End of Life Care: Improving Communication Skills to Enhance Palliative Care
The goal of hospice care is to reduce the pain from a person who is suffering from terminal illness and may have less than six months to live. Many hospice programs are covered under Medicare. Moreover, Medicaid and other insurance plans are also providing hospice coverage. Furthermore, hospice Care includes physicians, nurses, volunteers, social workers and bereavement care (Villet-Lagomarsino). A patient from hospice care program is referred by a primary care physician to a team of hospice professionals and can be delivered by any location. Hospice cares are restricted and focus on palliation of symptoms (Villet-Lagomarsino). In contrast, the goal of palliative care is for anyone with a chronic illness and it can be at any stage of an illness. Most insurance plans are covered for palliative programs but Medicare and Medicaid are also eligible for palliative care treatment. Palliative care usually provides patients with regular physician and nursing visits and the assistance can be at any location.Additionally, nutritionists, massage therapists, and other healthcare providers can also be part of the team if needed for the patient (Villet-Lagomarsino). Treatments are not limited with palliative care. Palliative care includes hospice care; however, palliative care only provides the treatment to whom may be curative. Unlike in hospice care, treatment is no longer to cure the patient but to provide comfort.
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The communication skills in the healthcare environment are very important. In these days, the biggest issue in the medical profession is the lack of communication skills. When a patient is at the end of life process, good communication will be an essential to deliver the importance of the sickness. Cultural backgrounds and values are the major impact in the end of life discussions between a patient and a physician. Moreover, comprehending ethnic varieties is significant, healthcare provider must be cautious to label anything regarding racial and cultural beliefs of the patient’s background. Whenever physicians think that medically would be hopeless in the condition of the patient, the struggle will be increasing for the patient and families. Misunderstanding in the discussion must be avoided from physicians. Therefore, listening and promoting trust will help the physicians in terms of the discussion involving to the end of life process with patient and families. Also, a good communication will help to bring down the patient’s pain and depressing and it is easier to deliver treatment process. The main goals in the communication at the end of life are delivered with respect and show empathy for the patient. With this major concern, the goals will elevate the hope to the patient and families.
Communication is a major issue between the relationship of the patient and healthcare provider. Miscommunication is a biggest concern in the healthcare environment. As a professional healthcare provider, effective communication involves a positive exchange of ideas between or among individuals. Developing trust is needed to a good communication and often must be educated between healthcare provider and the patient. The need for trust in the healthcare setting is not limited to the healthcare provider and patient relationship, but rather diffuses all working relationship. Moreover, empathy is the ability to mentally place oneself in another person’s situation to have a better understanding of a patient’s situation. The healthcare professional is able to observe and communicate the needs of the patient without emotional connection to the point of becoming inappropriately immersed in the situation. Clarifying anything not understood is a must that healthcare providers have to take responsible for. Some method of explanation includes using easily understood language, giving examples drawing a picture, making a list, and finding ways to stimulate other senses to enhance the ability to understand. Not only does effective communication help in understanding one’s situation, but it also adds the element of safety in the care of the patient. (The Joint Commission, 2010).
Hospice care and palliative care is the model of quality of life at the end of life. At the end of life stage, the care of the patient is focused on comfort, while also maintaining the dignity of the patient. Palliative care helps patients manage pain while hospice delivers extraordinary care to increase quality of life for the patient and families (Robinson and Segal 2014). Looking for hospice and palliative care is not nearly giving up expectations or speeding up death, but it is a way to get the most suitable care in the end of life. The task of a healthcare profession is to recognize the patient’s beliefs and needs, and provide the suitable care interventions. To improve the quality of life model of a patient at the end of life needs, a healthcare profession must acknowledge the patient’s racial, ethnic, cultural, and socioeconomic background, as well as the diagnosis and prognosis.
In Gregory’s case study, the nurse must explain the importance of the palliative care outcome to him since he can live more than six months; therefore, hospice care is not suitable for him. The writer believes that there are many different methods to assist Gregory in his conditions. Supportive care is very important in palliative care; it helps to manage the condition and treatment in Gregory’s case study. Starting from the pre-diagnosis, Gregory will obtain the assistances of treatment with the effects of the disease.
In Gregory’s condition, the writer believes that palliative care process must include the cares of psychological, social, spiritual, and symptom control. Furthermore, in those cares, the healthcare provider must include the specialist to better assist Gregory. Gregory seems overwhelmed regarding his condition. Therefore, he was required to see a psychologist to assure his distressing. Next, palliative care team must offer Gregory a social worker to take care of his medical insurance if needed. Volunteer could also be a good assistance to help manage his family since his mom can no longer take care of him due to her old age. Following that, spiritual care is also very important to Gregory, but only if he is into any religion beliefs. In that case, palliative care team members must consider what fits best for Gregory’s beliefs. Lastly, the symptom control is the primary issue that the palliative care team must pay more attention in Gregory condition. The outcome in this palliative care is varying based on the result of process and supportive care. If his health becomes better, palliative care must be continued to better recover his illness and if this is not the case, the healthcare provider must reconsider to transfer Gregory into hospice care to better suit his condition.
Ann Villet-Lagomarsino, A. (n.d.). Hospice Vs. Palliative Care. Retrieved October 8, 2014, from http://www.caregiverslibrary.org/caregivers-resources/grp-end-of-life-issues/hsgrp-hospice/hospice-vs-palliative-care-article.aspx
End-of-Life Care: Guidelines for Patient-Centered Communication. (2008, January 15). Retrieved October 10, 2014, from http://www.aafp.org/afp/2008/0115/p167.html
Hawryluck, L. (2000). Communication with Patients and Families (Vol. Module 5, p. 5). Toronto.
Robinson, L., & Segal, J. (2014, September 1). Hospice and Palliative Care. Retrieved October 8, 2014, from http://www.helpguide.org/articles/caregiving/hospice-and-palliative-care.htm
Selman, L., & Harding, R. (2010, January 1). Palliative Care Explained. Retrieved October 8, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936087/
The Joint Commission. (2014, July 28). Retrieved October 8, 2014, from http://www.jointcommission.org/Advancing_Effective_Communication/
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