Management of Chronic and Terminal Illness
For people dealing with chronic or terminal illness, stress levels can be very high. While that is to be expected, high stress levels only make things worse. Accepting the inevitable is easier on a person's emotional well-being, but it may take some time to get to that point (Taylor, 2005). If a diagnosis is new, denial is often the first emotion the person faces. He or she does not want to believe the sickness or the severity of it. After denial, there are other stages that a person usually works through, including bargaining, anger, and depression, before acceptance finally sets in and the person is able to get on with life as much as possible. Chronic illnesses can include things like diabetes, kidney disease, heart disease, COPD, and other health problems (CDC, 2010). Many of these diseases are preventable, but they are not curable…...
mlaReferences
Anderson, G. (2004). The growing burden of chronic disease in America. Public Health Reports, 119.
CDC (2010). Chronic diseases and health promotion. Retrieved from http://www.cdc.gov/chronicdisease/overview/index.htm
Taylor, S.E. (2005). Health psychology (8th ed.). New York, NY: McGraw-Hill
Suffering is part of life. People feel joy and they feel pain. Christianity and Buddhism share many similarities when it comes to suffering. Christianity provides the story of Job and his suffering at the hands of Satan. Buddhism offers Siddhartha and his journey into enlightenment. While Christianity and Buddhism differ in how they respond to suffering, both are aware suffering is inevitable. The case study of George and his diagnosis of ALS is similar to the stories of Job and Siddhartha. All three came from a means of success and then suffered later on. But it is how that suffering is interpreted that the worldview of each faith can be examined and thus applied to the case of George and his difficulties with ALS.
To begin, Christianity has always included the idea of suffering, with the story of Job being the most prominent example. Job was a good man that loved…...
mlaReferences
Hesse, H. (2008). Siddhartha (1st ed., p. 19). [Waiheke Island]: Floating Press.
Jordt, I. (2007). Burma's mass lay meditation movement (1st ed.). Athens: Ohio University Press.
Kruse, C. (2012). Paul's letter to the Romans (1st ed., p. 467). Wm. B. Eerdmans Publishing.
Olson, C. (2005). The different paths of Buddhism (1st ed., p. 49). New Brunswick, N.J.: Rutgers University Press.
Healthcare EthicsThe bioethics debate surrounding physician-assisted suicide and euthanasia centers on how lives are valued. The article by Papavasiliou et al. (2014) focuses on the issue of whether physician-assisted suicide is morally permissive in healthcare. Opponents argue that it is wrong to take away someone elses life when they do not want any more pain, while others believe in a moral philosophy where patients deserve an easier death than what nature has prescribed for them because living with illness or injury can be painful enough (Papavasiliou et al., 2014). Terminal sedation may appear as though there would not really ever need be anyone requesting its use but this type of intervention involves administrative oversight; withdrawing care from a patient whose vitals have stopped - whether by choice or by nature.Terminal sedationor palliative sedationis the continuous administration of sedative drugs to a dying patient in order to keep them unconscious until…...
mlaReferencesPapavasiliou, E. E., Payne, S., & Brearley, S. (2014). Current debates on end-of-life sedation: an international expert elicitation study. Supportive Care in Cancer, 22(8), 2141-2149.Vaughn, L. (2012). Bioethics: Principles, issues, and cases. Oxford University Press.
While the medical field agrees that prolonged suffering is not a desired product of medical care it has not yet reached the point of accepting that it is actually torture.
When we are at war we have soldiers how are standing trial for the torture and inhumane treatment of prisoners of war, however, we are not allowed to prevent that same level of torture from being thrust upon our loved ones who are ill / this makes no sense. Making someone endure the fevers, the pain, and the physical maladies that come with many of the life ending diseases today is actually a form of torture. It makes a person suffer against their will and at the hands of someone else, in this case the medical community.
More recently there have been strong arguments in courtrooms regarding Euthanasia and the right to choose to die now rather than later after suffering.
