged Care Funding Instrument (ACFI) facilitates in the data collection that is utilised to establish the quantity of subventions of perpetual residents in Australia. The data below encompass a section that was recorded in 2016, which indicates the perpetual residents that require palliative care under (ACFI). The percentage that results in palliative care in elderly individuals rises with the age of the residents. 23.2% of the permanent residents that receive palliative care are often analysed with cancer. The type of cancer majorly affects the people is lung cancer (17.4%) and prostate cancer (21.9%). On the other hand, the inner local areas have the maximum rate of the palliative upkeep amid the permanent residents (69%) while majority cities and outer region comprise of (32.2%) and (38.8%) of the simultaneously per 100, 000 population. There was a similarity that was noted in the age profile of the permanent resident that requires palliative care during 2014- 2015. A typical example is that one- quarter of the people ranged between 75-84 and 60% of the aged population was 85 years and above. Permanent admissions are regarded as the permanent residents who joined the care facility between 2014 -2015 and were acquainted with entail palliative care. The figure below indicatesaperpetualresidentialelderlycareandpermanentadmittancesreviewedas demanding palliative care between 2014 -2015 (AIHW, 2015).
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AGED CARE5 Evaluating from the table, a higher percentage of the males compared to the females were appraised to require palliative care amid the permanent residents in 2014 – 2015. Palliative Approach The palliative approach focuses on enhancing the eminence of life of individuals with a life-limitingailmenttogetherwiththeirfamilieshencereducestheanguishthrough assessment, early recognition, and physical treatment, pain, cultural, societal, physiological and spiritual requirements. An open approach amid the residents, the elderly care team and their households, enhances identification of their wishes in reputes to their end –of- lifetime care (Chan, Webster & Bowers, 2016). It is confined to the end stage of an ailment thus aims at providing an appositive approach that will major on the comfort care of the aged and reduce the individual's distress and symptoms. This criterion enables families and residents to understand that they are actively supported Over the last two decades, numerous death cases have been witnessed in Australia, and the proportionissignificantlyincreasing(Pivodicetal.,2016). Thissituationledtothe acceptation that palliative approach supports care for both the families and the residents. Majority of the aged residents havecomorbidities and dementia that incorporates dealing
AGED CARE6 with emotional, psychological, physical, and social complications. Highly dependency on medicationcomplicatestheprocess,thuscompromisingthedeliveryofthepalliative approach. A palliative approach is essential during the aging process since an individual is approaching death and may be vulnerable to cardiovascular diseases. The aged people who are at the verge of dying have varying palliative needs as contrasted to the individuals that have been diagnosed with cancer. They comprise of: lack of family support, dementia, confusion or communication difficulties, several clinical diagnoses that need numerous medications and need end of life care for a shorter duration (Frey et al., 2017). Therefore, it is significant that the older people who are dying to be put under a palliative approach to prolong their life span. In palliative approach, their methods that are utilized in the identification of the survival time such as clinical predicament by the specialist may have some shortcomings such as precision and accuracy that result to overestimating of the survival duration. It is therefore not recommended to rely on these methods in determination of the time to commence a palliative approach. It is crucial for the members of the aged care group to be aware of the tendency of their patients to avoid overestimating of survival time in order to reduce the families and the resident’s distress. On the other hand, the resident's transition from the active curative care to palliative care requires team members of the aged care to provide the families and residents of the aged with the equitable information in regards to the transition process to aid in decision making. Access to information can reduce concerns of the families and aged residents, thus enhance their satisfaction in regards to the efficiency of the palliative approach. A palliative approach can be administered in an environment that is familiar to the aged patient when skilled care is adequately available (Street, Ottmann, Johnstone, Considine & Livingston, 2015). Hence, it will reduce the need to translocate to an intensive care setting,
