The Importance of Palliative Care

As the world population of the elderly continues to increase, there is a need to understand palliative care globally. Early palliative care is essential where clinicians should consider it from the time of diagnosis forming an integral part of the care for people who may die in the foreseeable future (Kelley & Morrison, 2015). Nurses need to embrace palliative care during their routine practice to meet the healthcare demands of people whose conditions are deteriorating daily. Various approaches may be used to provide palliative care for multiple patients. The current study aims at identifying the essential elements of quality palliative care that exist. The study seeks to answer the question: What are the different essential elements that improve the quality of life for patients in palliative care? The study will also test the hypothesis that the quality of life for patients improves with the implementation of the essential palliative care elements.

Study objective

To establish the various elements of palliative care that enhance the quality of life of patients  

The study could also be useful for clinical psychologists as they understand the important psychological aspects of life that the people in the palliative care face. Besides, approaches such as home-based care may imply the wellbeing of patients.

Methods of data collection

The study will rely on online library research using search engines with keywords which will include palliative care, quality of life, and palliative care approaches. Online library research is convenient and saves on time. There is a vast amount of literature that relates to the topic in the online libraries which makes it easy to gather their information within the short time available. As opposed to other methods like cross-sectional surveys, the technique is relatively cheap since the main cost incurred is the one relating to internet use. Another approach will be the use of literature reviews using various sources. Various scholars around the world have studied related topics, and thus there is a lot of information in the literature that helps to answer the study question. Researchers have employed different tactics, methods and approaches in their studies which will help to explain the concepts of palliative care in details. Interacting with such information will assist the current research to identify the various results that the studies found out to answer the study objectives.

Analysis

Seow and Bainbridge (2017) assert that one of the most significant and preferred settings for palliative care are home. However, the authors note that little is known regarding the components of the home-based care that enhance the efficacy of the programs. The study focused on five different palliative homecare studies using various study approaches. The approaches included surveys for bereaved caregivers, in-depth analysis, systematic review, general public surveys and interviews for administrators and providers. Research has shown that home is a place where most people would wish to spend the last days of their lives with their loved ones.

Additionally, hospital care is majorly costly and limiting since most families want to stay with their loved ones at the end of life. The concept of homecare encompasses health care services such as nursing, occupational therapy and physiotherapy; equipment services, and effective services. The main purpose of palliative care is to have much professional help the patient as they accept the dying process in peace.

Seow and Bainbridge (2017) provide enough information that reveals that six primary elements of the home-based palliative care were common across all the studies. Firstly, the concept of integrated teamwork was essential. The survey interviewed various teams involved in palliative care including community nurses, family physicians, personal support workers, home care case managers, and private support workers. The groups were varying in their scope of operation, the aspect of life they dealt with and the areas they served. However, all the teams worked in harmony with each other to provide quality care to the patients. For the current situation, it is essential that nurses team up with other service providers to promote the quality of life of the patients harmoniously. Working together helps to address the problem of duplication of efforts while making sure that the resources allocated to the patients are well utilized.  

The second element of quality palliative care is the management of pain and physical symptoms. The study revealed that there is a need to have a workforce of caregivers with the basic knowledge of palliative care. Also, some caregivers should have the relevant specialized skills to enhance proactive symptoms management. There should also be a way in which the frontline caregivers consult with the specialists when the need arises. However, it is clear that there are barriers to accessing pain management medicine. The nurses in the area need to understand the challenge and enhance their ability to access the medication from the hospital promptly. The nurses should be conversant with the provincial drug policies to help in pain management for palliative care patients. Avoine-Blondin et al. (2018), recommend that there is a need to increase training for nurses involved in palliative care. Such instructions will enhance communication among the team members involved in the multidisciplinary team of caregivers engaged in palliative care.

The third essential element is the holistic management of patients' physical and nonphysical symptoms. Dying is preceded by various aspects including social, spiritual, physical and mental which the caregivers must address comprehensively. Thus, it is essential to create multidisciplinary support teams which could comprise of social workers, nurses, bereavement workers, pharmacists, and psycho-spiritual counselors. The importance of the interdisciplinary team is that it helps to address the varying needs of the patients using a customized care plan. As suggested by Avoine-Blondin et al. (2018), the interdisciplinary team will be vital in assessing the quality of life of patients in palliative care. The holistic approach allows the patient to come into terms with death, improve the quality of their life, be at peace which eventually resolves all types of pain and suffering the patient may be undergoing.

The fourth essential element of palliative care is to constitute a team with the right people. Palliative care team should have skilled, dedicated, and compassionate people who are willing to help the patient. To sustain such a group calls for the careful selection of personnel, professional development through training, providing adequate pay, and motivating the team players using various reinforcement approaches. The nurses should be aware of the likelihood of burning out in the process of dealing with palliative care patients. The management should continuously provide motivation and professional training to avoid any burnouts and turnover as the patients cope with palliative care patients. The care providers should be aware of the context within which the patients are operating. The training should be specific to the palliative care needed, likely challenges, and the approaches that are relevant in particular situations (Avoine-Blondin et al., 2018).

