End Of Life care for seniors

Death is a natural stage in an aging society and with may be associated with chronic conditions such as cancer, heart failure, chronic obstructive airway disease and the complications of dementing illness. A large number of seniors will need end-of-life care over a long period of time.

Countries will need the expertise to address complex issues that deal with end of life for diverse populations and Aboriginal peoples.The burden of middle-aged people caring for dying parents is becoming more prevalent and their needs should be addressed as well.

Myths & Misconceptions of Dying

  • Seniors don’t need end-of-life care as they are going to die anyway.
    • Many seniors would prefer to continue living even if they have a terminal illness. They will need help with self-care, emotional support, nutrition and pain control.
  • Most seniors die in long-term care facilities and already receive end-of-life care .
    • Only one third of seniors die each year in long-term care facilities. Even health care workers in palliative care and nursing homes require education on stress management and physiological impacts.
  • Seniors are prepared for death.
    • Many seniors may be in denial, indecisive and ambivalent. This can interfere with implementation of directives such as what health care they want.
  • Seniors die of old age.
    • Aging itself does not cause death. They may die from heart disease, cancer, respiratory diseases and strokes.
  • Nothing can be done for seniors who are dying.
    • Many things can be done including informing seniors of their rights, support for family members and exploring end-of-life decisions. Much can be done to enhance the quality of life for seniors and their loved ones.

Improving End Of Life

End-of-life care is an integral part of dying. The following can offer tips so your loved one can have a kind and gentle death.

  • Comfort to patient
    • Medication needs to be available to control pain and other treatable symptoms.
    • Optimize physical functions and timely care.
    • Eliminate fear and anxiety.
  • Decision-making
    • The patient and family members should be able to choose the use of life-sustaining treatments in the last days of life.
    • Ask permission to do something, respect freedom of choice and encourage them to make difficult decisions.
  • Support
    • Support needs are different for everyone including the patient and family.
    • The senior may make decisions that are not in their own best interest, but instead protect their family from emotional or financial pressures.
  • Issues to consider
    • Treatment of physical and emotional symptoms.
    • Support of function and autonomy.
    • Advance care planning, patient and family satisfaction, global quality of life.
    • Family burden, survival time, health care and social service provider continuity.
    • Bereavement
  • Social Needs
    • Provide supportive environment to strengthen relationships.
    • Opportunities for social contact.
    • Encourage opportunities for life review and reminiscence about old times.
    • Let them discuss their true feelings, dreams, fears, desires and expectations.
  • Culture
    • Care is consistent with cultural values and beliefs.
    • Provide access to spiritual guidance and practices.
    • Some cultures do not promote individualism and there the individual may leave decision-making in the hands of others.

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