Lack of access to Palliative Care-Myassignmenthelp-Myassignment

Question: Write an Essay on Lack of access to Palliative Care. Answer: Introduction End of life care is particularly challenging for the healthcare professionals as it requires extensive collaboration and critical insight to ensure health and wellbeing of the distressed individuals in need of care. In contrast to the terminally ill patients who require palliative care services for management of their condition, the ones afflicted by dementia like disorders is shrouded with impediments that hamper their quality of life significantly. Dementia has been identified as a debilitating syndrome that causes progressive deterioration of the cognitive brain functioning encompassing memory, perception, reasoning, understanding and behavior. The geriatric population is more vulnerable to acquire this condition and majority of the incidences reportedly occur at age 65 years or more (World Health Organization, 2017). Data in the context of Australia for the year 2014 has revealed that dementia including Alzheimers disease is the second leading cause of death accounting for 7.8% o f total mortalities in Australia (Abs.gov.au, 2017). In consideration of the above situation it is imperative to resort to prudent approaches as offered through palliative care facilities for enhancing the prevalent scenario with respect to the dementia patients living in Australia. The following essay will highlight on three relevant issues that might hinder the provision of person-centered and family focused palliative care for older people living with end-stage dementia in residential aged care facilities in Australia itself. Issues that may hinder the provision of person-centered and family focused palliative care for older people living with end-stage dementia in residential aged care facilities in Australia Rendering person-centered and family focused palliative care for older people thriving with end-stage dementia in case of aged care facilities may be disrupted due to pervasiveness of various issues such as paucity of access to palliative care, communication problems and faulty pain management. These issues impede the proper management of the deleterious health condition of dementia that tends to rob oneself of her personal stand. Lack of access to palliative care Dementia is a potentially debilitating illness in which the declining cognitive status of the affected person majorly influences the judgment, reasoning, memory and communication skills thereby posing threat to the victims. Hence, providing adequate and most appropriate treatment intervention is a challenging task for the healthcare professionals. Moreover, end stage dementia is particularly hard to handle due to insufficient and considerable knowledge acquisition on the part of healthcare professionals in addition to limited resources and dearth of curative therapies. Transcending the traditional care with respect to dementia patients, novel and improved healthcare practices are required to remedy the sufferings of the dementia affected patients as well as their families thereby providing opportunities for maximizing the quality of life of them across various stages of illness. Poor outcomes because of end of life issues in dementia patients is of particular botheration as it tend t o jeopardize the stability in a persons life and incur threats to health (Lee et al. 2017). Further, researches carried out with respect to the provision of end-of-life care depicted that despite being a terminal illness condition; dementia is often undermined that leads to inadequate healthcare delivery. People with end stage dementia do not have access to most suited end-of-life care needs that compromise their healthcare outcomes in a major way. In contrast to other terminal illness, stereotype and stigma is attached with dementia that makes it more difficult to combat the adverse outcomes. Difficulty in dementia diagnosis coupled with lack of education regarding the disorder by the healthcare workforce, families and caregivers predisposes the vulnerable group of elderly population to encounter the wraths and negative repercussions. Inability to detect complications associated with end stage dementia by the healthcare professionals further aggravates the problem and harness poor end-of-life outcomes to strategize suitable interventions based on the individualized needs of the affected dementia person. The composite needs of the victims are not succinctly addressed due to such negative results emanating from dearth of clinical expertise and insight for recognizing the specific symptoms of dementia. Fewer referrals to suitable palliative care facilities are another major hindrance (Dowling et al. 2015). The culturally, linguistically and ethnically diverse groups are particularly susceptible to face discrimination in terms of access to healthcare and equity in service provision. Therefore, timely diagnosis and prompt intervention are delayed that procrastinates the chances of recovery of the dementia patient in a huge manner. Adequate navigation of the healthcare system if not fulfilled satisfactorily has the ability to diminish the service outcomes for dementia patients in spite of exhibition of similar symptoms like that of pain, confusion, agitation, lack of sleep and eating as happens in terminal illness like cancer (King, Goeman and Koch 2015). Communication issues In contemporary healthcare sector, communication is considered crucial and complementary to other modes of therapeutic interventions for deriving optimal benefits for the distressed patient. In case of dementia-affected patients, similar results may be expected out of appropriate following of communication strategies. The affected individuals may not always verbally articulate sufferings instead, they may resort to expressing their issues of concern through behavioral gestures and similar symptoms. Functional decline of the dementia sufferers