Question

NURSING PRACTICE IN THE COMMUNITY

Clinical Discussion (Stanhope & Lancaster, 2014, p. 554)

• Identify 1 palliative care service (home-based or hospital/facility-based) in New Jersey. What basic skills of professional hospice caregivers be applied in that clinical setting?
• How do caregivers adapt to a hospice home death, inpatient death, or a sudden, unexpected death in which, for example, many people have died as a result of a natural disaster or bioterrorist act?

Answer 1

One of the palliative care service in New jersy is Light House Hospice.

• They provide all medications, durable medical equipment (DME), and medical supplies related to the illness they are managing
• They provide care 24 hours / 7 days a week
• They never charge our patients or families anything for the services they provide
• They are additional care to what you provide – they do not replace the care or expect the patient relationship to cease but instead look forward to coordinating care.

Basic skills of professional hospice caregivers be applied in the clinical setting are:

1. Compassion

Showing compassion means being able to tune in to other people’s distress and feeling a desire to alleviate it. This attribute is first on the list because many clients are in distressing and even painful situations.

2. Communication

Caregivers must have excellent communication skills, both written and verbal.

3. Observation

It’s not just enough to talk with or even listen to the patients. Sometimes, they may not be able to articulate what’s going on with their health, or they may even try to actively hide something from us if they are afraid of revealing any deterioration in their condition.

4. Interpersonal Skills

Working as a caregiver is a very social job, and be interacting with people all day. Caregivers don’t have to be an extrovert to work, but it certainly does help.

5. Patience

Most clients are dealing with challenges of one type of another: significant mental and/or physical ailments, limited communication abilities and more. Clients may be irrational or critical (or both), and otherwise lead to some frustrating situations. Caregivers need to remain calm in these scenarios, so having a near-unflappable personality is really important for successful patient care.

6. Flexibility

Because a patient’s condition can change from day to day, so can the work as a caregiver. No two shifts are the same, and caregivers need to have a flexible mindset so they can handle these changes with grace.

7. Initiative

Caregivers need to be comfortable being proactive, making informed decisions and taking action in an emergency.

8. Physical Strength & Stamina

Caregivers perform a variety of physical tasks, Having a baseline level of physical strength and stamina is important to maintaining one's own health and that of the clients.

How do caregivers adapt to a hospice home death, inpatient death, or a sudden, unexpected death:

Unexpected death has significant impact on care, including unrealized dreams and unfinished business among patients, a sense of uneasiness and complicated bereavement among caregivers, and uncertainty in decision making among healthcare providers.

Furthermore, because of the emotional impact of unexpected death on bereaved caregivers, clinicians should provide close monitoring and offer prompt treatment for complicated grief.

Family caregivers, particularly spouses, are at risk for a variety of mental and physical health decrements as a result of their caregiving experience.

Complicated grief is another potential concern for bereaved family caregivers.

Untimely death is often linked to the element of surprise, and could exacerbate the emotional distress and the lack of sense of control among caregivers.

Furthermore, unexpected death may sometimes be preceded by catastrophic complications such as massive gastrointestinal bleeding, stroke, and acute respiratory failure that can be particularly distressing to caregivers.

Understandably, unexpected death is associated with higher rates of complicated grief, major depressive disorder, panic disorder, substance use, and mortality in bereaved caregivers.