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conferenceseries
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Volume 7, Issue 3 (Suppl)
J Palliat Care Med, an open access journal
ISSN: 2165-7386
Palliative Care 2017
June 21- 22, 2017
3
rd
International Conference on
June 21- 22, 2017 | Philadelphia, USA
Palliative Care & Hospice Nursing
J Palliat Care Med 2017, 7:3(Suppl)
DOI: 10.4172/2165-7386-C1-009
CONSUMER DIRECTED CARE AND SPIRITUALITY | END OF LIFE FROM A DIFFERENT
PERSPECTIVE
Peter Bewert
a
a
The Salvation Army Aged Care Plus Sydney, Australia
Session Description:
Care planning in residential aged care is a regulatory requirement. Despite a compliance framework, the
importance of individualism, one’s story and spirituality is integral to holistic care provision for the older person, especially during
end of life. The session will outline clinical assessment processes which achieve a holistic framework of care provision for terminal
phase care grounded in the uniqueness of individuality and one’s spiritual self. The session will outline how clinical assessment is
completed from a lifestyle approach to ensure the most positive end of life experience during the terminal phase of palliation.
Findings:
The Salvation Army Aged Care Plus has implemented a number of systemic changes in relation to care planning and
assessment to ensure spirituality is a primary consideration as part of the person centred approach to care delivery. The uniqueness
of individuality and the interface with culture, religious practice and spiritual expression are key considerations associated with
end of life care planning (Advanced care planning). The Changes to care planning includes a focus on the importance of "story"
and encapsulates individuality and the "inner spirit" of Older Australians. Comprehensive spiritual assessment and care planning
is paramount to a person centred approach. During palliative and terminal phase care, spirituality is a significant consideration; it
cannot be underestimated in its significance to the completion of an individual’s story through dying and end of life.
Objectives:
An understanding of clinical assessment processes from an individualised perspective which embraces persons lived
experiences associated to end of life. Clinical assessment from a nursing and medical model perspective has a very prescriptive
framework that often does not include adequate analysis of spirituality. When completed from a person centred philosophy which
embraces an understanding of spirituality the assessment process can encompass a more meaningful context. This result in improved
well-being and a quality of end of life experience for not only the individual, but their family and loved ones as well. An understanding
of staff awareness and how to overcome bias when being confronted with spiritual planning and end of life is important. One’s
own story and spiritual awareness is critical to the success of assessing others and putting this into practice in a consumer directed
approach to death and dying. Personal bias is present for all individuals; this is a consequence of our own individual stories. In order
to ensure a comprehensive holistic spiritual assessment which underpins care planning processes, biases need to be made aware.
Staff impacts are significant as spiritual assessments results in confrontation of our own spiritual awareness. An understanding of the
multi-collaborative approach between clinicians and chaplains to achieve optimal outcomes for residents in their dying experience.
AVOIDABLE EMERGENCYVISITS BY HOME HOSPICE PATIENTS: IS THERE A SOLUTION?
Cindy Porter
a
a
MCPHS University, USA
A
lthough research has shown the majority of terminally ill people would prefer to die at home, many who are utilizing home-
based hospice end up in the emergency room during their final weeks of life. This integrative review evaluates published studies
identifying the causative factors and impact of emergency room visits among home-based hospice patients and their family/caregivers
in the last few weeks of life from January 2005 to current. A search of the electronic databases EBSCO Host was utilized as well as
the U.S National Library of Medicine/Pub Med, Google Scholar, and the Cumulative Index of National and Allied Health Literature
(CINAHL) using key words: Nurse Practitioner, palliative care, hospice, end of life care, and emergency. Data was evaluated using
a constant comparative approach as well as thematic content analysis to identify key issues. Thirteen studies from the United States
were included as well as ten studies from other countries. From these studies, several factors are addressed including: primary reasons
for accessing emergency services, the impact on perceived quality of life and caregiver bereavement outcomes, and prevention and
guidance aimed towards reducing hospital admissions. The impact of potentially avoidable end-of-life hospital visits by the terminally
ill has been shown to adversely affect quality of life and bereavement outcomes. A comprehensive and coordinated specialist palliative
care approach may help minimize the number of patients presenting to the emergency department unnecessarily, thereby helping to
maintain them in the setting of their choice for the provision of end-of-life care.