¶ … learning experience related to end of life care surrounded two particular issues: communication with the patient and family members and the concept of caregiver grief. This internal grief fits well with the communication issue because communication with the client and family are external, while caregiver grief is internal. The focal point of the assignment, however, is to examine the way in which I applied these learning issues to my practice, nursing a patient with Alzheimer's disease at the end of life and then analyzing my own communication skills when interacting with the patient and family members. Reflection is defined as a process of reviewing an experience of practice in order to describe, analyse and evaluate to inform externally and develop internally regarding a practice, theory, or set of events (Reid 1993). Significantly, end of life issues are often critical incidents for health care professionals and often cause a person to contemplate events to try to gain some sense of meaning, and are often difficult to adequately prepare oneself (Chiplasky 2012). In nursing, in order to continually develop in one's professional practice, critical incidents can offer the opportunity to grow both emotionally and intellectually. An important consideration surrounding this type of learning is the ability to organize both the factual data one learns from the experience and combine it with the emotional side, understanding that in a holistic care environment, both are crucial for both the patient and caregiver (Elliott 2004).

Additionally, the healthcare scenario in the U.S. has undergone a drastic change in the last few decades. The modern nurse's role is far broader than ever; taking on a partnership role with both the doctor and patient as an advocate, caregiver,...

It is a given that the modern nurse will have a far greater exposure to new medical methods, pharmaceutical interactions, and techniques than many nurses of the past. In fact, "the use of clinical judgment in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death" is one of the definitions of modern nursing (Royal College of Nursing 2003).
In my particular scenario, I am a Community Nurse in the UK, working with Mary, a patient discharged from the hospital after several falls. Mary's husband died two years earlier and Mary is exhibiting symptoms of dementia and potentially Alzheimer's. While Mary has care givers visit several times per day, she is alone in her home. She has two daughters, one who has her own set of problems and issues (severe depression), the other who has a full-time job, but still coordinates care and does what she can to look after her mother. Mary's condition has continued to deteriorate to the point that she becomes bedridden, now needing a doctor rather than just nursing care. As Mary's condition deteriorates, communication issues become more and more intense with the daughters who begin to ask very detailed questions about their mother's prognosis.

There are an estimated 820,000 people in the UK with dementia, a number likely to increase as the demographics of aging evolve. Dementia is a terminal disease, common in about 1 per cent of those 65-69 years of age, rising to 6 per cent by the time a person reaches 80. One of the real challenges with dementia is that it is difficult to define the way dementia…