Definition of End of Life Care:
This type of care may be defined as the 30 Multidimensional and multidisciplinary physical, emotional, and spiritual care of the patient with terminal illness, including support of family and caregivers.”
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In medicine, nursing and the allied health professions, end-of-life care refers to health care, not only of patients in the final hours or days of their lives, but more broadly care of all those with a terminal illness or terminal disease condition that has become advanced, progressive and incurable.
Core Principles for End of Life Care:
- Be sensitive to and respectful of the patient’s and family’s wishes;
- Respect the dignity of both patient and caregivers;
- Assess and manage psychological, social, and spiritual/religious problems;
- Provide access to palliative care and hospice care;
- Offer continuity (the patient should be able to continue to be cared for, if so desired, by his/her primary care and specialist providers);
- Use the most appropriate measures that are consistent with patient choices,
- Encompass alleviation of pain and other physical symptoms;
- Provide access to any therapy which may realistically be expected to improve the patient’s quality of life, including alternative or nontraditional treatments;
- Respect the physician’s professional responsibility to discontinue some treatments when appropriate, with consideration for both patient and family preferences;
- Promote clinical and evidence-based research on providing care at the end of life;
- Respect the right to refuse treatment.
7 Major Legal Myths Regarding End of Life Care:
The 7 major legal myths regarding end of life care are:
- Forgoing life-sustaining treatment for patients without decision making capacity requires evidence that this was the patient’s actual wish;
- Withholding or withdrawing of artificial fluids and nutrition from terminally ill or permanently unconscious patients is illegal;
- Risk management personnel must be consulted before life-sustaining medical treatment may be terminated;
- Advance directives must comply with specific forms, are not transferable between states, and govern all future treatment decisions; oral advance directives are unenforceable;
- If a physician prescribes or administers high doses of medication to relieve pain or other discomfort in a terminally ill patient, resulting in death, he/she will be criminally prosecuted;
- When a terminally ill patient’s suffering is overwhelming despite palliative care, and he/she requests a hastened death, there are no legally permissible options to ease suffering; and
- The 1997 Supreme Court decisions outlawed physician-assisted suicide. Many legal barriers to this type of care are more mythical than real, but sometimes there is a grain of truth. Physicians must know the law of the state in which they practice.
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Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “maria.mona023@gmail.com”