An overview of the end-of-life discussion

Edwards, Phil

doi:10.12968/ijpn.2005.11.1.17447

Cited by 8 publications

(9 citation statements)

References 25 publications

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“…Physicians and nurses may be uncomfortable discussing EOL topics or believe that it is not their responsibility (Edwards, 2005;Schulman-Green, McCorkle, Cherlin, Johnson-Hurzeler, & Bradley, 2005). They may want patients and their families to maintain hope as long as possible.…”

Section: Barriers To Making Decisions About Hospice Carementioning

confidence: 99%

Family Perspectives on Communication With Healthcare Providers During End-of-Life Cancer Care

Royak-Schaler

Gadalla²,

Lemkau³

et al. 2006

Oncology Nursing Forum

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Section: Barriers To Making Decisions About Hospice Carementioning

confidence: 99%

Family Perspectives on Communication With Healthcare Providers During End-of-Life Cancer Care

Royak-Schaler

Gadalla²,

Lemkau³

et al. 2006

Oncology Nursing Forum

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“…When residents discuss the deaths of others, it is an opportune time to initiate discussion about EOL choices because this is a time when elders are open to discussing their own preferences. 9,13 However, residents in this study experienced minimal opportunities for discussing EOL healthcare choices. Most of their discussions had been about taking care of the practical preparations for end of life including financial and funeral planning, consistent with findings in the study by Malcomson and Bisbee.…”

Section: Differing Perspectivesmentioning

confidence: 96%

“…9 Elders may think their family members already know their EOL care preferences, which is another potential barrier to discussion. 10 In focus groups in senior centers and ALFs, participants said they were comfortable discussing EOL care issues, but they viewed others as being uncomfortable and resisting discussion about EOL decisions and expressed that a provider emphasis on cure and treatment prevented discussion.…”

Section: Background and Significancementioning

confidence: 99%

“…9,13 Analysis of focus group data from three different elder populations with ethnic and socioeconomic diversity revealed four categories of influence for their participation in advance care planning: concern for self; concern for others; expectations about how advance care planning would impact them; and their own anecdotes, stories, and experiences. 14 Additional factors that facilitate EOL discussion are a straightforward approach and having someone else initiate and facilitate the discussion.…”

Section: Background and Significancementioning

confidence: 99%

“…Elders need uninterrupted time and someone who is skilled in communicationVactive listening, encouraging disclosure and allowing silence, providing written material, and addressing inconsistency in verbal and nonverbal messages. 9,15 Assisted living and long-term care (LTC) settings emphasize maintaining health and rehabilitation, which can lead to confusion about care goals for EOL care. In one study, based on interviews with LTC staff (RNs, licensed practical nurses, and social service workers), researchers suggested that staff members did not have a formal ''script'' or set of expectations for discussing end of life and providing palliative care.…”

Section: Background and Significancementioning

confidence: 99%

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End-of-Life Discussion in Assisted Living Facilities

Schaffer

Keenan

Zwirchitz

et al. 2012

Journal of Hospice & Palliative Nursing

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Discussion about end-of-life healthcare choices can contribute to honoring preferences and facilitating a peaceful dying process for residents in assisted living facilities. Focus groups were used to explore perspectives on end-of-life discussion with residents, family members, and staff members in three assisted living facilities.Residents were most concerned about practical matters such as decisions about inheritance, financial matters, and funerals. They expressed that they were ready to accept death but felt that their family members were resistant to discussion. Family members were most concerned about good care for their elderly relative. Staff members expressed confidence in providing end-of-life care and supporting families but less confidence in initiating discussion about end-of-life decisions. Residents reported that physicians most often focused on illness progression and treatment. Residents and family members may be at different stages in accepting the dying process. To ensure that residents' choices for end-of-life care are honored, the perspectives of all involved, including family and staff members as well as organizational practices, must be considered in the development of strategies and resources for promoting discussion about end-of-life healthcare choices for residents in assisted living facilities. KEY WORDSassisted living facilities, end-of-life decisions, end-of-life discussion C oncerns about how to pay for healthcare for an aging population have brought increased visibility to making choices about treatment and healthcare at the end of life. It is challenging to initiate and facilitate discussion about end-of-life (EOL) healthcare choices in a healthcare organizational culture that has traditionally emphasized treatment and cure. Without discussion between elders, family members, and health professionals, it is unlikely that preferences for EOL care choices will be honored. Elders may choose to live in assisted living facilities (ALFs) in their later years but may not have discussed their expectations and wishes for care when their care needs increase because of a decline in physical and/or mental functioning. As more ALFs provide opportunities for residents to ''age in place,'' discussion in the assisted living setting about EOL treatment and care options will be needed to honor residents' preferences when they are terminally ill. 1-8 Knowing how to talk with patients and families about dying is challenging in a culture that tends to deny aging and the inevitability of death. BACKGROUND AND SIGNIFICANCE

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The meaning in life for patients recently hospitalized with congestive heart failure

Mello

Ashcraft

2014

Journal of the American Association of Nurse Practitioners

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Purpose Quality of life (QOL) is based on individual values and is identified by what each person believes it to be. To provide patient centered care, practitioners must have an understanding of what each individual identifies as important in their lives. The purpose of this study was to identify what provides meaning to the lives of patients recently hospitalized with congestive heart failure (CHF). Data source Participants for this pilot study were a convenience sample of 32 patients hospitalized as a result of complications of CHF. Study methodology was a cross‐sectional, interview style survey, utilizing the Schedule for Meaning in Life Evaluation (SMiLE). Conclusion No statistical significance was found between SMiLE scores and demographic data, including number of admissions or length of time since diagnosis. These findings suggest meaning in life (MIL), and subsequently QOL, may not be related to having a diagnosis of CHF. Implications for practice Identifying patients’ relationship with their families, through the use of the SMiLE, has the ability to guide advanced planning decision making. Knowing, and preparing for, various family dynamics before the final stages of CHF may decrease episodes of care provided in opposition to patients' wishes, whether or not their wishes were previously stated or documented.

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An overview of the end-of-life discussion

Cited by 8 publications

References 25 publications

Family Perspectives on Communication With Healthcare Providers During End-of-Life Cancer Care

Family Perspectives on Communication With Healthcare Providers During End-of-Life Cancer Care

End-of-Life Discussion in Assisted Living Facilities

The meaning in life for patients recently hospitalized with congestive heart failure

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