Need for the End of Life Care Essay Example

Medicine is always considered a way forward in attaining comfort and saving lives. However, there are cases in which medicine proves otherwise. Under chronic diseases and terminal conditions, medicine may fail to provide a cure, and therefore a patient may need to make decisions on the best way expected to spend the last end of life days (Glaudemans et al., 2014, p.17). In this case, patients deserve comfort and palliative care to enhance life quality rather than a cure for their condition. On the other hand, some cases may not guarantee the improved quality of life to the patient.

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Many cancer, chronic heart, brain and kidney diseases' patients have many questions on what might happen during their last days of life (Song et al., 2016, p. 223). This is a common question among patients with advanced chronic and terminal diseases, and it entails questions on how they would expect to spend their last days alive. Patients are allowed to stipulate how they expect to spend their last days, express their wishes as well as the type of hospice care they expect accorded to them by healthcare givers and other caregivers (O'Halloran et al., 2018, p.4). They define some of the compromising decisions that family members may be faced with in making critical decisions on their life at times when they would be in a position of not talking.

Advanced care planning provides a platform for discussion with the patient, clinicians, family members and other caregivers on the end of life's wishes and thoughts. Death decisions are critical engaging in with the patient, loved ones and caregivers but are necessary for facilitating the quality end of life care to the patient. Foreseeing the end in some circumstances such as medical conditions is difficult and to that effect, based on the patient's beliefs and values, making decisions on end of life care may be compromised. To the rescue, advanced care planning provides a platform for conversations that focus on the best wishes and beliefs that are aimed at providing relief to the loved ones and the caregivers along with health care providers on the potential care the patient would like given.

Care decisions are more profound to most patients and therefore they should be allowed to make their end of life decisions (Johnson et a., 2016, p.379). Advanced care planning targets at supporting the patients' autonomy. However, advancing patient autonomy may not guarantee good death to the patient. Some patients prefer retaining the autonomy and the decisions on their medical conditions since not all patients prefer making their medical decisions (MacKenzie et al., 2018, p.901). Some patients may strongly reject Advanced care planning and therefore eliminate possibilities of a discussion on their end of life care. Provision of the end of life care is a professional and ethical responsibility to the healthcare employees inclusive of clinicians, clergies, support staffs, and caregivers. Additionally, the managers, payers as well as policymakers should facilitate a sustainable, comfortable, best quality end of life care and most importantly, compassionate care to the patients (Johnson et a., 2016, p.380). Not only does the end of life care (EOLC) improve the quality of social services and medical care to patients and their families but it also provides for a sustainable system of care (Kermel-Schiffman and Werner, 2017, p.138).

The need to improve end of life care lies in the increase in the number of old people and the rise in chronic diseases. According to Ke et al., an old population characterized by physical and cognitive disabilities, frailty, chronic diseases, and functional limitations consider the end of life care an essential requirement (401). The diversity in the US population is also critical which raises the need for responsive care that is patient-centered (Hughes et al., 2018, p.26). Additionally, the healthcare system is continually transforming as well as overwhelming cases in the health care system which makes it hectic to offer quality end of life treatment and care (Jimenez et al., 2018, p.10). In situations such as mismatch in the patient and service care preferred by family members, barriers to disadvantaged group accessing care and insufficient specialists and physicians offering palliative care and advanced chronic care; quality care delivery is compromised (Johnson et al., 2018, p.6).

According to Johnson et al. (2016), delivery of end of life care through advanced care planning is limited through legal, cultural, organizational and conceptual barriers (370). Improvements at the end of life care do not necessarily emanate from the institutionalization of advanced care planning but are brought about by the changes in the delivery and design of care (Johnson et a., 2016, p.381). Care accorded to people in their dying moments takes a lot of sensitivity, commitment, compassion, integrity, and the relevant skills to deliver the required care to the patient. The skilling process may entail training programs which enhance the competence of health professionals and improve their decision-making capacity regarding delivering the end of life care. Systemic transfer of information is also critical in facilitating advanced care planning. However, systemic transfer of information may be challenging due to the most decisions of end life care arrived at in an outpatient setting which may include the patient and family members only. In this light, it is difficult for medical staffs to accord the expected end of life care. Another detrimental fact is that most of the emergency care staffs, as well as hospital-based staffs, lack access to outpatient records in which advanced care planning discussions are documented. The information that reaches the service providers, therefore, fails to attain accord the patient the necessary care deserved.

