End of Life Care

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End of Life Care and Decision Making Introduction “The term ‘‘end-of-life care’’ is often used interchangeably with various terms such as terminal care, hospice care, or palliative care. Shifts in the preference of terms to use in the last 30–40 years have occurred.” (Izumi, Nagae, Sakurai, and Imamura, 2012) The terminology still varies greatly by person, region and country. “While use and advantages of palliative care and hospice are gaining momentum at unprecedented speed, there remains disparity in access geographically. In addition to general access disparities, the type of care patients receive at the end of their life varies according to where they live and what acute care facility they happen to be a patient in.” (Giovanni, 2012) As technology advances more people are dying in the hospital versus in their own home. This is due to machines prolonging life, medications are stronger when administered by a nurse versus a by mouth pain pill and due to rigorous disease treatment cycles (cancer, lung disease, HIV, Hep B/C, etc) Most patients that are able to relay information in their last days, would like to die a good death. By dying a good death, it can be explained as suffering from minimal pain, having friends and family around, and a non hospital setting. “Influenced by concerns regarding the care of dying people, scientific and debates about assisted suicide and euthanasia, strategic documents privilege the pursuit of a ‘good death’ by raising the profile of dying people’s needs and preferences, prioritizing choice, inviting individuals to plan for their dying and deaths and encouraging the use of end-of-life care pathways for the imminently dying.” (WATTS, T. T. (2012) It is critical to remember that few patients are admitted into the hospital because they want to be there. “It can become stressful when one comes to know that he or she is

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