Key Definitions

1 (b) Health Care Developments: Inventions in the medical sector have shaped the attitude and beliefs of people about death (Robbins, 2018). Developments such as palliative care provide emotional, psychological, and physical assistance to individuals with terminal infections. Moreover, the care issues guidance and counseling to the friends and family members of the patient. The health care sector has also created management strategies towards the symptoms.

1. Death and dying create a somber mood in my family. The cultural belief is that death robs the family of an individual who can help in the future. However, palliative healthcare has helped the family to accept death and assist people with terminal diseases. The family undergoes a lot of pain when an individual dies due to a non-terminal condition.
2. Key elements of cultural safety

 The individual should reflect on their culture. Additionally, people should examine the beliefs and attitudes of other individuals. People should hold respectful, open, value-free and clear communication between themselves (McCall et al., 2017). There is also a need for developing long-lasting trust amongst one another. Individuals should identify and avoid barriers due to stereotype. Individuals should be free to share knowledge in interactive communication. Knowledge about cultural shock is essential.

1. Individuals having life-limiting diseases fear that disclosing to family members and close friends can make them isolate him. Therefore, the patients fear the loneliness that can encounter their admission of the state of health (Candy et al., 2015). The affected persons also feel that talking about their condition can make family members overprotective. Other friends start to look at the patient as an already dead individual.
2. Some of the physical changes in terminal disease patients include fatigue and immense pain. The individual feels tired and cannot perform any physical activity (Kendall et al., 2015). The psychological changes include anger, fear, and regret. An individual who is nearing death fears the experience and blames self for the predicaments. The social changes make family and friends move closer to the victim. The family members also become emotional due to the condition of the patient.
3. Individuals with terminal diseases fear pain and other symptoms despite the management strategies since the control has undesirable side effects. The painkillers have side effects such as diarrhea, nausea, and vomiting. The fear of the patient is also due to the physicians’ limited knowledge of analgesics. The patients also have misconceptions about the symptoms of the terminal diseases. A majority of medics lack adequate time to assess and apply the proper symptom management strategy.
4. Quality of life (Q.O.F) is a broad term for the well-being of a person or a society (Dumuid et al., 2017). The term explores the positive and negative sides of an individual’s life. Researchers gauge the quality of life regarding a person’s family, wealth, safety and religious beliefs. Other aspects of QOF include one’s education, environment, education and the physical environment. An individual with proper education has a high quality of life.
5. Healthcare should understand the patient’s perception of quality of life to improve the provision of quality medical attention.  The knowledge enables the caregivers to select the method of treatment that suits the preferences and needs of the patient. Individuals also believe that certain types of medications improve the quality of life. The perception changes with time. Therefore, the care provider must understand the patient and offer the appropriate drug.
6. The statement in the WHO’s definition insinuates that palliative care at the point of diagnosis of the terminal disease. However, the intensity of care should increase throughout the life of the patient. The pillars of palliative care such as decision making and symptom control should kick off after diagnosis. Psychological family and patient care should also start in the early stages of medical attention.
7. I would keep the caregiver’s words not to inform the patient about the terminal illness. The care provider has the expertise of breaking the news to the affected patient. Moreover, the physician may be looking for the best time to break the news to the patient. Otherwise, premature information can be catastrophic to the patient. The affected individual may contemplate actions like suicide and take poison.
8. I would summon palliative specialists to provide guidance and counseling to the patient. I would also convince the patient that the family and friends need her company. Furthermore, I would explain to her the essence of treatment.  I would explain the fact that treatment minimizes pain and other symptoms such as fatigue.
9. (a) palliative approach is a strategy that endeavors to elevate the lives of people with terminal diseases and that of their families (Adelson et al., 2017).

(b) A specialist is a palliative caregiver who provides treatment to a specific symptom due to a terminal illness (Adelson et al., 2017).

(d) A palliative care provider is a healthcare professional who offers care to individuals with life-limiting diseases (Adelson et al., 2017). Furthermore, the caregiver also attends to the emotional needs of the family.

