End-of-life care becomes an issue at some point for elderly clients. 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 clients regarding end-of-life care in accordance with their wishes. Support your response with evidence-based literature. Wednesday September 9
Introduction
End-of-life care is a critical aspect of healthcare for elderly clients. Despite the availability of palliative care programs and hospice services, many elderly people do not die in their own home, which has been shown to be their preference. This trend raises important questions about the reasons behind it and the role nurses can play in supporting clients in achieving their desired end-of-life care. This paper aims to delve into these issues, drawing on evidence-based literature to provide insight and recommendations for nurses.
Reasons for the Trend
There are multiple factors contributing to the trend of elderly individuals not dying in their own homes. One significant reason is the lack of adequate support and infrastructure for home-based end-of-life care. Elderly clients often require complex care, including pain management, symptom control, emotional support, and assistance with activities of daily living, which may be challenging to be provided by family members alone. Inadequate access to healthcare professionals, such as doctors and specialized nurses, in the home setting can further hinder effective end-of-life care delivery (Houttekier et al., 2014).
Additionally, societal and cultural factors can influence the location of a person’s death. In many cultures, the institutionalized setting of hospitals or nursing homes is seen as the appropriate place for end-of-life care. Family members may also struggle with the emotional burden of providing care at home and prefer the support of healthcare professionals in a clinical setting. Moreover, the healthcare system itself may unintentionally promote institutional care due to reimbursement structures that favor hospital or nursing home-based care over home healthcare (e.g., lack of adequate reimbursement for home healthcare services) (Celis-Morales et al., 2016).
Furthermore, the lack of knowledge and understanding about the benefits and availability of home-based end-of-life care options among both healthcare providers and clients can contribute to the trend. Many individuals may mistakenly believe that hospice care is only available within institutional settings and may be unaware of the broader options for home-based care. Education and awareness regarding the benefits and feasibility of home-based end-of-life care can be critical in empowering clients to make informed decisions aligned with their preferences (Snyder et al., 2019).
Role of Nurses in Supporting Clients’ End-of-Life Care Wishes
Nurses play a vital role in supporting clients in achieving their desired end-of-life care. Firstly, nurses should prioritize effective communication with clients and their families to understand their preferences, values, and goals related to end-of-life care. Open and honest discussions can assist in identifying clients’ preferences for location of care and death, and help to align their wishes with available resources and services. In addition, nurses can serve as advocates for their clients, ensuring that their preferences are respected and that appropriate services are provided accordingly.
Secondly, nurses can provide education and information to clients and families about the benefits and options for home-based end-of-life care. By dispelling misconceptions and providing evidence-based information, nurses can empower clients and families to make informed decisions aligned with their preferences. This can include discussing the availability of specialized community-based services, such as home palliative care teams, that can provide comprehensive care in the home setting (Houttekier et al., 2014).
Thirdly, nurses can collaborate with interdisciplinary teams, including doctors, social workers, and hospice care providers, to develop individualized care plans that prioritize clients’ preferences. This includes facilitating discussions about advance care planning, including the development of living wills and healthcare proxies, to ensure that clients’ wishes are respected even when they are unable to advocate for themselves. Nurses can also provide ongoing emotional support to clients and families, as well as facilitate access to counseling services if needed.
Conclusion
The trend of elderly clients not dying in their own homes raises important questions about the reasons behind it and the role nurses can play in supporting clients in achieving their desired end-of-life care. The lack of adequate support and infrastructure for home-based care, societal and cultural factors, and insufficient knowledge about available options all contribute to this trend. Nurses can address these barriers by prioritizing effective communication, providing education and information, and collaborating with interdisciplinary teams to develop individualized care plans. By doing so, nurses can help clients and families to make informed decisions aligned with their preferences and improve the quality of end-of-life care.