Category: Ethics

Articles about end-of-life ethical issues including ethical dilemmas

Doctors Ignoring Family Concerns in Dementia Care

Welcome to our discussion on a topic close to many hearts: the care of our loved ones with dementia. When a family member is diagnosed with dementia, it feels like a part of them slowly fades away. But as they lose parts of themselves, your role in their life becomes even more crucial. This article isn’t just words on a page; it’s a beacon of hope and understanding, shining a light on why your voice, as a family member, is vital in the care of your loved one.
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Hospice Access for Undocumented Immigrants

Welcome to our guide on hospice care for undocumented immigrants. This article is crafted with the utmost empathy to support family members and caregivers as they navigate the complexities of end-of-life care. Our goal is to provide a clear understanding of hospice services and the unique challenges faced by undocumented immigrants during these tender moments.
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Advocating for your loved one on Hospice Services

Take Charge
When someone you love is extremely sick and needs hospice care, you may feel scared, sad, or angry. You may not know what to do or how to help them. You are not alone. Many people go through this challenging time. As a hospice nurse, I have met many families who have loved ones in hospice. Some of them are continually active and involved in their care. They ask questions, make decisions, and speak up for their needs. Others are more passive and trusting. They let the doctors, nurses, and staff do whatever they think is best. They don’t say much or ask for anything. Who do you think gets better care for their loved ones? The active ones or the passive ones?
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Optimizing Hospice Respite Care: A Comprehensive Guide for Families

hospice four levels of care
Caring for a loved one who has a terminal illness can be extremely rewarding, but also particularly challenging. You may feel exhausted, overwhelmed, or isolated by the demands of caregiving. You may also feel guilty or anxious about taking a break from your loved one. But you deserve some time to rest, recharge, and take care of yourself. That is why hospice respite care can be a great option for you and your loved one. Hospice respite care is a service that allows you to temporarily place your loved one in a facility, such as a hospital, nursing home, or hospice house, where they can receive professional care and support. You can use this time to do whatever you need or want to do, such as sleeping, working, running errands, visiting friends, or enjoying a hobby. Respite care can last up to five days at a time.
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Supporting a Loved One’s Decision to Voluntarily Stop Eating and Drinking in Hospice Care

vsed and the body response
When a terminally ill loved one expresses a desire to voluntarily stop eating and drinking (VSED), it can be a challenging and emotional situation for families. Understanding their wishes, providing support, and ensuring a comfortable end-of-life journey are essential considerations. In this article, we will explore how families can support their loved ones' decision, help, and alleviate suffering during this grim time.
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To Wake or Not to Wake: A Dilemma for Caregivers of Dementia Patients in the Final Stage

Daughter Feeding Her Mother Via A Straw
Dementia is a challenging disease that affects thinking, memory, and daily activities. In the final stage where the patient can no longer support their head, caregivers face a crucial decision: whether to wake the terminally ill dementia patient for feeding or let them sleep, periodically checking for alertness. This article explores the ethical dilemma surrounding this decision, providing insights into the pros and cons of both choices.
Read MoreTo Wake or Not to Wake: A Dilemma for Caregivers of Dementia Patients in the Final Stage

Statins Increase the Risk of Dementia or Worsening Dementia

Atorvastatin
Pharmaceutical advertisements often highlight the benefits of a particular drug, including its ability to reduce the risk of various health conditions. However, the actual risk reduction provided by these drugs may be different from what is portrayed in the advertisements. It is the opinion of the author that if cardiologists and other providers told their patients the absolute risk reduction of statins is 0.8% for all-cause mortality, 1.3% for myocardial infarction and 0.4% for stroke and the side effects of going on a statin include dementia, worsening dementia, confusion, muscle problems, such as aches, pains, weakness, muscle breakdown, falls, nausea, constipation, diarrhea, and increase the risk of type 2 diabetes, would you or anyone else ever agree to take a statin?
Read MoreStatins Increase the Risk of Dementia or Worsening Dementia

Failure to Decline in Hospice – The Good and The Ugly

Live Discharge Flow Chart
If your loved one is facing a discharge from hospice due to failure to decline, it's crucial to comprehend the situation clearly. This discharge indicates that the healthcare team believes your loved one's condition has stabilized and no longer requires hospice care. While this might be a positive sign, it's important to weigh the pros and cons before making decisions. Let's delve into both the positive and negative aspects of this situation to help you navigate it effectively.
Read MoreFailure to Decline in Hospice – The Good and The Ugly

Advocating for Your Terminally Ill Loved One in a Facility

distressed woman
As a family member of a terminally ill loved one receiving care in a facility, you play a vital role in ensuring they receive the best possible care and support during their journey towards a good death. Advocating for your loved one involves understanding their needs, communicating effectively with the facility staff, and staying informed about their care plan. This article aims to provide you with guidance on how to be an effective advocate, asking the right questions, and ensuring your loved one's comfort and well-being.
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Eye-Opening Lessons on Trusting Nursing Facilities: Advocating for Comfort in End-of-Life Care

Empty Hospital Bed At A Nursing Facility
As an experienced hospice visiting registered nurse, today offered me profound insights from two interconnected perspectives. The first highlights the blind trust we often place in facility nurses and doctors when caring for our loved ones. The second involves the challenges I encountered while advocating for proper end-of-life care for a patient with Alzheimer's.
Read MoreEye-Opening Lessons on Trusting Nursing Facilities: Advocating for Comfort in End-of-Life Care

Two days…. until…

tairway_to_heaven_Jacobs_ladder
There is a spiritual connection in hospice dealing with death and dying forty plus hours per week. We who are in the field see it often, but there are times we hear it strongly from the patients and families whom we serve. Let me share with you the most recent event that took place during Memorial Day, 5/29/2023, week.
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Ethical Dilemmas in Hospice

I have seen many ethical dilemmas arise in end-of-life situations over my time as a hospice RN case manager. Hospice care is unique in that it focuses on providing comfort care to patients who are no longer seeking curative treatment for their illness. As a result, the ethical concerns that arise in hospice care are different from those in other healthcare settings. In this article, we will explore some of the ethical dilemmas that can arise in hospice care and how they can be addressed. Before I go over several case studies gathered from the sources in the resource section below, please allow me to share a current one of mine that is ongoing as this article is being published.
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The Dark Side of Physical Therapy for Geriatric Patients with Dementia

As a seasoned hospice nurse, I have witnessed the advantages of physical therapy for patients grappling with diverse medical conditions. Nevertheless, when it concerns geriatric patients with dementia in the terminal stage, physical therapy can at times yield adverse effects. In this discussion, we'll explore five key reasons why physical therapy might not be the optimal choice in such cases.
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Faith stories — yes, faith can be a part of nursing life

Faith and religion in the workplace; yes, faith has a place in work and when utilized to direct how you work and interact with your patients and families can result in a blessing that does not disrespect others. This article came to be in part as a response to one of my favorite YouTube nursing channels where Nurse Katherine provides educational videos for new as well as experienced nurses. Her most recent episode at https://www.youtube.com/watch?v=N_lE9O1I3LQ asks the valid question relating to the place of “Religion, Beliefs, and the practice of Medicine | should & can they be combined?”
Read MoreFaith stories — yes, faith can be a part of nursing life

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