Palliative caregivers need to respond promptly to the crises that may occur from time to time. It is important that the team of care providers returns the needs of the patients independently and in teamwork. The patient’s family should be educated on the ways to identify crises when they occur and know what to do first hand (Wiener, Weaver, Bell & Sansom-Daly, 2015). Ideally, the family should be in a position to contact a member of the team 24/7. Nonetheless, the family should have clear information and instruction on what to do in case they cannot reach any of the team members in time. That way, the family can avoid unnecessary hospitalization, worsening of the situation, as they feel supported. The timely response also includes identifying patients who need palliative care within the family and community to avoid the last minute rush to critical zones when death is imminent. The nursing fraternity in the area should institute a procedure for identifying the patients who need palliative care. The nurses will have to determine the best approach to training the families to recognize crises when they occur.

Finally, an essential element in promoting the quality of palliative care is enhancing the preparedness of patients and families. It is crucial to support the patient and their families as a unit to provide high-quality care. Preparing the family calls for prior training on what they should expect as the disease progresses and various functions of the body decline. Therefore, it is plausible to empower the families and the patients with knowledge to become proactive care providers when the need arises. The nurses in the area should play a role in training the families and preparing them for the outcomes they should expect.

Conclusion

Palliative care calls for various essential elements to enhance family and patient experience before dying. The study illuminated some factors which include teamwork, pain and symptoms management, holistic care, appropriate providers, responsive, timely care, and preparedness of both the patient and the family. Adhering to these elements improves the quality of palliative care for the patients in the long run. These aspects of the information will ensure that the nurses can attend to the patients in palliative care hence enhance the quality of life for the terminally ill. The nurses have out-of-date details on handling palliative care patients. Thus, there is a need for an understanding of the critical elements in promoting the quality of life for palliative care patients. Training the nurses on how to handle patients together with other factors discussed in the report will be crucial to enhance the nurse's work in palliative care within the community. Currently, the teams that deal with palliative care do not operate under a single umbrella. It is therefore imperative that the management hold various stakeholder meetings to ensure that all caregivers and related workers work together to increase the satisfaction of families and patients in palliative care.

The patients and families have their perceptions about the quality of life as a result of implementing the essential elements mentioned above. A future study would assess the attitudes of patients and families regarding the quality of life resulting from the full implementation of the factors identified in the study.

References

Avoine-Blondin, J., Parent, V., Fasse, L., Lopez, C., Humbert, N., Duval, M. and Sultan, S., 2018. How do professionals assess the quality of life of children with advanced cancer receiving palliative care, and what are their recommendations for improvement?. BMC palliative care, 17(1), p.71.

Kelley, A.S. and Morrison, R.S., 2015. Palliative care for the seriously ill. New England Journal of Medicine, 373(8), pp.747-755.

Seow, H. and Bainbridge, D., 2018. A review of the essential components of quality palliative care in the home. Journal of palliative medicine, 21(S1), pp.S-37.

Wiener, L., Weaver, M.S., Bell, C.J. and Sansom-Daly, U.M., 2015. Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer. Clinical oncology in adolescents and young adults, 5, p.1.

Appendix

Seow, H. and Bainbridge, D., 2018. A review of the essential components of quality palliative care in the home. Journal of palliative medicine, 21(S1), pp.S-37.

Avoine-Blondin, J., Parent, V., Fasse, L., Lopez, C., Humbert, N., Duval, M. and Sultan, S., 2018. How do professionals assess the quality of life of children with advanced cancer receiving palliative care, and what are their recommendations for improvement?. BMC palliative care, 17(1), p.71.

Currency

2018

2018

Study findings

Capitalising on existing processes is an essential part of creating sustainable palliative care programs through assets and partnerships.

There exists a need to formulate a systematic strategy that contributes to the development of common care goals through enhanced communication between professional and families. 

Strength of study

Uses various research approaches including survey, in-depth analysis, and a qualitative analysis

Used qualitative research design and applied thematic analysis 

Relevance to objectives

Answers the research objectives entirely by providing all the essential elements of quality palliative care.

The article discusses only issues relating to children thus becoming limited in its ability to fully answer the research question.

Reliability

The reliability of the article is high, and it would produce the same results after repeated trials

The research may produce different results in repeated tests since the sample size was small and localised.

Validity

Internal validity: the study has a high internal validity

External validity: being a compilation of various studies, the study results can be generalised to any population.

Assess how sound the research is.

Internal validity: the study has high internal validity

External validity: the study cannot be generalised beyond the study sample due to the small sample size

Benefits

The information is highly beneficial to the nursing profession as it gives the essential elements that people working in palliative care should know 

The information supplements existing literature on what jobs in palliative care recommend as a way to promote quality of life for patients

Risks

There information has no risks since it can be used with any patients in palliative care

There is a risk associated with generalising the info beyond children with cancer. However, the data is still relevant for patients of all ages.

Feasibility associated with information

The study can be applied entirely to the workplace

The data can be used in the workplace especially the recommendations on communication among the various team players involved in palliative care.

Conclusions

The study showed that there are some essential elements that when implemented can help in enhancing the quality of life for patients in palliative care.