1. The child experiences loneliness when they start to visualize life after the death of the parent. The status of the parent distracts the young ones; hence, they cannot concentrate on school work. The child is on the verge of losing parental love, and financial support after the parent passes on. The young ones can also lose hope in life.
2.  I would tell the parent that it is normal to get worried about the effects of terminal diseases on the children. However, I would summon the palliative care specialists to provide psychological assistance to the parent and the children. I will show love to the children and help them to accept the fact that the parents can depart anytime.
3. The first barrier to the discussions between physicians and the distressed patients is the concern of how the patients can react to the news of death.  Certain caregivers lack sufficient knowledge on the management of the terminal diseases. The unpleasant experience of discussing with previous patience limits physicians from talking to their present patients. A language barrier is another hindrance to the discussion of patient and caregivers.
4.  Introducing sensitive issues such as spirituality and intimacy is a difficult task for health professionals. They can introduce the topics by supplying spiritual and intimacy books and journals to the patients. The caregivers should encourage them to read the books as the content reduce pain and speeds up the recovery process.  The physicians can also communicate to family members who then introduce the topics to the patients.
5. (a) hospital. The family members complain of hygiene standards of the health facilities. The family has a feeling that patient care is inadequate at the hospitals. The caregivers find difficulties in the discussion of end-of-life care with the patient.

(b) Home. The family gets emotional as they find it hard to accept that the patient will eventually die. The caregiver has a difficult time in balancing capacity and burden.

(c) Hospice. The family believes that the hospice providence an appropriate place for patient care. The care providers have adequate resources to attend to the patient.

1. (a) Life-limiting illness (LLI) is a disease whose direct consequence is death. Examples of the disease include heart diseases, cancer, COPD, and renal diseases (Kutner et al., 2015). Other LLL include heart failure and neurodegenerative diseases.

(b) Illness trajectory refers to the course of a disease from the moment an individual undergoes diagnosis until the point of death (Luttik, Jaarsma, and Strömberg, 2016).

(c) Prognostic factors are variables that physicians monitor to estimate whether an individual can survive an infection or otherwise (Johung et al., 2016).

1. (a) The statistics of lung cancer in Australia indicate that 9.2% of the population has the disease in 2018. Out of the affected individuals, 18.9% have no chance of survival. Only 15% of the patients can survive for more than five years (Torre et al., 2015).

(b) The survival rates due to heart failure are low in Australia. The prevalence of the disease ranges from one to two percent of the total population (Torre et al., 2015).

1. (a) Lung cancer branches into small cell carcinoma and non-small cell carcinoma. Lung cancer has the limited stage and the long stage (Torre et al., 2015). The limited stage is when the carcinoma is affecting one lung and the lymph nodes. Extensive stage involves the spread of cancer to other body organs and the next lung. The carcinoma has more than ten prognostic factors which include sex, age, histology, hemoglobin level among others. The carcinoma can be high or low grade (Torre et al., 2015). Small-cell carcinoma is high-grade lung cancer.

(b) Heart failure (HF) has four classes. Individuals in the first class can conduct physical activity without limitations (Sahle et al., 2016). Those individuals in the second class encounter minimal limitation when conducting physical activities. The third class limits the ability of a person to conduct the physical exercise. People in the fourth class experience discomfort when conducting the physical exercise.

The disease has four stages. Individuals at the first stage are at risk of contracting CHF. However, the heart lacks structural disorder. Persons in the second stage have a heart with a structural disorder (Sahle et al., 2016). However, the individuals require CHF symptoms. Individuals at stage three also experience CHF symptoms. The fourth phase is the end-stage. The individual needs specialized medical attention. A prognostic factor such as improved medical care has improved the survival rates due to HF (Sahle et al., 2016). Other factors include ICD and device therapy.

1. The first issue is a consistent progression of the complication and an evident end-phase of the disease (May et al., 2016). The second health problem is the slow decline of the patient and other moments of rapid deterioration. The patients of the life-limiting illness may show points of complete recovery. Some patients also encounter unexpected and untimely death. A specific group of patients undergoes a gradual and prolonged decline.
2. The continuous and continued slump is a trajectory that is similar to that of a frail old person who is dying. The elderly also undergo a consistent progression and an evident end-phase. Therefore, the health issues in life-limiting conditions are similar to those that the old experience when they are approaching their terminal stage in life.
3.  The first principle is to evaluate the factors contributing to the disease (McCall et al., 2017). Secondly, the physician should gauge the symptoms’ characteristics. Thirdly, check at what the symptom means to the bearer. Fourthly, check at how the symptom interferes with the patient’s behaviors.
4. Primary goals of Palliative Care

