THE END OF LIFE CARE

Palliative Care helps the patient with a terminal illness feels better, because it provides relief from pain and symptoms of disease. Palliative care doesn't make put off death, but it gives comfort and peace instead of cure.
In addition, this type of care also focuses on providing emotional support to the patient and his family.

THE MAIN OBJECTIVE OF PALLIATIVE CARE IS TO IMPROVE THE PATIENT'S QUALITY OF LIFE

I consider that the most important nursing intervention in this type of patients, is to get the patient accepts his death as an inevitable part of the life cycle and can encourage the grieving person to take time to cry or to express his feelings and concerns. However, many times is not easy to get it because the patient doesn't believe that he will die or refuses to talk about his illness.

It's true that many professionals are afraid to confront the communication with these type of patients, especially if the patient is young or they may feel unprepared and have difficulty dealing with a death. But this situation should change, because our duty is to reduce the patient's anxiety about death.

Firs of all, nursing must discover if the patient wants to have information about his terminal situation. If the patient wanted receive information, nursing would adjust the information of patient's rate assimilation. In addition, it's important that the information is distributed in several sessions to ensure the understanding, and the most important: the hope should never be removed but neither should be generated.

When the patient is diagnosed with a terminal illnes, he passes through five stages. The five stages of the Dra.Kübler-Ross stage model are the best-known description of the emotional and psychological responses that many people experience when faced with a life-threatening illness or life-changing situation. These stages, don't necessarily follow in a specific order, because a person may move in and out of stages unpredictably and erratically. 
For this reason, nurses should be able to identify the stage where is the patient, according to the patient's behaviour, since this model helps to identify individuals who are experiencing severe or protacted grief. In addition, nurses should be able to identify individuals who may need a grief counselor who has special training and tecniques to help the person.

In conclusion, I consider that the palliative cares provide a better qualify of life (physically and psychologically) to the patiente, since his illnes, because people who receive palliatives cares can spend more time with his family, friends... because these cares help to the patient feels better. But I think that the most important of palliative cares are that they allow a dignified death, because the family's patient and patient have a support from health professionals which provides them support and the means to go through this hard process. In addition, palliative cares allow the patient to be accompained when it comes his time to die. And finally, these cares bring quiet to the family, because the family is normally satisfied by the care received and in this way, the family won't experience guilt feelings when the patient dies.

*** KÜBLER-ROSS'S STAGES OF GRIEF

1926-2004

1. DENIAL

The patient doesn't accept the possibility that he has a terminal illness for which there is not cure. 

     2. ANGER

The patient has anger because begins to believe that the new is true and  suffers from thinking about all the unresolved things.

     3. BARGAINING

The patient try to identify whether they could have done something different to prevent the death. some may make resolutions to change their behavior or lifestyle based on this reflections. Then, the patient establishes a pact with a superior entity (religious beliefs) or with the doctor and finally, the patient adds another promise which express his willingness to not ask for anything more if the first pact is fulfilled.

The patient adds another promise that expresses its willingness to not ask for anything more if the first is true.

     4. DEPRESSION

The patient begins to understand that the pact not be produce, and is aware that death is inevitable

     5. ACCEPTANCE

The patient is aware that death is inevitable and in some cases, inmediate.

" CONSIDER THE RATIONALE OF TRYING TO PROLONG LIFE BY ADDING TIME TO THE PERIOD OF DYING"