Quality of Life and Functioning for End of Life Care

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Quality of Life and Functioning for End of Life Care. HAT2 Community Health Nursing. Western Governors University.

Competency 725.8.5: Quality of Life and Functioning - The graduate selects nursing actions during illness and end-of-life stages to maximize quality of life and functioning for individuals, families, and communities; promotes wellness principles and programs for individuals, families, and communities; and reflects on how personal beliefs or perceptions about quality of life and health promotion impact approaches or decisions in nursing care.

Quality of Life and Functioning
Alice Collins
Western Governor’s University

Death and dying are extremely personal experiences with an endless array of situations and reactions. Terminal illness holds it’s own plethora of difficulties and circumstances. As a nurse, treating a terminally ill patient takes an acute awareness of personal philosophies and perceptions in order to provide the level of care necessary. Nurses, often times, also provide care to family and friends. This can make for a varied and complex situation. Nurses are trained to promote health and protect life: This particular nursing philosophy can sometimes cause cognitive dissonance when dealing with a terminally ill patient and their family.

For instance, euthanasia may be seen as assisted suicide or having the right to choose when a patients’ quality of life is too diminished. Choosing when to withhold life saving treatment is also a very personal choice and opinions about the appropriate time can be extremely diverse from patient to family to friends to healthcare providers. Patients choosing to continue detrimental behaviors and actions, that may have resulted in the terminal illness, can also prove to be frustrating to nurses and family providing support and care.

Ultimately, there is no appropriate or inappropriate way to deal with death and dying. As a nurse, personal opinions must be put aside in order to focus on what is most important to the patient. This also allows the patient to fluidly transition between the phases of death and dying as she or he processes the difficult realization of personal mortality. Allowing for a space to express concerns and fears without passing judgement is the utmost way to ensure a feeling of empowerment for the patient and family. A well-educated, understanding and empowered nurse will have the capacity to provide excellent care and navigate difficult situations despite encountering oppositions to personal values, perceptions and philosophies.

There are many facets to address when assessing quality of life: An aspect that may be viewed as a negative component by one person can as easily be viewed as a positive component by another person. In relation to Mr. and Mrs. Thomas, there seems to be negative component concerns about lack of support/connectedness, financial stability and spousal coping abilities. Addressing each of these issues in a supportive manner and ascertaining the concerns and desires of Mr. and Mrs. Thomas is the first step of possible alleviation of these quality of life inhibitors. Providing support and creative suggestions is the role of the nurse in this situation.

In regards to lack of support, the challenges are Mrs. Thomas’s lack of female family members, geographical distance of children and reluctance in asking for support from friends and coworkers. Mrs. Thomas’s family history is possible evidence of her experiences with death from the same terminal illness. By providing Mrs. Thomas with information, encouragement and support to attend a support group by other’s experiencing the same illness as sense of cohesion may be obtained by sharing with individuals similar to herself and her family members.

Mrs. Thomas’s children both live out of state: This causes difficulty in facilitating familial support and connectedness. In addition to this geographical complication is her son’s...
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