Symptoms and Prognosis of Heart Failure

The first goal is to reduce the pain of the patent (Wiener et al., 2015). The terminal illnesses induce physical to the patients. The medical team has the responsibility of using clinical methods to minimize the pain. The other goal is medical attention to treat the symptoms of the diseases. Palliative Care also endeavors to assist the patients in locomotion. The care allows for constructive engagement between the client, their close friends, community, and families.

1. Assessment of an individual’s preference for care is achievable by asking the patients about their preferred choice of medication. I would also look at relevant data about the individual. The data includes the medical history of the patient. Other data collection methods such as questionnaires are also useful in the assessment.
2. A supportive family gives hope of a cure to an individual with the terminal disease. The affected individual lives a happy life when the friends and family keep them company. Caregivers who provide efficient person-centered care make the patients have the goal of cure. The patient’s response to medication also gives them goal for the cure. Therefore, family members, caregivers, and the medications provide patients with the goal of cure.
3. (a) the first step involves thinking about the right things for an individual. Secondly is to research on medical procedures. Thirdly is choosing an individual’s second decision maker (Lum, Sudore, and Bekelman, 2015). Fourthly is to discuss one’s wish with the chosen decision maker. Fifthly is to record an individual’s wishes for end-of-life care.

(b) Advanced care planning has the support of the Australian laws. Therefore, the law protects the health professional.

30 (b) subjective and cannot be objectively measured

31 (b) to act as a protective mechanism

32 (b) subjective data

33 (a) pain levels and tolerance

34 (a) gate control theory

35 (d) Opiates

36 (c) Oral

1. (c) Guided imagery

38 (d) Respiratory depression

39 (a) Intramuscular

1. Functions of a multidisciplinary palliative care team.
2. The team fights for the rights of patients, their families, and care providers (Amorim et al., 2018).
3. The team also implements various strategies that address individual needs.

• The team implements the planning of advance care process.

1. I would support the patient to locate from one place to the other. Additionally, I would cook for the patient. I would also keep the patient company at most times. Moreover, I would also conduct other errands for the patient such as washing the clothes and fetching water.
2. (a) Advanced Care Planning involves decision making about the type of care that individuals would like to receive when they cannot speak for themselves (Imam et al., 2016). The decisions depend on an individual’s preferences, values, and conversation with friends and family members.

(b) The Care planning enables the family members to conduct the wishes of a patient of terminal disease after their death (Imam et al., 2016). The plan also ensures that the patient receives person-centered care at the hospital.

1. Physical Symptoms of Incurable Illnesses
2. Anorexia (Doherty et al., 2017)
3. Dyspnoea

• Pain

1. Fatigue
2. Constipation
3. The first action is to induce a remedy that can make the emancipated person relax. The nurse should also counsel and supervise the patient. The caregiver should also calm the patients and enable them to maintain an appropriate sleeping position in bed. The care provider should conduct specialized training for the emancipated patient. The nurse should ensure person-centered for the patient.
4.  The first way is teaching the spouses about skills and knowledge about caring for terminal disease patient. Secondly, the nurse should help the partners to cope with the emotional and physical demands of caring for the patients. Thirdly, the family members should support the spouse to care for the patient. Fourthly, nurses should train the spouses on the caring methods for the patient. Fifthly, the government should provide financial support to the spouses.
5.  Tai—chi: is a Chinese tradition that involves movement in a focused and slow manner (Kurlan et al., 2015).

Benefits: the exercise incorporates meditation, gentle movement, and breathes control to strengthen and stretch muscles (Zeng et al., 2014). Tai-Chi relieves pain from lingering injuries, arthritis, and headache. The exercise mostly benefits the elderly and has no contradictions.

References

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Amorim, I., Rego, S., Pires, G., Proeça, S. and Correia, F., 2018. The inherent role of the multidisciplinary palliative care team on pain management: A critical review. Annals of Physical and Rehabilitation Medicine, 61, p.e117.

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The Role of Palliative Care in Terminal Illness

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