Nurse advocates in end-of-life care ensure that the patient is looked after ethically and that they receive care according to their needs and preferences.
Nurse advocates play a huge role in end-of-life care in the following ways:
- Provide emotional support: Nurse advocates act with empathy and patience. Advanced diseases and the treatment involved can make patients feel vulnerable, restless, depressed, anxious, and irritable. Nurse advocates at end-of-life care are well-versed in these emotional issues and can help the patient overcome them without judgment or mistreatment.
- Ensure physical comfort: Nurse advocates are not rigidly focused on treating the disease and instead prioritize the patient's comfort. Terminally ill patients may need more sleep, more pain relief, and support for feeding and hygiene. All these are taken care of by the nurse.
- Allay patient concerns: Chronically ill patients often have many questions that their doctors may not always have time to answer. Nurse advocates help address these issues and empower patients with information about their disease, including its treatment and outlook.
- Help the patient make informed decisions: Nurse advocates help patients understand the various treatment options and their consequences. This allows patients to participate actively in treatment decisions.
- Support caregivers: Nurse advocates can help bring patients and their caregivers to a shared understanding about the patient’s desires. They may help caregivers understand why their loved ones may be behaving differently and prepare them for the impending grief or worsening of the patient’s condition.
What is the goal of end-of-life care?
Terminal illnesses such as advanced chronic obstructive pulmonary disease (COPD), chronic renal failure, congestive heart failure (CHF), and cancer can leave both patients and their caregivers extremely apprehensive and stressed.
End-of-life care (also called hospice or palliative care) aims to improve the quality of life of critically ill patients and provide support to their caregivers. The care team is typically made up of doctors, nurses, counselors, dietitians, and volunteers. The role of nurses is critical in ensuring adequate end-of-life care for the patient.
Advocacy is an important pillar of the nurse-patient relationship because it helps build a rapport between the nurse and their patient, thereby improving the quality of care.
Patients requiring end-of-life care may require a more empathetic and supportive approach as their disease progresses and causes both physical and emotional distress. Nursing advocacy ensures that the patient gets appropriate and compassionate care that is in line with their values or wishes concerning their treatment.
With proper nursing advocacy, there are higher chances of patient compliance as well.
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Hebert K, Moore H, Rooney J. The Nurse Advocate in End-of-Life Care. Ochsner J. 2011;11(4):325-329. http://www.ochsnerjournal.org/content/11/4/325
ANA Center for Ethics and Human Rights. Nurses’ Roles and Responsibilities in Providing Care and Support at the End of Life. https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics/endoflife-positionstatement.pdf
National Institutes of Health. Providing Care and Comfort at the End of Life. https://www.nia.nih.gov/health/providing-comfort-end-life
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HospiceHospice is a service that offers support, resources, and assistance to terminally ill patients and their families. In such late stages of diseases, especially when there is "nothing left to do," hospice can offer help for patients and families. There are many aspects of a patient's well-being that can be addressed. Hospice can play a key role in managing physical symptoms of a disease (palliative care) and supporting patients and families emotionally and spiritually.
How Long Do End-of-Life Symptoms Last?End-of-life symptoms vary from person to person. For some, they may end quickly, and for others, they may linger for days, weeks, or even months.
What Is End-of-Life Care for Patients With CHF?End-of-life care for CHF patients involves ensuring proper nutrition, adequate rest, physical rehabilitation, and caring for physical, mental, and emotional needs.
What Is the End-of-Life Care for COPD?End-of-life care for COPD is a team effort that aims to manage the patient’s symptoms and mental health and ensure they receive proper nutrition.