In the…...
mlaReferences
____(2006) Jury to Rule Whether Woman Had Right to Die
South Florida Sun-Sentinel
Doerr, Ed. (1997)The Right to Die. The Humanist
Government Regulations and Hospice
Government Regulations Affecting Health Care in Hospice
Hospice
Regulations Affecting Health Care in Hospice
Impact of rules on Hospice services
Annotated Bibliography
This paper focuses on how government regulations impact hospice. The paper starts off with an introduction to the hospice system that was revived by a nurse, Cecily Saunders, who then went on to become a physician, establishing one of the first modern hospices. The concept of total pain is explained in some detail. The body of the paper then includes the studies that have been conducted on patients and caregivers in hospice systems as well as on people who died after they were diagnosed with terminal illness resulting in death in six months following the prognosis. The overall conclusion that can be drawn here is that while in Japan there is a marked need for improving the Day hospice system, the American hospice industry is acting as a mature competing…...
mlaWorks Cited
American Medical Directors Association. (n.d.). White Paper on Palliative Care And Hospice In Long-Term Care. Retrieved March 10, 2012, from American Medical Directors Association: http://www.amda.com/governance/whitepapers/palliative_care.cfm
Carlson, M.D., Morrison, R.S., Holford, T.R., & Bradley, E.H. (2007). Hospice Care: What Services Do Patients and Their Families Receive? Health Services Research, 42(4), 1672-1690.
Centers for Medicare & Medicaid Services. (2008). Medicare and Medicaid Programs: Hospice Conditions of Participation; Final Rule. Federal Register, 73(109), 32088-32220.
Christakis, N.A., & Escarce, J. j. (1996). Survival of Medicare patients after enrollment In hospice programs . The New England Journal of Medicine, 172-179.
There are certainly different approaches to the theory of anticipatory mourning. Clearly, one of the major issues within the literature surrounds the communication between the dying person and the caregiver, and both caregiver and patient and those who will be most affected or will mourn their loss. Conventional theory finds that preparing for loss involves experiencing most of the features of grief prior to the demise of the patient; numbness, anger or blame, fear, desperation, and even despair. However, an important difference is that the period of mourning begins before death occurs, and while contact and communication with the dying person is still a viable option. Because of this, there are additional emotions involved; hope, nostalgia, kindness, tenderness, and opportunity for closure (Fulton, 2003). It is this sense of hope, this feeling that there may still be something that can be done for the patient that is the focus of…...
mlaREFERENCES
Caregiving Statistics. (2010, February). Retrieved from National Family Caregivers Association: http://www.thefamilycaregiver.org/who_are_family_caregivers/care_giving_statstics.cfm
Aliiance, F.C. (2010, September). Selected Caregiver Statistics. Retrieved from:Circlecenterads.info: http://www.circlecenterads.info/documents/FCAPrint_SelectedCaregiv...pdf
Boerner, Schulz and Horowitz. (2004). Positive Aspects of Caregiving and Adaptation to Bereavement. Psychology and Aging, 19(4), 668-75.
Davidson, F. (2002). The Caregiver's Sourcebook. New York: McGraw Hill.
Indeed, dental issues are a big problem, but in fact they are just the top of the iceberg which is the American medical system. Even if there have been serious attempts to reform the system and introduce a universal means of publicly financing medical care for all people, "Americans have fewer doctors per capita than most Western countries. We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries. We are less satisfied with our health care than our counterparts in other countries. American life expectancy is lower than the Western average. Childhood-immunization rates in the United States are lower than average." (Gladwell, 2005) Indeed, given the fact that the U.S. is considered to be the most advanced country in the world it is rather peculiar the lack of a reasonable medical care system,…...
mlaReferences
Ellis, J, and Celia Hartley. (2004). Nursing in today's world: challenges, issues and trends. New York: Lippicott Williams&Wilkins.
Gladwell, M. (2005) The moral hazard myth. The bad idea behind our failed health-care system. In The New Yorker. Retrieved 15 January 2007, at http://www.newyorker.com/fact/content/articles/050829fa_fact
Jarvis, W. (2001). Infection Control and Changing Health-Care Delivery Systems, in Emerging Infectious Diseases, Vol 7, No 2. Retrieved 15 January 2007 at http://www.cdc.gov/ncidod/eid/vol7no2/jarvis.htm
Kikuchi, J, and Helen Simmons. (1994). Developing a philosophy of nursing. New York: Sage Publications.
Death
Linda Wertheimer and Robert Siegel extensively interviewed Helen Payne, an 81-year-old woman dying of leukemia, and family members, regarding the process of coping with terminal illness in a loved one. hey included observations from Payne's oncologist and hospice nurse as well. heir interview shows a wide range of logical and emotional responses exhibited by family members as Payne's illness progressed, and demonstrated just how complex our reaction to such illness can be.
