1 Understand the requirements of legislation and agreed ways of working to protect the rights of individuals at the end of life. 1.1 Outline legal requirements and agreed ways of working designed to protect the rights of individuals in end of life care. Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.
A legal requirement of end of life care is that the wishes of the individual, including whether CPR should be attempted, as well as their wishes how they are cared for after death are properly documented. This means that their rights and wishes even after death are respected.
1.2 Explain how legislation designed to protect the rights of an individual in end of life care applies to your own job role. When an individual is at the end of life, usually you are aware due to the documentation that is present.
(which is a legal requirement) In my job role I would read and acknowledge the rights and wishes of the individual, including any religious beliefs to ensure they are cared for according to their wishes. 1 understand factors affecting end of life care
2.3 Outline key points of theories about the emotional and psychological process that individuals and key people may experience with the approach of death. Although each person reacts to the knowledge of impending death or to loss in his or her own way, there are similarities in the psychosocial responses to the situation. Kubler-Ross’ (1969) theory of the stages of grief when an individual is dying has gained wide acceptance in nursing and other disciplines. The stages of dying, much like the stages of grief, may overlap, and the duration of any stage may range from as little as a few hours to as long as months. The process varies from person to person. Some people may be in one stage for such a short time that it seems as if they skipped that stage.
Sometimes the person returns to a previous stage. Death is emotional and it is natural to experience emotions. It would also have a psychological affect on an individual as knowing you’re going to die may be frightening. 2.4 Explain how beliefs, religion and culture of individuals and key people may influence end of life care Depending on the individual’s background and religious beliefs, they may wish to be cared for in a specific way, for example CK is Sikh, and therefore her religious beliefs forbid CPR. Her wish is to stay at home and be nursed. After her death she will be treated to a traditional Sikh funeral. The key people in her life are her family who are also Sikh, therefore their beliefs and wishes are the same.
2.3 Explain why key people may have a definitive role in an individual’s end of life care. Depending on a person’s physical and mental state, will depend on whether they are able to complete their end of life care planning. If an individual is unable to plan their end of life care then key people like next of kin, friends or social worker will plan their end of life care, using background information about the individual, trying at best to keep to their religious beliefs and wishes. 2.4 Explain why support for an individual health and wellbeing may not always relate to their terminal condition Every individual at some point needs support. For example: an individual has terminal cancer, she also has a hearing impairment and her hearing aid isn’t working.
She is distressed and depressed about this which is not good for her health and well being, therefore you give support and reassurance and change the batteries of her hearing aid, effecting her health and wellbeing. 2 Understand advance care planning in relation to end of life care 3.1 Describe the benefits to an individual of having as much control as possible over their end of life care A person will benefit enormously at having control over the end of life care. To know that everything “is taken care of” relieves some of the stress and emotion that an individual may feel at the end of life. They are also reassured that their beliefs and wishes will be adhered too, which is good for their health and wellbeing.
3.2 Explain the purpose of advance care planning in relation to end of life care Advance care planning provides a mechanism to improve the quality of end of life care for people. It enables the coordination of their desired access to resources and services, to match their anticipated care needs. Advance care planning also offers everyone, and especially people living with a terminal condition, their families and significant others the opportunity to take control of decisions which affect their care. Advance care planning should not be considered only relevant to people nearing the end of life but be considered by everyone. It should be considered as an ongoing conversation between the individual, their care team and as appropriate their family, significant others and carers.
3.4 Outline ethical and legal issues that may arise in relation to advance care planning
Ethical issues near the end of life often arise because of concerns about how much and what kind of care make sense for someone with a limited life expectancy, particularly if the patient is very old. There is often conflict between physicians or nurses and family members about what constitutes appropriate care. Many of these conflicts can be avoided by clarifying who makes the difficult decisions, (which legally has to be done through a solicitor and if it is contested through a court) to limit care and by advance care planning. Understanding the ethical and legal framework in which such decisions are made can also transform what appear to be problematic questions into straightforward answers. 3 To be able to provide support to individuals and key people during end of life
4.1 Support the individual and key people to explore their thoughts and feelings about death and dying There are several reasons many people have a difficult time interacting with a dying person including not wanting to face the reality of their own death, not having the time to become involved, and not having the emotional reserves to deal with such an intense situation. Feelings of guilt over whether they could have done something to prevent or cure an illness, or over how their relationship with that person has been recently may also cause someone to avoid a dying person. It is important to support the individual who is dying but also the next of kin, by inviting them to talk about end of life care and advanced planning. This makes death a lot less scary, and enables them to talk about their thoughts and feelings surrounding their illness and their death.
4.2 Provide support for the individual and key people that respect s their beliefs, religion and culture. Again completing end of life care and advanced planning documents, helps you support the individual and their next of kin and involves you understanding and respecting their beliefs, religion and culture. So that at the end of life their wishes, beliefs and culturistic wishes are adhered too, therefore giving them support and peace of mind.
4.5 Demonstrate ways to help the individual feel respected and valued throughout the end of life period. Treat people as you wish to be treated. Some individuals are unable to communicate in any way at the end of life care, this does not mean that they are not human or should not be respected the way another individual would be. For example assisting with an individuals personal hygiene. A person at the end of life care needs to be made to feel comfortable; therefore I would still provide personal hygiene assistance as I would with any other individual.
4.6 Provide information to the individual and/or key people about the individual’s illness and the support available. Usually this would be done with the manager or the doctor. These are the best people to give the correct information about the illness an individual may have. Information via leaflets may be given or the medical professional may explain the medical condition. Cancer for example is a nasty disease and when its terminal The McMillan nurses are available for advice and support.