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Analyzing Palliative Care for HIV AIDSResearch Paper

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Palliative Care for Chronic Obstructive Pulmonary Disease (COPD)

Palliative care is a multidisciplinary process aimed at relieving the pain of patients and also enhancing their quality of life. Palliative care is provided at the same time with all other medical interventions used in the management of diseases. The main health care professionals who take part or get involved in providing palliative care are care managers, physicians and nurses. These care givers help in making complex medical decisions and in the management of complicated signs and symptoms (Hui et al., 2010). Most of the time, palliative care is rightly perceived as supplementary to the spiritual and psychosocial support that the patient and their family is already receiving. The palliative care team can also provide necessary support when the patient dies.

Proper and comprehensive palliative care is critical to the well-being and health of patients living with COPD (Chronic Obstructive Pulmonary Disease). In cases where patients opt to live at home, a family member or any other loved one can be trained by a health care worker on how to provide psychological and physical support. They can also be trained on how to effectively give prescribed drugs. The close family members, relatives and friends have to be properly trained to ensure that the care they give makes the patient as comfortable as possible (Merlin et al., 2012; Deitrick et al., 2011). This training should be continuous and the home-based caregivers should be continually supported even in the period immediately after the patient dies. The palliative care team should make sure they provide bereavement counseling to ensure that the family and friends of the patient are properly supported and advised on how to move on.

One of the biggest cultural issues in the provision of palliative care is gender. Chronic pulmonary obstructive disorder has increased the burden of palliative care, especially on women and girls in parts of the world with the highest infection rates. This is because in most cases, girls and women are made responsible for the patients suffering from the disorder. And despite dedicating their time to helping these patients, they are not compensated in any way. The care they provide is despite health, economic, or even social implications for them and their families (Matzo & Sherman, 2009).

Palliative care is composed of various kinds of care, one of which is psychological care. Psychological care deals with the non-physical aspect of suffering, it may include: bereavement counseling; mental health counseling; support after the disclosure of COPD status; care and support groups; treatment of COPD-linked conditions such as anxiety and depressions; and the integration of age and culture-specific mental care (Hui et al., 2010).

Quite a number of obstacles might account for the low levels of utilization of hospice care. Some of the obstacles include: confusion surrounding the term 'hospice'; possible mistrust due to suspected economic motives; and misperception about the scope and intent of hospice care. Another barrier could be the lack of comfort among medical doctors in having end-of-life conversations; this is possibly one of the reasons why most patients don't get hospice referrals (Atun et al., 2010). There are many causes behind these obstacles. Some of them are: lack of awareness of the availability of palliative care and palliative care givers; inaccessible hospice care; zero or little integration of hospice care in most healthcare systems around the country; difficulties in getting through the religious and cultural beliefs of families and patients; and lack of effective palliative care for diseases such as cancer.

Clinical Evaluation

For individuals with COPD infection, palliative care includes a continuing care that is directed at COPD and its related conditions and illnesses such as malignancy and infection, and interventions aimed at making those suffering from the condition as comfortable as possible for the rest of their days. It also involves interventions aimed at symptom control. For this care to be provided, it is easy to see why the disorder requires a multidimensional and multi-professional team to provide: nursing care; physical therapy; complementary medicine; alternative medicine; social work; pharmacy and COPD medicine (Ferrell, Coyle & Paice, 2015). The recent advances made in COPD care and therapy, have made COPD infection a not so fatal disorder or condition. Nowadays, patients who take a sufficient level of palliative care experience a highly manageable illness. One of the most important components of care for individuals living with COPD is palliative care since it helps alleviate the symptoms and pain (fever, fatigue, exhaustion, nausea, shortness of breath, pain and diarrhea) that COPD patients often experience. If patients suffering from terminal illnesses such as COPD do not receive any palliative care, the unmanaged symptoms may prevent the patient from continuing to go about his or her daily activities. At the local level, lack of such care means that public clinics and hospitals have to shoulder that responsibility (Dahlin & Lynch, 2013).

In spite of the fact that pain can be subjective, patients can usually state the severity of their pain, utilizing a scale. Scales help improve the ability of care givers to consult among themselves, and provide the best care to the patient. Simply put, they facilitate the highest pain treatment. Some of the validated pain assessment tools include: faces scales, visual analog, scales and numeric scales (Dahlin & Lynch, 2013; Atun et al., 2010).

When considering whether or not to recommend palliative home-based care, the healthcare worker responsible must consider the socioeconomic status, home environment, and emotional state of the patient. Some of the factors that they specifically need to consider include: stigmatization of the family, economic impact, fear of the infection spreading and the sadness and grief of family members (Matzo & Sherman, 2009).

Interaction amid social, physical, and psychological facets of COPD at the conclusion of life and its influence on burden are also a concern. Empirical accounts disclose that psychological and physical burdens are actually hard to separate from each other. The association amid the psychological and physical burden for patients suffering from COPD is seen in the form of dyspnea and the concept of 'total dyspnea' as an outcome of the relationship between physical burden, spiritual, psychological as well as social distress in palliative care.

Management

For successful palliative care, there is a need for cooperation among the different healthcare professionals involved in the provision of care. The first stage of COPD palliative care management is assessment and analyses of the patients' needs and then looking into how the patient can be made as comfortable as possible through the management of symptoms. One approach that has been used in the palliative management of COPD involves: telling the patient the prognosis on the first consultation; assigning an individual to discuss advance directives; giving hospice information within first 3 consultations; and then discussing the prognosis, coping strategies and objectives of palliative care.

Palliative care NPs order referrals for diagnostic tests, treatments, and medical services. They are also responsible for physical therapies, diets and exercises for patients having terminal illnesses. They can also prescribe medication depending on the state they live in, however prescription of medication is often left to medical doctors (Hui et al., 2010).

APRN Role Functions

In the last few years, there has been an increase in demand for palliative care services. The increase in demand has led to the need for more and more APRNs. APRNs help in the provision of palliative care through clinical practice function and education (Harding et al., 2010). APRNs involved in the provision of palliative care focus on the management of symptoms and in educating the patient's friends and family. In other words, they provide holistic care for the patient's mind, body and spirit. They don't just serve the patient, but also provide relevant psychological care to the patient's family (Matzo & Sherman, 2009).

Nurses are full partners with providers of other disciplines in palliative care and they occupy important positions on the care teams. By definition, palliative care teams should entail a physician, nurse, social worker, as well as spiritual leaders and experts from other areas (Ferrell et al., 2015).

In Jefferson County, APRN are dedicated to assisting families in caring for their loved ones at the end of life. In the course of the coordination of home care together with care on the inpatient unit, the family is trained on hospital care, end-of-life concerns, and bereavement. The APRN could also reduce the workload on the family. Home health assistants assist in daily living practices, like bathing, changing shits, or eating. Counseling by social workers is also available for the family and patient. Chaplains provide spiritual help and are always available to the bereaved family for one year after the death of a patient (Merlin et al., 2012; Harding et al., 2010).

Case Study

Mrs. Kathleen Davis is a 47-year-old woman suffering from COPD. She stays at home with Ann, her daughter. Ann is okay taking care of her mother; however, she accepts that her mother shall become more dependent on her with time and it might become… [END OF PREVIEW]

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