Wertheimer and Siegel are presumably competent radio reporters. heir article was organized around open-ended questions they put to Helen Payne, one of her granddaughters, and medical experts. he result is a compelling narrative reflecting how families handle the complex emotions that occur when a loved one faces death. Family members demonstrated both logical and emotional responses to Payne's situation, although Payne herself accepted the doctor's diagnosis with poise and dignity. Since this article was not research, including medical experts…...
mlaThat anecdote in particular was moving to me because my grandmother did something similar when she was dying. I spent hours sitting by her bedside. One time she drifted off to sleep. When she awoke, she told me that she was ready to die. She had dreamed of heaven, and in the dream, when she got there, was told of her beloved cousin who had died many years before. She was told this cousin was anxiously waiting to see her again. This belief that death would rejoin her with loved ones gave her great comfort.
In doing more formal research on this topic, it would be interesting to see if it is typical for those in say, the eightieth or ninetieth decades of life to accept the prospect of impending death more easily than their family members can.
Wertheimer, Linda, and Siegel, Robert. "All Things Considered." National Public Radio, 1997.
Anticipatory Guidance Project
Mammogram screenings guidelines
The suitability of screening mammography has been a contentious issue because of a number of reasons. For instance, the lack of consistency of screening guidelines reveals the complexities in coming up with definitive conclusions on the suitability of the procedure. Another issue with mammographic screening is the degree to which a mammography helps to reduce mortality among women. There have been arguments from some quarters that there is no evidence that mammography reduces mortality. In addition, sometimes screening can provide false-positive results resulting in needless additional testing, which may include the probability of invasive surgical processes. These controversies have elicited intense debates from various components of the society.
Background information about the guidelines
The American Cancer Society gives a number of guidelines on mammogram screenings (The American Cancer Society, 2013). First, it recommends that women who are 40 years and older of age should undergo a mammogram every…...
mlaReferences
American Cancer Society (2013). American Cancer Society recommendations for early breast cancer detection in women without breast symptoms. Breast Cancer: Early Detection. Retrieved from: http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs
Brant, W.E., & Helms, C.A. (2012). Fundamentals of diagnostic radiology. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health.
Kwabi-Addo, B., & Lindstrom, T.L. (2011). Cancer causes and controversies: Understanding risk reduction and prevention. Santa Barbara, Calif: Praeger.
Nundy, S. (2010). Stay healthy at every age: What your doctor wants you to know. Baltimore: Johns Hopkins University Press.
Physician Assisted Suicide in Patients With Unbearable Suffering or the Terminally Ill
One of the most hotly debated issues today is physician-assisted suicide. ecently, California became the fifth state to legalize physician-assisted suicide, and there is an increasing likelihood that other states will follow suit in the foreseeable future. The purpose of this study is to determine if the factors chosen have any bearing on those who choose to end their life with physician assisted suicide. In support of this purpose, the objectives of this study were as follows: (a) to research scholarly articles regarding physician-assisted suicide and gather pertinent information into a comprehensive profile; (b) to research whether unbearable suffering is the dominant motive to request physician-assisted suicide; (c) to research whether the race and level of education of the patient are contributing factors when physician-assisted suicide is requested; and, (d) to research whether the type of terminal illness the…...
mlaReferences
Bauer-Maglin, N. & Perry, D. (2010). Final acts: Death, dying, and the choices we make. New Brunswick, NJ: Rutgers University Press.
Biller-Adorno, N. (2013, April 11). Physician-assisted suicide should be permitted. The New England Journal of Medicine, 368(15), 1451.
Black's law dictionary. (1990). St. Paul, MN: West Publishing Company.
Boudreau, J. D. & Somerville, M. A. (2013,April 11). Physician-assisted suicide. The New England Journal of Medicine, 385, 15.
Nursing & Humanities, Alice Munro
SLIDES FOR A PRESENTATION OF HUMANTIES AND NURSING: CHRONIC AND TERMINAL CARE ISSUES PRESENTED IN ALICE MUNRO'S "THE DAY OF THE BUTTERFLY," BELLE & SEBASTIAN'S "IT COULD HAVE BEEN A BRILLIANT CAREER," AND TONY KUSHNER'S "ANGELS IN AMERICA"
"The Day of the Butterfly" by Alice Munro is a quiet portrayal of elementary schoolgirls in 1950s Canada learning one of their classmates has a terminal illness.
"It Could Have Been A Brilliant Career" performed by Belle and Sebastian is a song about a young stroke victim and his caregiver.
