Community Health, Essay Example

Personal Perceptions

Personal perceptions of a dying person especially one with a terminal illness are based on several factors such as religion, culture, medical needs and social factors relating to the particular illness and degree of medical need. People who are guided by the likes of the Bible focus on the dying process as part of life and are guided by the focus of dying as a part of life and realize salvation is granted to those who have lived a good life through the salvation of Jesus. Further they realize pain and suffering are a part of life and there must come a time that all will die. Some religions such as the Jehovah Witnesses believe to refuse a blood transfusion at all costs and to allow a person does dye sharing the belief that a person’s destiny is at the will of God. With this belief no form of medicine would be used to prolong a person’s life. Other religions do not believe in prolongation of a person’s life through the use of any type of medical life support system. They thoroughly believe a person’s bodily functions should be fully supportive on its on aid. However, this viewpoint that would eliminate the chance of anyone coming out of comas and surviving. Where do we draw the line between modern medicine and religious beliefs?

Often doctors are able to postpone death and further aid those with what is often referred to as a ‘good death’. It is contemplated that the definition of a good death is one without suffering and one that is peaceful without much agony for the patient that spares the family. There are such things as mercy killings which are quite controversial in today’s society. Often a patient specially requests to die through euthanasia but that is deemed illegal.  Postponing a death is totally different from mercy killings through the use of euthanasia. Postponing a death is allowing a person to live a little longer, make peace with God and his/her family and to die with some dignity.  There should always be an avid and compassionate approach to the dying person where he/she should be able to make the choice whether his/her life should be preserved with dignity. Spirituality takes on the plan that God nurtures all without attention to past sin on his/her death bed if he/she asks for forgiveness and assistance. Medical intervention should be made with compassion and education by the person chosen by the dying person. The intervention should be the choice of the patient and should be made in advance if possible.

Strategies

A key factor to promote strategical methods for improving the comfort levels and life of dying patients are conducting random clinical and qualitative trials to determine what each patient desires to accomplish a comfort zone. Following plans that other facilities use is a starting point but researching what other patients have found essential in these same situations might be most helpful to advocate a plan into action. Another key issue is to continuously educate technicians and clinicians to utilize necessary tools to keep patients comfortable. A third method is to have family personally engage in the care and maintenance of the terminally ill patient to ensure they receive the utmost maximum care available and love needed during this dying time. The key focus should be to allocate the necessities to what the patient needs to maintain a comfort level, dignity and minimal pain. Medical and nursing staff should be medically educated with continuing courses as well as courses with emphasis on empathy and compassion.

Holistic Nursing Action Plan

A holistic nursing plan is an individualized nursing plan detailed to help care for a patient either at home or whilst in a nursing home. For the purposes of this paper this holistic nursing plan will be developed for at home care for Mr. Martin. This plan is designed to incorporate medicine, nursing care, flexibility and compassion from family members. There will be a formal daily documentation of all medication Mr. Martin will consume. This medication will be administered by both the nurse and the family when the nurse is not present at the home. The doctor will be in charge of prescribing and monitoring the dosage as needed as the illness progresses through the stages. The family will monitor the changes of the pain level since they spend the most time with the patient. A social worker will be present to inspect and approve the initial plan and any major changes to the holistic plan. Since therapy will not improve Mr. Martin’s condition no formal therapy will be recommended at this time other than weekly religious communion services at the family’s request. A volunteer will come into the home two times per week for two hours per day to assist the family with needs for Mr. Martin’s care and to assist with medical and other needs such as running errands. Massage, music and healing therapy techniques are recommended for emotional healing as per approved by the family and patient. When the patient is no longer coherent enough to make these choices it will be up to the family to make these decisions. Medical tests will be carried out as recommended by the primary physician but will be limited as deemed necessary as illness progresses due to limited mobility of patient. The holistic plan can be amended as needed but will be successful with pure dedication of the medical team, nursing team, volunteers and support of Mr. Martin’s family. There should be a very low nurse to patient ratio so that each terminally ill patient receives adequate care. There should be a twenty four hour hotline to reach the duty nurse in times of emergencies.

Functional Ability

Teaching a patient to deal with his/her illness is the key to maximizing functionality of his/her body and mind. This positive state of mind helps to improve physiological functions through state of mind. That is not to say multi-dimensional goal structure will raise a dying patient to a healthy body and mind but it can certainly prolong a person’s life and help a person to have a more suitable dying experience and keep functional ability much longer. At the early stages of the illness physical and emotional therapy techniques can be used to prepare the patient for the interim part of the illness which will aid him/her to have a healthy mind and body to deal with the hospice and dying phase of his/her disease.

Chronic Anxiety

Often seen with dying patients that are quite coherent there is a surmountable level of anxiety associated with the associated illness such as congestive heart failure, the inability to breathe properly, the fear of dying amongst other ailments and fears. The usage of anxiety pills is often of good nature to help ease the fears of dying. Hospice Care comes into the situation toward the end of the illness and doctors prescribe various anxiety medications to ease the fears of the patient. Social workers are often called in to access the situation to determine if a patient should be recommended to a physician for anxiety medication. Often the family of the terminally ill patient can be prescribed a mild anxiety pill to ease the trauma. Music is often used as a collaborative therapeutic effort to ease anxiety. The combination of pain, anxiety and anticipated grief are often very difficult to deal with at one time. Medications and music aid in keeping panic attacks down. Often dying patients are not able to cope and deal with their feelings quite as well as a healthy person would because death is final.

References

A Statement of Consensus on Care for the Dying Retrieved January 12, 2010 from, http://www.adventist.org/beliefs/statements/main_stat6.html

Dying in the ICU Retrieved January 12, 2010 from, http://www.springerlink.com/content/p7702114756514m5/

Holistic Nursing in the Homecare and Hospice Setting Retrieved January 12, 2010 from, http://www.pathwayshealth.org/PR/Media/08/American_Holistic_Nurses_Association_Magazine_Integrative_Therapies_Esther_Johnson_Fall_08.pdf

The Goals of Medicine Towards a Unified Theory Retrieved January 2010 from, http://www.springerlink.com/content/w47878x68085750q/