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How Nurses can use Palliative Care to Improve Quality of Life

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As a nurse, you will care for or be around patients who require specialized medical care for their serious, life-threatening illnesses. One specific type of care, palliative, focuses on providing relief from the stress and overwhelming symptoms of a serious or terminal illness. The entire goal of this practice is to improve quality of life for both the patients and their families.

This type of care is typically used for people suffering from illnesses such as cancer, kidney disease, Alzheimer’s, chronic obstructive pulmonary disease, congestive heart failure and more. Doctors, nurses and specialists work together to provide an extra layer of support for the patients. This level of care is right for patients of any age and at any stage of a serious illness, as it can be provided along with their current treatment plan.

A brief history of palliative care

As a multidisciplinary approach to specialized medical and nursing care, palliative care centers around the relief of pain and other problems associated with a terminal illness, ranging from symptom relief to spiritual guidance to mental health assistance. Since 2016, this specific degree of care has shown evidence to support improvement in quality of life. This determination was reached by a research team led by Dr. Areej El-Jawahri of Massachusetts General Hospital.

El-Jawahri and her team examined the effectiveness of inpatient palliative care for the quality of life for patients undergoing bone marrow transplantation, as this procedure is highly challenging and presents a difficult recovery process. During the transplant, patients must receive a high-dose of chemotherapy to remove diseased blood and bone marrow cells, where the side effects can include vomiting, diarrhea, pain, fatigue, insomnia and nausea.

A week later, these patients then get an infusion of healthy blood stem cells to replenish their bone marrow, but because they are particularly susceptible to infection during this procedure they must remain isolated from friends and loved ones during this time. As a result, they may experience emotional issues in addition to the physical pain they are already experiencing.

El-Jawahri and her researchers enrolled 160 people who underwent bone marrow transplants for their leukemia and lymphoma. They determined after three months that palliative care intervention led to significant improvements, such as better quality of life and less depression among the test participants. In a later study from Dr. Dio Kavalieratos of the University of Pittsburgh School of Medicine, researchers included nearly 13,000 adults with serious illnesses and 2,400 of their caregivers. They also found palliative care boosted quality of life, if not improved survival rates.

When is palliative care the right option?

While primarily used for vital end-of-life care, the palliative approach can be effective at any stage of an illness, ranging from initial diagnosis to final treatment options. It can be administered at the hospital, at skilled nursing facilities or even in the comfort of the patient’s home. It can be extremely beneficial for patients who have recently completed treatment for potentially recurring cancers and for those currently receiving treatment for a terminal illness.

Patients and their families should speak with their primary care physician or specialist to determine if palliative care might be the right option for them. Nurses and doctors can surround patients with a team of mental, physical and emotional health care professionals to help patients experience the highest quality of life, no matter what their outcome may be.

How does palliative care improve quality of life?

Palliative care improves quality of life because it deals with more than just treating the illness. Instead of solely focusing on ridding the body of cancerous cells or undergoing surgery for various health conditions, a team of nurses, doctors and specialists look at the patient holistically and carefully consider their unique needs. For example, in the initial diagnosis stage, patients and their families may feel overwhelmed and may be in need of emotional support or guidance.

Meanwhile, for patients nearing end-of-life care, the palliative care team will provide as much physical, emotional and spiritual comfort as needed. This may include hospice services for those who have six months or less to live, or pain relief and management for various symptoms during their final few months. This type of care extends to the families, as well, as many programs offer grief counseling or even assist in funeral or memorial service planning. The primary goal is to make this time as manageable as possible for the patients and their loved ones.

How can nurses assist in palliative care for their patients?

According to the official position statement from the American Nurses Association regarding end-of-life care, nurses are required to provide compassionate and comprehensive care during this time. Some of these duties may include acknowledging when patients’ time is nearing the end and notifying their loved ones. They are responsible for collaborating with members of their healthcare team to minimize or manage symptoms to the best of their abilities.

In conjunction with health care specialists, nurses should establish decision-making processes that recognize patient preferences, physiologic realities and specific patient and familial needs. By creating these goals for end-of-life care, nurses provide a framework for discussion about what should be provided and what patients and their loved ones are comfortable pursuing. This realization of the need and timing for end-of-life care is important, as the provider’s failure to recognize the gravity of the situation may deprive patients and their families from responsibilities related to last rites.

Palliative care also accounts for patients who no longer have a say in their quality of care and decision-making process. In these cases, nurses and health care providers must address their questions and options toward the families, regarding the reality of the situation, possibilities and preferences. This helpful palliative guidance during a difficult time may help the patients’ loved ones cope with their challenging experience.

Students who earn a BS in Nursing from Rutgers University will not only learn about how palliative care can improve quality of life, but also understand the critical nature of this practice in the overall health of themselves and their patients. A higher level of education in the nursing field will enable these medical professionals to provide the best service possible to those individuals who need it most. Contact one of our enrollment coaches today to learn about our comprehensive online program.

Recommended Reading:
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Sources:

http://www.uptodate.com/contents/benefits-services-and-models-of-subspecialty-palliative-care

https://www.cancer.gov/news-events/cancer-currents-blog/2016/palliative-care-quality

http://jamanetwork.com/journals/jama/article-abstract/2585979

http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Resources/Ethics-Position-Statements/EndofLife-PositionStatement.pdf

http://www.massgeneral.org/cancer/research/researchlab.aspx?id=1668

https://getpalliativecare.org/whatis/

https://www.nih.gov/news-events/nih-research-matters/palliative-care-improves-quality-life-cancer-patients

https://www.livestrong.org/we-can-help/emotional-and-physical-effects-of-treatment/palliative-care-to-improve-quality-of-life

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