Introduction
In the field of nursing care, the nurse plays an important role for being as a client advocate for the reason that it is one of the most effective ways to protect that client’s integrity even if the client is already experiencing near death experiences as revealed from their medical assessments. Palliative care is referred as the process of providing supportive action that can be provided by the health care provider to preserve the dignity of the patient that is already at the brink of terminating their lives as mentioned by Aden (2008).
As an overview of Australia, it is a current total population of 24 million as of 1016 Australian census. It is estimated that there are at least over a million total numbers of Australians who are above 65 years of age. This means that there is a growing number of ageing population that needs skilled workers in the country for the next years to come. Australia has a low population mark, making it as one of the less densely populated countries in the world.
During palliative management, the nurse show always show empathetic behavior towards the client as well as in front of the client’s relatives for the reason that this would help to prevent instances of untherapeutic environment that will raise that client relative’s agitation and aggression towards the nurse. During this kind of scenario, the nurse is always aware that establishing rapport is one of the most important activity that should be maintained so that it would help to maintain positive interpersonal communication with the relatives of the patient that are already dying. There are also considerations that can be utilized by the nurse as he or she will be involved with the post-mortem care for the patient that are already dying that includes the manner of discussing with the significant others regarding ethical decisions regarding the patient’s integrity.
Target population for palliative care
The most suitable target patients are the elderly. This is the population wherein it displays the last stages of the human being. When a person reaches their elderly status, they start to experience mental, emotional, and psychomotor degradation. The reason behind is that they are unable to regenerate their cells, tissues, and organs to maintain their productive physiological and physical integrity. In Australia, there are number of elderly patients who seek for palliative care management because their body is unable to confront environmental and health challenges that are responsible for degrading their body’s physiological mechanisms. Palliative care is also indicated for patients who are suffering from terminal illness. They might not be elderly, but their condition indicates that they are given few days before they will depart from this world. This issue can be applicable for patients who are suffering from end stage chronic diseases that are no longer treatable.
Application of palliative care for elderly patients
Palliative care is applied for patients who are mentally incapacitated. This fall for patients suffering from brain related disorders. Alzheimer’s and dementia is the most common chronic diseases that affect the intellect and emotional well-being of patients. It is a degenerative disease wherein there is an accumulation of aluminum substance across the brain of the patients. As a result, patients starts to forget everything from their past, making it difficult for them to forget everything that they are going to do or any recent events that they encounter from their lives. As a result, they end up having difficulties recalling their past activities.
Physiological related diseases such as terminal cancer needs palliative care. This is a disease wherein patients must have to accept the reality regarding their terminal stage due to the progression of the disease. As a terminal stage, there are only few weeks, days, or months that the patient will have to wait before they will be meeting their demise. Palliative care offers management that would alleviate temporary discomfort as their body is already suffering from a major irreversible damage. This is similar for patients who are suffering from end-stage renal disease, immunocompromised patients, and patients who are suffering from severe trauma with irreversible major damages.
Health teaching for palliative management
Upon discussing the components of family education plan for the patient along with his or her relatives that are present on the bedside, the attending nurse on duty should be discussing with the patient using a positive approach that will allow coordination and trust. The nurse along with the doctors will try to explain all possible explanations that will inform the patient’s relatives regarding the outcome of the patient’s condition that will state about the lesser chance of revival or to restore the patient’s health care status to avoid conflicts and misunderstandings. Goshen (2009)stressed that palliative care for the patient includes the provision of full support by trying to alleviate the pain management for the patient to be able to alleviate painful sensation towards their affected part of the body that are worsening their medical condition. Explaining advanced directives that includes organ donation is also essential that will broaden the relative of the patient’s minds regarding the possibility of getting their consent if they will decide to donate the patient’s organ. In providing a humane and healing environment, it is important for the nurse on duty to consider the patient that is unresponsive as a normal individual by talking and explaining to the patient about all routine intervention that are being provided for them because they can still hear all voices that are produced in their surroundings. As an ethical issues, the usual practice that are being practiced by nurses and doctors is to make a broad decision for the patient’s relative that they will decide if the life support machines will still be connected or unplugged by allowing them to be the one who will unplug all connections. This reason is to avoid possible lawsuits that can be forwarded against the nurses as a protection from legal lawsuits from the patient’s family or relatives. These are one of the most sensitive ethical scenarios that have been making public and media’s attention because some relative and the patient’s family members will suddenly sue medical officials even if they have decided to close all attached supportive connections to the patient to end their life according to Madison (2009).
The members of the interdisciplinary team that the family will encounter is always the attending physician because these are medical professionals that are assigned to tell the patient’s real medical conditions as a provision of the patient’s right to know necessary information regarding their medical case. The members of the team who can meet the family’s various needs can be the nurse on duty as well as the nursing aides that are also on duty during the time of the incident because they are the followers of the doctor’s orders that will fulfill the process of medical goals and objectives. Other health care issues that can be significant to the family are all about health teaching in relation to the patient’s condition that will give the patient’s family an overview. A nurse can be a mediator that will act to facilitate debriefing activities for the patient’s family to help them cope with grieving process so that they will not develop severe anxiety related disorders or the presence of clinical depression due to the loss of a loved one according to Goshen (2010).
Implication and Recommendation of the Study
It has been learned from the study that palliative care is the temporary care applied for patients who are suffering from terminal illness. This is also applicable for patients who are elderly that are suffering from irreversible damages to their body. Palliative care is applicable for those nurse professionals who are attending to a patient that are experiencing terminal medical conditions needs a special treatment for the reason that they are already in a stage where they will enter their second life in another world. Berbose (2009) claimed that interpersonal communication skills is very important during this scenario for the reason that it helps to create positive and harmonious environment to all relatives and family members of the patient that are suffering from terminal medical case to avoid conflicts and misunderstanding. In addition, patients still has the right to be treated with respect and with full dignity even if they are experiencing terminal stage because this has been imposed under the patient’s bill of rights as indicated from Tuscan (2010).
As a recommendation of the study, attending nurse should always undergo training and workshop seminar on how to deal with patients including their significant others to alleviate their grieving process so that the attending nurse will be more knowledgeable and more skilled to accomplish appropriate tasks. Furthermore, it is important for the nurse to have the patience of dealing with the patient’s relatives by answering them politely even in a very difficult situation of being yelled or being verbally harassed because it is a way to promote therapeutic environment that acts as an absorbent to decrease the level of tensions as indicated by Aden (2008).
