Palliative care plays an important role in the lives of persons with serious illness. Palliative care can be given to patients who have chronic illness or life limiting conditions. It involves multidisciplinary aspects which should be addressed so as to enhance the quality of life for terminally ill patients and their families. Palliative care mainly emphasizes symptom control and pain management to provide comfort to the patient as the end of life approaches. Age appropriate palliative care entails certain measures such as gives better understanding of the nature of the illness and provides psychological support to the family and patient during the end stage of life. Age appropriate palliative care is important in order to meet the individual needs which will differ according to their age group. The importance of providing age appropriate palliative care to a person and their family is discussed in this essay. This is followed by a detailed account of the nurse’s role in addressing the needs of young adults and their family in a palliative care context.
Patients and their families feel more comfortable and relaxed in age appropriate palliative care because they know that support will be provided according to their age, according to their condition, and as per their individual needs. Age appropriate palliative care encourages the patient and their families to choose their prefe
ed atmosphere for a peaceful and dignified death (Sorensen & Iedema, XXXXXXXXXXAge appropriate palliative care gives more room to the patients and their families to express their emotional feelings and it increases self-confidence and self-awareness in patients. Age appropriate palliative care respects the patient’s autonomy in decision making (Sorensen & Iedema, 2011) and therefore, provides continuity of care which promotes a sense of safety and trust for patients.
In 2011, worldwide it was predicted that 20.4 million people would require palliative care at the end of their life. The statistics shows that 69% of people who required palliative care were over 60 years, and 25% of people were 15-59 years old, whereas 6% were children less than 15 years of age (Worldwide Palliative Care Alliance & World Health Organisation, XXXXXXXXXXEven though the number of palliative care places for paediatrics is less than for older people, giving care to the paediatric patients is more challenging than geriatric care because children and their parents need more emotional and psychological support than do elderly patients (Williams-Reade et al., XXXXXXXXXXChildren and parents often feel more distressed and suffer from complicated bereavement grief more than older patients. Thus, early and proactive interventions to support children facing death can help them to adapt to loss (Hall, Browne, Bexon, Bleakley & Cheadle, XXXXXXXXXXOverall, age appropriate palliative care prepares the patient and family to accept the patient’s condition, tries to fulfil the patient’s last wishes, and provides holistic care at end of life.
When treating young adults aged 19-35 year old, the nurse should pay more attention to the patient’s physical, social, emotional, cognitive and spiritual changes, because young adulthood is a period when they start to become more independent, and this is the time when they make life partners (Clark & Fasciano, XXXXXXXXXXHowever, the disease process will inte
upt their life events like education, employment, ma
iage, career and parenthood (Bhatnagar & Joshi, XXXXXXXXXXDue to their ill health, young adults will lose their healthy peers and partners; sometimes they even get separated from their family members, which will lead to isolation. Thus, the nurse should provide social support to the young adults and their families to avoid the loneliness that may occur in the disease experience. Trevino, Fasciano, Block, and Prigerson XXXXXXXXXXstated that social support is a significant and primary coping strategy for terminally ill young adults and their family. Social support from friends, community members and healthcare providers will reduce the distress and increase the psychological wellbeing of young adults and their family. When they get enough social support, life seems more meaningful and worthwhile to them.
Providing health education to the young adults and their loved ones is a most significant strategy in palliative care. As a result of this health education, young adults and their families will have a better understanding of the disease process and its treatment. Evaluating and managing symptoms is a key element of end of life care. Thus, in the education program, the nurse should provide a clear explanation of the disease process, pain and symptom management (Malloy et al., XXXXXXXXXXFirstly, a nurse needs to discuss pharmacological strategies with the young adults and their family. These include the medication dosage, route administered and side effects of the medications. Secondly, nurses should teach the young adults and their relatives about non-pharmacological strategies: these include heat and cold therapy, acupuncture therapy, massage and other alternative therapies. Thirdly, nurses should give more information about recreational therapies: these may include music therapy and physical exercises to control their symptoms and reduce the pain (Kilonzo, Lucey & Twomey, XXXXXXXXXXTherefore, the health educational program about symptom control and pain management strategies will help the young adults to spend quality of time with their family and to develop positive attitudes towards life.
Nurses should provide psychological support to young adults and their families during the last stage of life, because at this stage they often suffer from low self-esteem, anxiety, depression and fear of abandonment. Thus, psychological support promotes awareness of stress management and coping strategies by allowing the young adults and their family to participate in social activities. Social activities include joining in the community club and playing games. Kulkarni et al., XXXXXXXXXXdiscus that caregivers will suffer from more stress than the patient because they have a lack of knowledge about care providing and they are not prepared to accept the condition of the patient, which can cause the young adults to have lack of support from caregivers. Thus, nurses should provide counselling to the family to gain confidence about giving care. Nurses should assure young adults and their family that they can reduce their stress and enhance their mental health wellbeing by doing yoga, meditation and other alternative relaxation therapies (Clark & Fasciano, XXXXXXXXXXIt is the nurse’s responsibility to provide all the information to the young adults and their family about where to get help if they have any concerns or feel overwhelmed, or when they feel they cannot manage it themselves. By providing this information, the nurse can prevent stressful events for young adults and their family.
Overall, age appropriate palliative care provides coordinated, comprehensive and holistic care to the patient and their families at the end of life. The main goal of age appropriate palliative care is that nurses must respect the right to life and the importance of patients’ preferences, dignity and being treated courteously. Age appropriate palliative care empowers the patient and their family to give their life as much comfort as is possible during the last days of life. In addition, palliative care nurses mainly focus on pain management, symptom control, providing health education, social support and psychological support to the patient and their family to reduce stress and strengthen their confidence about disease and pain management. In short, their main aim is to enhance the quality of life of the patient and their family at the end of life.
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