"Angels in America" is a television-film adaptation of the Pulitzer-Prize-winning play by Tony Kushner, and depicts the AIDS epidemic in 1986 before any cure or medication had been discovered.
FOUR
From the standpoint of a professional Nurse, these artistic depictions of terminal and end-of-life illness teach us emotional lessons about the experience of survivors -- they ask not only how does the patient…...
The nursing professional must be adept at dealing ith these kinds of conversations, and ithout increasing the guilt that the family member or patient might be experiencing, and keeping in mind the patient's probable depression; it is the responsibility of the nursing professional to take the conversation back to the treatment and therapies that ithin the realm of the legal and ethical practices in delivering medical nursing care.
Jacquie Peden, Darlene Grantham, and Marie-Josee Paquin (2005) say that nursing standards in palliative care are based on the values of the nursing profession, and are developed by provincial and territorial regulatory bodies in Canada to guide the professional practice of nursing professionals (p. 2). The hospice palliative nurse, they rite:
Believes in the intrinsic orth of others, the value of life, and that death is a natural process.
Establishes a therapeutic connection (relationship) ith the person and family through making, sustaining, and closing…...
mlaworks cited here support the need for continued and expanded research involving the different specialties in nursing and oncology to better serve patients and their families. Also, there is little nursing information that is found in the professional peer reviewed journals that speak directly to the issue of pancreatic patients and depression. There is much more literature on the subject from the physician and researcher perspectives, but there is a void in nursing literature. At this point in time, the depression of pancreatic patients as it concerns nursing, has received little attention. Both the nursing profession and pancreatic patients would benefit from further research in this area.
The conclusion from the study of the literature available is that not only is pancreatic patient depression not well understood, it is also lacking in research that would help professionals to address depression in these patients. Also, because it is directly linked to pancreatic cancer, and because the research does support the fact that patients suffering depression and pancreatic cancer do not enjoy the quality of life as those patients who do not suffer from depression, then pancreatic cancer patients and depression should be a distinct and separate therapeutic intervention from other groups of depression.
References
Adali, E., Merkouris a., Manoussou, E., and Priami, M. (2004). The Attitudes of General and Oncological Hospital Personnel toward Euthanasia, ICUS and Nursing Web Journal, 17:1-9, found online at retrieved 7 October 2009.http://www.nursing.gr/index1.html ,
Canadian Nurses Association (2008). Position Statement: Providing Nursing Care at the End of Life, Canadian Nurses Association.
The first point addressed by Clark's review determines that a fundamental change in medical perspective had begun to transpire with the assumption of varying clinical research investigations on the subject.
This would contribute to what Clark identifies as a major shift in the way that physicians had begun to perceive and treat terminal illness. As opposed to a cut and dry preparation of the patient for the certainty of death, Clark points to a juncture in the mid to late 20th century at which medical professionals had begun to adopt "an active rather than a passive approach to the care of dying people was promoted in which the fatalistic resignation of the doctor ('there is nothing more we can do') was supplanted by a determination to find new and imaginative ways to continue caring up to the end of life." (Clark, 2002) In addition to serving as a fundamental motivation…...
mlaWorks Cited:
Clark, D. (2002). Between hope and acceptance: the medicalisation of dying. The British Medical Journal, 324, p. 905-907.
Eckholm, E. (1991). The price of hope: Medicine's Disputed Frontier. The New York
Times. Retrieved April 8th, 2008 from http://query.nytimes.com/gst/fullpage.html?res=9D0CE6D6173AF93AA2575AC
0A967958260>.
Euthanasia
The word euthanasia originates from the Greek, its root words meaning "good" and "death." This understanding lies at the heart of the concept, which in the modern sense is defined as a person choosing to end their own life. This is not normally taken in the same context as suicide, but rather as a physician-assisted death, so that the person chooses how and when they will die, and that they may do so in a peaceful and painless manner. The term is not usually understood to encompass things like 'do not resuscitate" orders, where a physician is ordered not to save a person, but rather is specifically applied to situations where the person is actively killed, usually through the administration of drugs.
Euthanasia has become a hot button topic of late in the medical community, in particular in the field of medical ethics. In most societies, there are taboos against killing…...
mlaReferences
Gorsuch, Neil M.. Future of Assisted Suicide and Euthanasia. Princeton, NJ, USA: Princeton University Press, 2006. ProQuest ebrary. Web. 15 March 2016.