Advanced Care Planning (ACP)

In most cases, patients with chronic diseases are unable to talk and therefore require help in decision making in relation to the type of treatment they would want and what they wouldn't want. Advanced care planning guarantees the patient the necessary information on the types treatment to sustain their lives, gives the patient autonomy over the type of diagnosis up or against in end of life treatment and an opportunity to share personal information with family and friends (Jimenez et al., 2018, p.2). Additionally, advanced care planning also gives the patient an opportunity to put in writing his wishes and treatment preferences in the event of failure to talk or critical condition.

According to Kermel-Schiffman and Werner (2017), adhering to the patient's and family members' wishes in the administration of treatment boost the health condition of the patient and therefore improving the patient's end of life days (137). This allows for the provision of person-centered as well as family-oriented care which is achieved through a conversation between the patient family members and caregivers. Advanced care planning encompasses the decision-making process by allowing the patient and family members to discuss the preferred treatment and care given.

Various factors favor the need for the end of life care. The rise in chronic diseases and old age calls for special treatment in situations where a patient's decision-making may be compromised. Chronic health conditions and old age frailty are some of the conditions that may call for support from caregivers and nursing home services. Care accorded to such patients in the final days of their lives need to adopt a strategic structure to enhance the autonomy of the patient in handling his medical conditions. Ethically, healthcare services are aimed at the final improvement of the patient's medical condition. In order for Advanced care planning to work effectively, there are education and training programs which instill medical care providers with the skills and knowledge in end of life care delivery (Kermel-Schiffman et al.,2017, p.137).

There are various policies and payment systems that support the end of life care form part of the advanced care planning. Medicare plan includes provision for ACP and end of life care to the patient and therefore catering for the care given during critical medical situations. Advanced care planning calls for the training of the medical care providers, patient education on the need for the end of life care advocates for various policies and payment schemes that guarantee the quality end of days care (Kermel-Schiffman et al., 2017, p.132).

Importance of systemic review on the role of ACP in end of life care

The time factor is essential in researching a particular healthcare problem. Healthcare practitioners can save a lot of time by relying on a review of other people's work in the same area. The systemic review is effective in dealing with prefiltered evidence in a certain area. Prefiltered evidence in Advanced care planning can be researched and analyzed by the use of systematic narrative review and meta-analysis review. The systematic narrative review considers the research treatment patterns in relation to the methodology deployed. However, systematic narrative review encompasses search, and appraisal of all the evidence presented but leaves out calculations.

On the other hand, meta-analytic reviews take into consideration the calculations on data sizes. According to Kermel-Schiffman and Werner (2017), systematic reviews aim at reducing systematic error by closely adhering to a set of scientific methods adopted for the review (140). Time used and systematic reviews reduce expertise deployed in locating and initializing individual studies. To determine the impact of facilitated advanced care planning on the cost of end of life care, Klinger et al. (2016) carried out a systematic review on the cost implication and ethical considerations on the conflicting matters. This study encompassed both systematic narrative review as well as meta-analysis reviews. The use of systematic review analysis determined information on the impact of advanced care planning on the overall cost of end of life care. Calculations and data size determination were carried out through meta-analytic reviews.

Systematic reviews collectively obtain data both theoretical and statistical data on the impact of advanced care planning on the cost of end of life care. The wide coverage of studies reviewed increased the accuracy of information obtained. Systematic reviews aid in synthesizing ACP research evidence, outcomes, and implementation principles which are used in informing policies and related practices (Jimenez et al., 2018, p.3). In the determination of factors that affect advanced care planning, advanced care planning systematic review overview will be conducted which summarized legislations, cultural factors, and institutional policies to influence the development of ACP. The application of both systematic narrative review and meta-analysis review were deployed to come up with both statistical and theoretical literature.

According to Weathers et al. (2016), systematic reviews increases the viability of data obtained and the scope of study saving time, expertise and resources to run an individual study in advanced care planning. The common results in different reviews pointed at maintaining the patient's autonomy. A systemic review of journals on advanced care planning puts together details from different sources bases on the generation of conclusions and hence eliminates misrepresentation of the knowledge base. This increases transparency and eliminates biases in the derived information. Biasness is reduced through the adoption of sets of the protocol. The sets of protocols explicitly try to avoid the influence of study resul...