Accepting Death By Families

Accepting Death By Families

The hospice development has advanced in the United States in recent years, focusing on comprehensive physical, psychosocial, spiritual, and end-of-life support for terminally ill patients and their families. Hospice providers encourage personal responsibility by protecting patients from invasive interventions and offering peaceful, painless care at home whenever possible, rather than in hospitals (Dahlin, Coyne, & Ferrell, 2016). Hospice nurses deliver care primarily under Medicare Benefit Act of 1983 guidelines, facilitating a dignified death at home with loved ones present (Mor & Teno, 2016).

Palliative care provides interdisciplinary, compassionate approaches to ensure painless and comfortable management for patients nearing death, aiming to maximize comfort through pain relief, symptom control, and autonomy preservation (Kelley & Morrison, 2015). Hospice and palliative care nurses must remain personable, respecting social and religious values, with roles that overlap but differ in practice settings and focus areas (Ferrell, 2015; In Ferrell, 2015).

The primary challenge for hospice and palliative nurses is to support families in coping with terminal illness and impending loss while maintaining their previous roles and family integrity. These nurses work within interdisciplinary teams comprising physicians, social workers, chaplains, aides, and volunteers to address the complex physical, emotional, and spiritual needs of patients and families during end-of-life stages.

End-of-life care often reveals family denial, requiring intervention by interdisciplinary teams led by nurses to foster coping mechanisms, social engagement, and acceptance. This paper proposes establishing a support group aimed at assisting families through grief and role adjustment processes, with an emphasis on emotional and functional coping roles.

Paper For Above instruction

This paper examines the roles of hospice and palliative nurses, emphasizing their specialized focus on end-of-life care and their crucial role in supporting families through terminal illness and bereavement. It also details a proposed intervention—a support group tailored to families during these challenging times—to enhance their coping skills, foster acceptance of death, and promote holistic healing.

Introduction

The development of hospice care in the United States has significantly transformed how end-of-life concerns are addressed. With a focus on holistic care, hospice presents a model emphasizing dignity, comfort, and family involvement (Dahlin, Coyne, & Ferrell, 2016). It prioritizes relief from physical and psychological distress, emphasizing patient-centered care in familiar environments such as home, which enhances emotional well-being and familial support during terminal stages (Mor & Teno, 2016).

The scope of palliative care is broad, aiming to provide relief from suffering at any stage of serious illness, with a particular focus on quality of life. Both hospice and palliative nursing involve interdisciplinary teamwork but differ in settings and scope; hospice care generally pertains to the last months of life, whereas palliative care can be integrated earlier in the disease trajectory (Ferrell, 2015).

The roles of hospice and palliative nurses are defined through competency standards, emphasizing holistic assessment, symptom management, emotional support, and family care. As outlined in the Palliative Nurses Role Delineation Study, these nurses require specialized skills in communication, spiritual care, ethical decision-making, and cultural competence to meet complex patient needs (Ferrell et al., 2015; Glare et al., 2011).

Supporting families during end-of-life stages involves addressing denial, guilt, and anticipatory grief. Nurses serve as facilitators who promote understanding, acceptance, and emotional resilience. Often, families struggle to adapt roles and cope with loss, necessitating psychosocial interventions such as support groups that foster social sharing, emotional expression, and constructive coping strategies (Hudson et al., 2014).

Proposed Intervention Program

The proposed intervention involves establishing a structured support group targeting families coping with terminal illness and impending death. The primary goal is to aid family members in role adjustment, grief processing, and acceptance of death, ultimately fostering resilience and reducing psychological distress (Catania et al., 2017).

Objectives include providing a safe environment for emotional expression, sharing practical coping strategies, promoting social support, and facilitating phase-specific grief interventions. The program aims to enhance families' understanding of end-of-life processes, improve their communication abilities, and prepare them for bereavement.

Implementation will involve collaboration with hospital staff, secure stakeholder buy-in, and strategic planning, including funding, staffing, and logistical arrangements. An evidence-based intervention package will be developed, incorporating psychoeducational materials, guided group discussions, and resource referrals. The program will be pilot tested initially with 10 families over three years, with ongoing evaluation and refinement.

Guiding Framework and Evaluation

This intervention will be guided by the Transition Theory, which emphasizes understanding family adaptations during health-related crises and transitions (Meleis, 2010). The theory supports tailoring interventions to families' developmental and contextual needs in end-of-life care, emphasizing transition facilitation, emotional support, and resilience building.

To evaluate the program's effectiveness, validated tools such as the Caregiver Strain Index and the Family APGAR score will be administered pre- and post-participation to measure changes in perceived burden, family functioning, and support satisfaction. The evaluation will also include qualitative feedback to assess perceived benefits, challenges, and areas for improvement.

Role of Health Promotion and Education

The program will employ a health promotion and education planning model (Ottawa Model of Health Education) to ensure comprehensive family-centered education. This model involves assessment, planning, implementation, and evaluation, allowing for tailored interventions that empower families and improve their adaptive capacity.

In practice, educational sessions will cover topics such as disease process understanding, communication skills, emotional regulation, and grief mechanisms. Nurses, social workers, and chaplains will coordinate efforts, providing culturally sensitive education and ongoing support. The program will also promote peer support and community engagement to strengthen social networks.

Conclusion

Implementing a family support group in hospice and palliative care settings addresses critical psychosocial needs of families facing terminal illness and death. This initiative aligns with holistic care principles and emphasizes empowering families through education, social support, and facilitated coping strategies. Based on the lessons learned and the ongoing evaluation, revisions will focus on refining intervention content, enhancing accessibility, and expanding scope to include diverse family structures. This program aims to improve family functioning, promote acceptance of death, and ease the grieving process, ultimately enriching the quality of end-of-life care.

References

• Catania, G., Bagnasco, A., Signori, A., Pilastri, P., Bottino, M., Cervetti, C., & Sasso, L. (2017). A phase 2 quasi-experimental trial evaluating the feasibility, acceptability, and potential effectiveness of complex nursing intervention focused on QoL assessment on advanced cancer patients with palliative care needs: study protocol. Pilot and Feasibility Studies, 3(1).
• Dahlin, C., Coyne, P. J., & Ferrell, B. R. (2016). Advanced practice palliative nursing. Oxford University Press.
• Ferrell, B., In Coyle, N., & Paice, J. A. (2015). Oxford textbook of palliative nursing. Oxford University Press.
• Glare, P. A., Semple, D., Stabler, S. M., & Saltz, L. B. (2011). Palliative Care in the Outpatient Oncology Setting: Evaluation of a Practical Set of Referral Criteria. Journal of Oncology Practice, 7(6), 366–370.
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• Kelley, A. S., & Morrison, R. S. (2015). Palliative care for the seriously ill. New England Journal of Medicine, 373(8), 747–755. https://doi.org/10.1056/NEJMra1404684
• Meleis, A. I. (2010). Theoretical nursing: Development and progress (5th ed.). Wolters Kluwer/Lippincott Williams & Wilkins.
• Mor, V., & Teno, J. M. (2016). Regulating and Paying for Hospice and Palliative Care: Reflections on the Medicare Hospice Benefit. Journal of Health Politics, Policy and Law, 41(4), 697–716.
• Ottawa Model of Health Education. (n.d.). Retrieved from [source]