is commonly noted that may be indicative of the diagnostic presence of dementia in the concerned individual. Thus, the general practitioners through cooperative and synergistic efforts received from other allied healthcare professionals are capable of rendering accurate diagnosis and management for dementia. Empirical evidences have offered resolution in mitigating the challenging issues with respect to the dementia patients through undertaking of proper training, encouraging the dementia-affected to continue with exercise programs, healthy dietary intake and self-sufficient activities of daily living as much as practicable. Therefore, understanding the underlying symptoms through critical reflection is important for the health service providers to address the situation satisfactorily and has been categorically stated in the clinical practice guidelines for elderly dementia patients (Dyer et al. 2016). Apart from the healthcare workers, the family members who remain in close association with the patient might also encounter challenges to comprehend the immediate situation that indicate the behavioral underpinning linked to dementia. The healthcare prioritization of dementia like condition have garnered considerable attention in recent circumstances that further necessitated the need to incorporate all the elements surrounding dementia care to harbor positive outcomes. Emphasis has been attached to consider revision of care givers needs in liaison with the cultural values for reducing the subjective burden associated with dementia. The caregiver support mechanisms has been suggested to rest in conformity with the allied concepts of dementia care for prudent intervention regarding the matter. The ability to listen, respond and construe depending on the patients situation has been identified particularly important (Xiao et al. 2014). Better communication and comprehension of the non-verbal behavioral responses is likely to ensure the smooth implementation of the therapeutic interventions aimed to ameliorate the symptoms of the dementia patient. Non-verbal communication has been recognized as the most suitable therapeutic target through psychological intervention models within the delivery care framework. Specifically dementia and Alzheimers disease has been reportedly lead to the generation of improved outcomes through utilization of various technological resources so that communication between people wi th dementia and their caregivers presents significant transformation (Chenery et al. 2016). The inability to voice their feelings or express with the help of words should not stand on the way of offering appropriate health service to the patient, instead behavioral responses and facial expressions must be taken into consideration while assessing the dementia condition for the concerned affected person. The changing behavioral pattern in course of progressive stages of dementia need to be kept into account by the attending healthcare professionals to deal with the ensuing situation perfectly. Study findings suggest that increased education in addition to support for families circumscribing issues pertinent to end-of-life care decisions is fruitful for advanced dementia. In case, the patients do not have the capacity to take decisions about treatment modalities in end of life, the same must be entrusted upon the near ones of the patient comprising of family members preferably. The nec essary decisions on patients behalf will be taken by that concerned individual, which is to be clearly defined in statements surrounding advanced care planning where explanations for choices in end-of-life care will be documented (Reinhardt et al. 2014). Pain management There has been speculation regarding the use of analgesic medications in case of the dementia-affected individuals that has largely accounted for the reduced use of pain reliving medicines in case of such patients. Improper and decreased pain management is thus noticed. Effective treatment faces barriers in absence of successful communication of pain for severe dementia. Systematic study of facial expressions has brought to the forefront distinguished characteristics specific to the perception of pain that hold potential for future implication to alleviate dementia symptoms through proper therapeutic administration. The reliable indicators of pain has been found to be confounded by factors such as contextual variables, observers bias in addition to overall state of the individuals health and wellbeing. Thus, the susceptibility to pain by the elderly individuals is likely to be resolved by allaying the possibilities of under-recognition, under-treatment and under-estimation (Hadjistav ropoulos et al. 2014). Issues like that of grimacing pain because of progressive illness that cause significant decline of their health status compound dementia patients approaching end of life. The healthcare assistants recruited at the aged care facilities spend a bulk proportion of time with the ailing patients as opposed to other healthcare personnel thereby acting as the frontline healthcare workforce responsible for offering accurate healthcare service to the dementia patients. They conduct the operations related to identification of pain in the dementia-affected persons and reporting to the immediate authority for prompt medical intervention. Literature has supported the up skilling of this group of healthcare team members and reversal of the stigma attached to the role to render safe and quality dementia care for the concerned persons (Jansen et al. 2017). Targeted pain management services through incorporation of relevant pain assessment tools has been highlighted in furthe r study to allow better understanding in relation to the prescribing practices within the aged care facilities thereby accounting for improved quality of life for those affected persons (Tan et al. 2014). Healthcare staff and informal caregivers who remain in close proximity with