Accepting Death By Families 624195

Accepting Death By Families

The hospice development has advanced in the United States in recent years. The focus of hospice is on comprehensive physical, psychosocial, and spiritual care for patients with terminal conditions and their families. Hospice providers promote personal responsibility by shielding patients from burdensome interventions and offering peaceful, painless care at home whenever possible, rather than in a hospital setting (Dahlin, Coyne, & Ferrell, 2016). Hospice nurses deliver care primarily under the guidelines of the Medicare Benefit Act of 1983, a government program that enables patients to spend their final days peacefully at home surrounded by loved ones (Mor & Teno, 2016).

Palliative care is an interdisciplinary approach aimed at providing pain relief and comfort to patients nearing end of life, ensuring dignity and personal comfort through symptom management and control of side effects, while preserving autonomy (Kelley & Morrison, 2015). Hospice and palliative nurses share similar roles in patient care, emphasizing comfort, holistic support, and respect for religious and social values (Ferrell, 2015). However, their practice settings and focus may differ, with hospice nurses often working in home settings and palliative nurses frequently in clinical environments.

The challenge for hospice nurses extends beyond patient comfort to include supporting families coping with grief and stress. Nurses assist families in maintaining their previous roles and emotional integrity, promoting coping strategies and emotional resilience. As part of multidisciplinary teams comprising doctors, social workers, chaplains, and volunteers, hospice and palliative nurses collaborate to address complex physical, emotional, and spiritual needs of patients and families (In Ferrell, 2015).

Within hospice and palliative care, families often experience denial, fear, and emotional upheaval. Nurses and the interdisciplinary team work to facilitate emotional adjustment, providing education, spiritual support, and counseling. The development of support groups offers peer connection and shared experience, which are crucial for emotional recovery and acceptance of death (Hudson et al., 2014). Establishing a dedicated family support program aims to enhance coping and familial resilience in facing end-of-life challenges.

Paper For Above instruction

The purpose of this paper is to present an advanced practice nursing intervention project focused on assisting families in accepting the death of their loved ones at the end of life. Grounded in the frameworks of hospice and palliative care, this project emphasizes the development and implementation of a structured support group for families coping with terminal illness and loss. The intervention aims to facilitate emotional processing, enhance family resilience, and improve overall end-of-life experiences by providing education, peer support, and professional guidance.

The role of hospice and palliative nurses, as delineated in the Palliative Nurses Role Delineation Study, is central to this intervention. These nurses are responsible for holistic symptom management, emotional support, and spiritual care tailored to the individual needs of patients and families (Ferrell, 2015). They act as facilitators and advocates, ensuring that families understand the dying process and are supported throughout their grief journey. Evidence suggests that effective communication and psychosocial support significantly improve families’ ability to accept death and find closure (Hudson et al., 2014).

The theoretical model guiding this intervention draws from the Roy Adaptation Model, which emphasizes the importance of adapting to change and loss in a healthy manner (Roy, 2009). This model highlights the role of environmental stimuli, coping mechanisms, and adaptation in psychological well-being. By fostering adaptive coping strategies through peer support and education, the program aims to assist families in navigating grief and acceptance (Lazarus & Folkman, 1984).

To effectively implement the support group, a health promotion and educational planning approach, such as the PRECEDE-PROCEED model, will be utilized. This framework facilitates comprehensive planning by assessing community needs, setting goals, designing interventions, and evaluating outcomes (Green & Kreuter, 2005). Pre- and post-intervention questionnaires, validated for grief and coping assessment—such as the Texas Revised Inventory of Grief (TRIG) and the Coping Strategies Inventory (CSI)—will be employed to evaluate the program’s effectiveness in enhancing emotional resilience and accepting death.

The intervention will target families of terminal patients receiving hospice services at the University of Miami Hospital. The program will involve six monthly support sessions, facilitated by trained nurses, social workers, chaplains, and volunteers. Session topics will include understanding death and dying, emotional expression, coping skills, grieving processes, and spiritual considerations. The program will also provide informational materials and opportunities for peer sharing, fostering a community of support.

The budget for the initial year encompasses costs for venue, materials, refreshments, staff training, and evaluation tools. For instance, the first-year expenses include $200 for orientation, $350 for brochures, $150 for refreshments, $200 for travel, and $250 for staff training and materials. These costs are expected to increase modestly in subsequent years to accommodate program expansion and evaluation activities. Funding will be sought through hospital grants and donations, emphasizing sustainability and community partnership.

In conclusion, addressing family grief at end of life requires a proactive, structured approach that combines education, emotional support, and community connection. The proposed support group intervention, grounded in theoretical frameworks and evidence-based practices, seeks to improve families’ acceptance of death, support their emotional well-being, and foster resilience. Post-program evaluation will determine its impact and guide future enhancements, aiming to integrate this supportive model into standard hospice care practices.

References

• Ferrell, B. (2015). Structure and processes of care. In B. Ferrell, N. Coyle, & J. A. Paice (Eds.), Oxford textbook of palliative nursing (pp. 45-67). Oxford University Press.
• Green, L. W., & Kreuter, M. W. (2005). Health program planning: An educational and ecological approach. McGraw-Hill.
• Hudson, P., Trauer, T., Kelly, B., O’Connor, M., Thomas, K., Zordan, R., & Summers, M. (2014). Reducing the psychological distress of family caregivers of home-based palliative care patients: Long-term effects from a randomized controlled trial. Psycho-Oncology, 24(1), 19–24.
• Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.
• 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.
• Roy, C. (2009). The Roy adaptation model (3rd ed.). Prentice Hall.
• Hudson, P., Trauer, T., Kelly, B., O’Connor, M., Thomas, K., Zordan, R., & Summers, M. (2014). Reducing the psychological distress of family caregivers of home-based palliative care patients: Long-term effects from a randomized controlled trial. Psycho-Oncology, 24(1), 19–24.
• In Ferrell, B., Coyle, N., & Paice, J. A. (2015). Oxford textbook of palliative nursing. Oxford University Press.
• Hudson, P., Trauer, T., Kelly, B., O’Connor, M., Thomas, K., Zordan, R., & Summers, M. (2014). Psycho-Oncology, 24(1), 19–24.
• Werner, C. A., & Zabora, J. (2017). Challenges to family caregiving at the end of life. Journal of Hospice & Palliative Nursing, 19(2), 165-171.