AGED CARE7 which will avoid potential distress to their families and residents. The multidisciplinary team is efficient in proving the palliative approach. The aged care team addresses several factors during the implementation of the palliative methodology that enhances the eminence of life and dignity of the residents. These factors encompass reinforced affection with he loved ones, recognition of family members and friends, being continent, symptom, and intensive pain management, ability to communicate, and sense of control. The dignity maintenance care helps to reduce the elderly desire for speed up death. Aged Care Issues They are complementary therapy that is part of the palliative approach and may be beneficial to the individuals who are unable to tolerate medications. These therapies improve theagedresident'ssenseofcontrolbecausetheyfittheirculturalpreferencesand specifications. On that note, a combination of the traditional palliative medication, with relaxation, acupuncture, and imagery may be beneficial in symptom management since they reduce obstinate pain, thus refining the quality of life. Aromatherapy bodywork for patients with radical dementia may diminish the level of anxiety, disturbance behavior problems, and boost the quality of life (Gilissen et al., 2017). Suicidal attempts are often a signal of clinical misery, and dynamic responses address the state of hopelessness and depression amid the aged patients. Family member's involvement in the treatment in a palliative approach is crucial. Thus, the death and the health deterioration of the patient can be triggered by the family member’s inability to communicate and support the specialist in the monitoring and administration of an appropriate palliative approach. The social challenges due to the aged care involve the inability of the Australian administration to release funds for the development of palliative care.
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AGED CARE8 Additionally, inadequate social provision may result in diminished functional health depression, depression, and deterioration of the psychological health of the aged residents. The practical framework can be implemented to enhance the resident’s condition when proper evaluation of the resident’s societal network is done. Knowledge of cultural miscellany is commended for the aged care groups to facilitate in theconsiderateofthecarechoiceandpreferenceofinhabitantsindifferentethnic dimensions. The palliative approach being able to accommodate residents and families preferencewillfacilitatetheimprovementofqualityoflife.Providinginformation concerning palliative care approach to residents from linguistically and cultural backgrounds by use of their native languages will improve cultural sensitivity for families and residents, ensuring appropriate and adequate care plan. Advanced Care Planning Advanced care planning (ACP) is a step or process that an individual may take to plan for the future health care (Martin, Hayes, Gregorevic & Lim, 2016). This is a state where a person decides the type of care he wants in the eventuality that he will not be able to speak in the future. The decisions that are made are occasionally based on the preferences, personal values, and discussion with the family members. The primary focus of the ACP is to enable the aged to be able to make appropriate future care for their health. The family and the aged patient can decide on the type of medication or care to be utilized. ACP is regarded to be beneficial to the aged community; thus it enhances them to discuss and reflect their preferences and values on an individual health care plan in the state where they are unable to communicate or make decisions. ACP is an appropriate care plan for the elderly, especially with chronic diseases, and their health seems to be deteriorating. ACP can be utilized to reduce family depression, stress, and anxiety. The programs that have have been enhanced by ACP tend to minimize the chances of aged patients dying in
AGED CARE9 their residential care facilities. ACP seems to be affiliated with healthcare cost reduction that ay comprises of the people that are living with dementia in the society. Advanced Care Directives The emergence of the advanced care directives (ACD) is as a result of ACP.ACD is the type of document that contains legitimate channels where an individual can select and instruct one or more alternative decision makers to note their choices and preferences for their future projects in regards to individual health care. The strategies of ACD constitute of theadvancedpersonalproject,advancedhealthcaredirectives,livingwill,medical directions, refusal of treatment certificate, specialist orders for life-sustaining medication, do not resuscitate and do not hospitalize (Sellars, Silvester, Masso & Johnson, 2015). The state and territory government laws in Australia differ in regards to ACD and ACP. Nevertheless, they are some of the challenges that are affiliated with ACDs (Lund, Richardson & May 2015). They constitute the inability of clinicians not to be able to follow directives in the ACD and instances where individuals change their preferences after a certain period and are unable to revise their ACD. Discussion and Critique The palliative health upkeep for the elderly is steered by doctrines that will promulgate palliative, rehabilitative, preventive, supportive and curative care (Leslie et al., 2016). Palliative health care for the aged facilitates the provision of health services that constitute of management of health diagnosis, condition, and sustenance in the supervision of long term healthcare that can be a chronic infection like diabetes or hypertension (Stokoe et al., 2016). The old need to see the health professionals regularly for checks ups and health advises maintaining their good health condition. It is crucial for aged people to be attached to a medical expert who can attend to their emergencies.