Hippocratic Oath. Retrieved April 6, 2016 from https://www.nlm.nih.gov/hmd/greek/greek_oath.html
Nielsen, T. (1998). Guidelines for legalized euthanasia in Canada: A proposal. Annals of the Royal College of Physicians and Surgeons in Canada, Vol. 31 (7) 314-318.
Sanson, Ann, Elizabeth Dickens, Beatrice Melita, Mary Nixon, Justin Rowe, Anne Tudor, and Michael Tyrrell. "Psychological Perspectives on Euthanasia and the Terminally Ill: An Australian Psychological Society Discussion Paper." Australian Psychologist 33.1 (1998): 1-11. Web.
It is related that "This patterns of delayed referral does more than deprive individuals of palliative care-it jeopardizes hospice programs themselves. To be financially viable, hospice programs, which receive per diem reimbursements, must be able to balance out the high initial costs of services to new patients with the lower costs of maintaining stabilized patients." (Open Society Institute - Project on Death in America, 2007) Finally, it is related that "high quality end-of-life care depends upon an integrated network of in-hospital, out-patient, home and nursing home services." (Open Society Institute - Project on Death in America, 2007) Issues requiring research which present barriers to the provision of comprehensive quality palliative care include the issues as follows: (1) How does the six-month eligibility requirement affect patient access to end-of-life care?; (2) What is the impact of delayed referrals on hospice services?; (3) Are there cost incentives within HMOs to rush…...
mlaBibliography
Thomas, Keri Dr. (2003) Caring for the Dying at Home: Companions on the Journey. Chapter Five Excerpts. Online available at http://www.goldstandardsframework.nhs.uk/content/guides_and_presentations/Evidence_base.doc
Cramer, LD et al. (2003) Nurse's Attitudes and Practice Related to Hospice Care. J Nurs Scholarsh. 2003;35:249-255
Wright, K. (2002) Caring for the Terminally Ill: The District Nurse's Perspective. Br J. Nurs. 2002;11:1180-1185
Palliative Care (2007) Nursing Matters - Fact Sheet. Online available at http://www.icn.ch/matters_palliative.htm
Factors Contributing to Suicide Among Humans
Suicide, the intentional act of ending one's own life, is a complex and multifaceted phenomenon. While there is no single definitive reason why individuals commit suicide, research has identified a multitude of factors that contribute to this devastating act.
1. Mental Health Disorders:
Mental health disorders, particularly depressive disorders, are strongly associated with suicide. Individuals experiencing depression may have persistent feelings of sadness, hopelessness, and worthlessness, which can lead to suicidal thoughts and behaviors. Other mental health conditions linked to suicide include anxiety disorders, bipolar disorder, and schizophrenia.
2. Social Isolation and Lack of Support:
Social isolation and a....
1. The role of hospice care in providing comfort and support at the end of life
2. The importance of advance care planning and discussing end of life wishes with loved ones
3. Ethical considerations surrounding end of life decision-making and assisted dying
4. The impact of grief and loss on family members when facing the end of a loved one’s life
5. Cultural differences in beliefs and practices surrounding death and dying
6. The stigma and fear surrounding death and how to approach the topic openly and honestly
7. The role of palliative care in managing symptoms and improving quality of life at the end....
Here are some essay topics related to end of life that you can consider:
1. The ethical implications of end-of-life decisions, such as euthanasia and physician-assisted suicide.
2. The importance of advanced care planning and how it can impact end-of-life care decisions.
3. The role of spirituality and religion in coping with end-of-life issues.
4. The challenges and benefits of hospice care for terminally ill patients.
5. The impact of cultural beliefs and practices on end-of-life care.
6. The role of palliative care in improving quality of life for patients with terminal illnesses.
7. The psychological and emotional effects of caring for a loved one at the....
The Nadir of Birthday Titles: A Chronicle of Epic Fails
Birthdays, a time of celebration, joy, and well wishes, are often marked by thoughtful gestures and heartfelt sentiments. However, in the annals of birthday titles, there are some that stand out for their sheer awkwardness, insensitivity, or downright cringeworthiness. Here, we delve into the depths of embarrassment to explore the worst birthday titles that have ever graced the pages of greeting cards, social media posts, or verbal expressions.
1. "May Your Special Day Be As Meaningless As This Title"
This title is the epitome of birthday anti-cheer. It's like receiving a birthday gift....
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