End-of-life care becomes an issue at some point for elderly patients. Even with the emergence of palliative care programs and hospice programs, most elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your patients regarding end-of-life care in accordance with their wishes. Support your response with evidence-based literature.

Health Assessment of the Older Adult-Sample Solution

Most people prefer to receive care and die at home. However, research shows that home deaths are declining worldwide due to sudden deaths. In this case, premature deaths make it challenging to predict the trajectory in end-of-life care (Nysæter et al., 2022). Approximately half of the sudden deaths occur at home since they are unpredictable, and no particular care is offered beforehand. Interestingly, four in five deaths can be predicted because the endpoint of a medical condition progression is recorded in patient data.(End-of-life care Essay Example)

Despite the ability to predict such deaths, most people still do not die at home as they would prefer. A month before such deaths, most people are at home receiving home care, accounting for 52% of men and 39% of women, and 45% of both (Pennec et al., 2017). Nonetheless, 24% and 29% receive care in a care home and hospital, respectively (Pennec et al., 2017). However, as death approaches, the rate of hospitalization increases for both genders, and the proportion of people receiving care at home declines. The health status as someone nears death deteriorates, requiring close medical attention and increased hospitalization rates (Pennec et al., 2017). In non-sudden deaths, moving from home to hospital is more frequent as death nears, which helps explain the declining trend of home deaths against patient preferences.(End-of-life care Essay Example)

Discuss what you can do as a nurse to support your patients regarding end-of-life care per their wishes.

Fulfilling a patient’s preference toward their death presents ethical dilemmas because nurses must respect patient autonomy, including where they wish to receive care, and promote overall good while avoiding harm. If receiving care at home is less effective or increases the risk of preventable injury-related deaths at home, it overrides the need to respect the patient’s autonomy. However, nurses can help improve the quality of life by helping manage patient symptoms to make home care as comfortable as possible (Hagan et al., 2018). Nurses can engage in patient education, including fostering medication and physician instruction adherence and building communication skills to help patients communicate their health status and needs to promote end-of-life decision-making and symptom management. According to Schroeder and Lorenz (2018), nurses can advocate for the provision of palliative care concurrently with curative measures to address the multifaceted patient needs to ensure home care effectively promotes health and well-being at the end of life, which would help increase the rate of home deaths.(End-of-life care Essay Example)

References

Hagan, T. L., Xu, J., Lopez, R. P., & Bressler, T. (2018). Nursing’s role in leading palliative care: A call to action. Nurse education today, 61, 216–219. https://doi.org/10.1016/j.nedt.2017.11.037

Nysæter, T. M., Olsson, C., Sandsdalen, T., Wilde-Larsson, B., Hov, R., & Larsson, M. (2022). Preferences for home care to enable home death among adult patients with cancer in late palliative phase–a grounded theory study. BMC Palliative Care, 21(1), 1-10.

Pennec, S., Gaymu, J., Riou, F., Morand, E., Pontone, S., Aubry, R., & Cases, C. (2017). Most people would prefer to die at home, but few do so. Population Societies, 524(7), 1-4.

Schroeder, K., & Lorenz, K. (2018). Nursing and the Future of Palliative Care. Asia-Pacific journal of oncology nursing, 5(1), 4–8. https://doi.org/10.4103/apjon.apjon_43_17