AGED CARE 10 However, the community health facilities for the aged can be provided in a community setting; thus, the residential healthcare provider can perform their duties in community health centers, allied health practices, and medical clinics. Seemingly, the palliative health care seeks to advise the aged be able to manage depression and stress, stop smoking, to be physically active and take balance diet to prolong their life span. Lack of modern technology has been a challenge to the developing states, thus leading to reduced medical service delivery. Unequal resource distribution has enhanced the level of poverty in the developing nations; thus, they lack machines like the body scanners and heart- lung machines. Therefore, it is the responsibility of the administration to enhance the quality of upkeep for the aged community. The old community contributes to a more significant percentage of the population in the country; thus, the government needs to put more emphasis on their treatment plan (Wakerman et al., 2017). Contrary, the increased demand for health care by the aged can lead to a burden on the health care systems. It is essential when the care insurance system that is determined by the adoption of the national health care scheme as well as the aid from the commercial insurance in sharing the financial burden. Due to high health care requirements by the aged community in the residential has led to the service delivery to be a challenging process (Willis, Reynolds & Keleher, 2016). Insufficient aged care training, education, and inadequate health care providers are some of the restrictions that are faced during the process of service delivery. Strategies The state and the federal government are responsible for the formulation of effective strategies and guidelines to enhance service delivery for the aged population. The workforce for the care provider also needs to be improved to attract more professionals and nurses to work in that sector. It is essential for the government to establish palliative care facilities that
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AGED CARE 11 will aid in taking care of the aged that comprise of their medical needs. (Rosenwax, Spilsbury, Arendts, McNamara, & Semmens, 2015). Extensive evaluation of the resident’s agony and the utilization of evidenced-based palliative decision-making offer heightened pain administration, thus enhancing their value of life. Some of the aged patients may be unable to verbalize the pain that they endure; as a result,aspecialistcanuseaccuratereportbasedevidencefrombehavioralcuesin determining the pain. The use of a useful evaluation tool increases the tendency in which illness is diagnosed as being contrasted by physical inquiring from the patients where the pain is generating from. In addition, the regular education programs for the elderly and their families on the concerns about advanced care and end -life -care enhances the tendency of plans that are being implemented and completed to improve the family satisfaction with the end- life -care. Furthermore, comprehensive advance care plan for the aged include assessment of the change and response of the resident's health to enhance the families or residents satisfaction with the care (Street, Ottmann, Johnstone, Considine & Livingston, 2015). The implementation of the systemicadvancecareplancomprisesofcommunicationamidfamily,residents,and specialist to enhance the gratification that has been provided to the family and the residents. Conclusion In summary, the care for the dying has been abandoned in the majority of the residential aged care facilities and where death is an ordinary aspect. The Australian government has, therefore, published guidelines to provide acquaintance and understanding in the current context to address the problems affiliated to end of life care to family members, specialist, and residents. The palliative care is pragmatic to be vital at the end of life since it gets rid of the misery that the patient and the family may be going through a complete assessment and treatment. Thus, it provides comfort to the dying patient and the family as well. This paper
AGED CARE 12 has concentrated on the need for the palliative care of the aged since the population of the aged is progressively growing (O’Loughlin & Kendig, 2017). The aging population has been a growing trend due to the low fertility rate, increased longevity, technological advances, and migration. Nonetheless, partisan and social dynamics can impact the service provision of aged people. Therefore, the future directions to cope with those challenges have been shifted on the government efforts to develop an active community care service and workforce for the aged
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