the dementia afflicted patients in the aged care facilities exhibit attitudinal and knowledge barriers in assessment of pain that threaten the status of those persons because of exerting significant influence over practice behaviour. Thus, discernible attention and prudent intervention with respect to pain management through knowledge and other skills acquisition is desirable to elicit positive responses through better pain handling in the dementia patients during their end-of-life care (Chandler et al. 2017). Critically analyses Management of dementia in aged care facilities calls for greater insight, prudence and pragmatism through utilization of suitable multidimensional composite healthcare interventions that are capable of eliciting positive results on application. A team comprising of interdisciplinary healthcare members may undertake measures that properly address the needs of the dementia patients so that quality of life of both patient as well as caregiver may be improved. Prognosis, management and advanced care planning for the dementia patients are likely to culminate in generating holistic outcomes that will cause emancipation of the individuals health in addition to assessing their palliative care needs (Brody 2016). Delivery of effective dementia care planning has been found to be thwarted due to poor symptom assessment alongside possible inappropriate prescription of antipsychotic medication that may be further attributed to the lacunae in understanding and knowledge in managing dementia patien ts by the healthcare workers during their clinical intervention (OShea et al. 2015). Deeper probe into matters relevant to the dementia patients have referred to both the under-treatment and under-recognition of pain among the elderly dementia patients. The deficits in nursing knowledge and attitudes owing to the complexity and individualization with respect to pain behaviors have been held responsible for such implications. However, a standardized approach to pain management in conjunction with workforce stability and accessibility of proper training for the nurses might lead to successful management of pain in case of dementia patients (McIlfatrick 2015). Further, critical appraisal of dementia patient condition has talked about implementation of a facilitated approach to better equip with relevant resources essential to deal with older patients suffering from dementia. A collaborative nursing home culture supported by activities and ongoing associations for the healthcare workers is desirable to ensure safe and quality healthcare facility for dementia affected, palliative care patients (Luckett et al. 2017). Recommendation Positive healthcare outcomes specific to the elderly dementia patients may be represented through access to palliative healthcare services in residential aged care settings where the nurses and other healthcare staff make endeavors to render all round support for managing their condition. Information available in the context of Australia suggest that the escalating numbers of dementia diagnosed patients require extensive care in the form of palliative care services as accessible in the aged care facilities to ameliorate their declining health status symptoms (Aihw.gov.au, 2017). Empirical evidences have argued in favor of improvising and implementing appropriate interventions for the sake of addressing the end-of-life care services specific to the dementia patients that aim to harp on matters related to the challenges in course of the illness and trajectory. In conjunction with the interactive responses, the non-verbal communication has been considered crucial to better manage the co ndition besides being heed to the sufferings of the caregivers who remain in close association with the patients (Rexach2012). Apart from the traditional modalities of dementia management, it has been increasingly emphasized to recover the knowledge deficits and apply relevant learning, desirable skills regarding palliative care management of dementia patients among the healthcare workers and families of patients surviving with dementia that may be enhanced through evidence based practice. Palliative care has been identified as a potential way of managing dementia to live up to the heightened demands of optimal care for dementia afflicted (Robinson et al. 2014). Further, recommendations have highlighted on maintaining the ethical and legal standards of practice in nursing for safeguarding the choices, autonomy and dignity of the patients by means of providing insight pertaining to advanced care planning (ACP) that in turn may be facilitated through arranging training sessions for th e concerned healthcare professionals in charge of dementia affected patients (Health.gov.au, 2017). Conclusion Critical evaluation of the condition prevalent among the dementia patients receiving end of life care has brought to the forefront the barriers to management of such individuals within the residential setting framework of palliative care unit. Until date no cure for dementia has been discovered, however alleviation of the symptoms associated with the disorder has been found to be effective in tackling the situation specific to the patient. Therefore, it must be ensured so that they get access to specialized palliative care health services at par with others suffering from terminal illness. Accurate assessment and interpretation of the patient situation carried out by the nurses and other healthcare personnel is crucial to treat them holistically by catering to their individualized needs. Pragmatic observation of both the verbal as well as nom-verbal communication is beneficial in this respect where the nurses may satisfactorily acknowledge the distinctive scenario. Further, the pain management regime needs to be well monitored and comprehensive to prevent adverse outcomes and ensure better quality of life for the dementia affected old. 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