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NRS 434 Topic 5 Discussion Question Two

NRS 434 Topic 5 Discussion Question Two

Topic 5 DQ 2

End-of-life care becomes an issue at some point for elderly clients. Even with the emergence of palliative care programs and hospice programs, most elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your clients regarding end-of-life care in accordance with their wishes. Support your response with evidence-based literature.



Health Assessment


End of life care is the final phase of of a patient`s illness when death is imminent. Years ago, most people died at home but the trend has changed recently due to medical improvements and concepts of care and medical dynamics (National Institute on Aging, et. al.. 2021). Individuals and family now have the options to pre plan the care options they would receive when death comes.

Factors determining place of death

There are many factors that determine the place of death, the care to be given, the readiness of the patient and family, and the affordability of care involved with families. Most people prefer dying at home than at the hospital due to the peace and grief shared by patients and loved ones. However, it is important to discuss the preferences with professionals to ascertain what is suitable for them (National Institute on Aging, et. al.. 2021). What determines the type of care to provide is the patient`s level of insurance coverage and advance directives.

Role of a nurse in end – of life care

Generally, most patients suffer from discomfort in areas such as pain, breathing problems, skin irritations, digestive problems, temperature sensitivity and fatigue. The nurse should ensure that patient`s needs are met by providing comfort care, pain medication, skin care, oxygen, warm environment, and other support measures to satisfy the patient and family (National Institute on Aging, et. al.. 2021). In end of life care, giving love and affection, psychological support, respecting and fulfilling the patient`s desires are important.


Older people once stayed at home under the care of loved ones in their end-of-life period. But this trend has changed and many are now living in nursing homes or assisted living because the loved ones do not have enough time to provide needed care due to jobs or other commitments.



National Institute on Aging, National Institute of Health, U. S. Dept. of Health and Human Services, “Why Population Aging Matters-A Global Perspective,“ March 2007. (Accessed Nov. 17, 2021).



Good evening. Your work was very informative and detailed, thanks. Yes, I agree with you that individuals now have options’ completely true, but my experience working with elderly patients at the Extended Congregate Care (ECC) Nursing home for prioritize elderly nursing care of end-of-life and assisted living patient, show that most elderly patients actually want to be around loved ones during death. It is painful for me to see them anxious and confused, wandering to search for home or begging to go home.



Assessment Foundations for Effective Practice. Retrieved from: https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/5


Understanding the dynamics of the aging process. (n.d.). National Institute on Aging. https://www.nia.nih.gov/about/aging-strategic-directions-research/understanding-dynamics-aging


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It is sad that we have now started turning to admitting family members to nursing homes or long term assisted living. On the other hand, I understand life expectancy is much older now in comparison to years ago. When we ask patients to express his or her wishes in regards to all aspects of care, we must strongly encourage them to speak freely about what the wishes are in regards to end of life care. We always want those close to end-of-life to pass with dignity, so encouraging them to express his or her wishes with care will give a better chance for being able to match their wishes. Great job again this week.



You mentioned a very good point about the affordability of end-of-life care. Elderly choices should be respected and fulfilled however, if the family does not have resources or if the dying person did not take care of the financial part such as insurance, then it is challenging to fulfill all their wishes. I know there are some community resources available, however they cannot take care of everything. In such scenarios, family members should come together and make some arrangements for the elderly person to full- fill their wishes and provide comfort as much as possible.

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