Caring for Terminally Ill Patient
Personal Perceptions Regarding Quality of Life and Health Promotion The quality of one’s life is an important aspect in life and health promotion. Sadly, many people do not start to look at their quality of life until faced with a shortened lifespan. As humans, we tend to think too much. And, when faced with an illness, we often find ourselves thinking only about the negative aspects of the diagnosis: questioning what we did to deserve it, what our family will do without us, what we will be missing in the lives of our loved ones if the illness takes our lives…all very negative and depressing thoughts to have. When our illnesses get to the point where we can no longer work or enjoy daily activities, all we have time to do is think about those things…and our quality of life can suffer greatly. This writer is a firm believer that sickness and depression can go hand-in-hand; and, when quality of life worsens, depression can either become a new problem for patients, or worsen tremendously. These are the people others often say “gave up.” Conversely, we often see stories in the media of people fighting grave diagnoses while being very active in life—continuing to care for their children, teach and encourage future leaders in classrooms, even run marathons—all successfully fighting for their lives. Their scans may be worse than those patients who have passed on, yet they continue to live. It’s a testament to what the right mindset and positive quality of life can do to assist in recovery of a serious illness. I believe that my beliefs in regards to quality of life greatly impact the care I provide to patients facing terminal illness. I often spend extra time with these patients and their families discussing their beliefs, anxieties, and other needs. I offer to call family, friends and clergy, and encourage them to share their feelings, rather than holding it in and fueling the fear and anxiety they may have. I believe you have to address the whole patient—and their needs, not only the disease and their symptoms.
One of the strategies that may be useful in promoting quality of life in a patient with terminal illness is empowerment, which increases “one’s capacity to act rather than to be acted upon” (Vanderplaat, 2002, p. 89). This is very important, as it gives power back to the individual, rather than the disease. One step in empowering an individual is to provide knowledge and encourage both behavioral and structural changes. In the case of Mrs. Thomas, a patient fighting breast cancer who recently became unemployed, the behavioral changes may be the hardest to employ. With pain increasing, Mrs. Thomas has been spending more time in bed crying, rather than taking pain medications for fear of becoming addicted. She needs to receive education about pain management, narcotic use and dependency. With this education, she may grow to feel more comfortable using pain medication, possibly changing her behaviors to better control her pain, and decrease her time in bed. With less time spent in bed crying from pain, she may begin to feel better about other aspects of life, and possibly become more active, increasing her quality of life. A second strategy that may be beneficial to Mrs. Thomas is social marketing. This is important because people are influenced by their peer groups, nuclear and extended family, and norms that are promoted in the media (Clark, 2008). Furthermore, “loneliness, social support, perceived health status, self-efficacy, future time perspective, self-esteem, hope and depression” impact one’s health-promoting behaviors (Clark, 2008, p. 261). With a patient like Mrs. Thomas, these factors are almost working against her. By spending long periods of time in bed due to pain and refusing to leave the house, she has also separated herself from friends and family. Her husband, though physically present, is fighting worsening depression due to the...
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