So as to understand various aspects of palliative, the primary goal of the same which entails preventing and relieving of suffering as well as supporting the possible quality of patients and their families’ life that is best for them regardless of the disease’s stage or need for different therapies needs to be taken to consideration. The care is both a system that is highly organized to deliver care as well as a care philosophy. It expands the disease-model treatments used as traditional remedies to include the objectives of enhancing life quality for the patient and his/her family. It also helps in optimization, helping in decision making process as well as provision of personal growth opportunities. This makes it possible to deliver palliative care concurrently with care that prolongs life as the main focus (Sulmasy et al, 2008).
Psychological Aspects of Care
Pertaining to this aspect of palliative care which also touches on Psychiatry, assessment and management is done on the basis of the evidence that sis best available, that which is applied systematically and skilfully. Still on this domain the criteria to be followed has to entail support and promotion of care continuity across the entire setting and throughout the illness trajectory. It is a routine to inform patients and families about and refer them to hospice and other health care resources that are community based. Policies that enable sharing of information that is timely and effective are also implemented. Where possible, programs for hospice and palliative care staff frequently participate in meeting held by each other team so as to promote professional communication that is regular. Collaboration and a care plan that is integrated on behalf of families and patients are in palliative care.
Social Aspects of Care
Under this domain, interdisciplinary evaluation that is comprehensive helps in identification of patient’s social needs as well as their families’, and then follows a care plan which responds to these needs at the most possible degree of effectiveness. In the criteria for this, the essentiality of their being skilled practitioners while assessing and managing children’s developmental needs is availed for paediatric patients and the adult patients’ children, as supposed to. Formulation of the social care plan is done from a cultural and social assessment that is comprehensive and re-evaluation and reflection and goals, values and preferences of the documents is set by the patient and the family over time (Rydvall & Lynoe, 2008).
Spiritual Aspects of Care
Under this domain, dimensions on spirits and existence are evaluated and responded to on the basis of the best available evidence which is applied systematically and skilfully. Over time, re-evaluation of the impact of interventions that are spiritual or existential as well as preferences for patient-family occurs with the necessary regularity, and then follows documentation. Care needs, concerns and goals that re spiritual or existential are addressed, then documented and support given for life completion issues in a way that is consistent with the religious and cultural values of the individual and family as well. When appropriate, referrals to professionals who have specialized skills and knowledge in existential and spiritual issues are availed.
Cultural Aspects of Care
Under this domain, the program evaluates and tries to meet the patient, family and community’s needs in a manner that sis culturally sensitive. Concerns and background of the patient’s culture and his/her need and that of the family are documented after being elicited. All forms of communication with patient and family are done in a respectful manner to their cultural preferences, with regards to disclosure, decision making and truth telling. Identification of cultural needs is then done by the team providing palliative care and the family which are addressed in the care plan of the interdisciplinary team (Preston & Kelly, 2006).
Ethical and Legal Aspects of Care
Under this domain, preferences, goals and choices of the patient are given due respect within the applicable federal and state law limits, within accepted standards currently in the medical care field, which forms the basis of the care plan. Incase patients are not in a position to communicate, the palliative program of care tries to identify directives for health care in advance, evidence of wishes expressed previously, preferences, values and the surrogate decision makes that are appropriate. They are then assisted on ethical and legal basis for surrogate decision making, up to and including patients’ honour referred to as substituted judgement, preferences and criteria for best interest.
In my opinion, so as to apply the core values of community respect and integrity one needs to understand the different aspects in operations of pain’s effective management and other symptoms of distressing while at the same time incorporate spiritual and psychological care, considering the needs of both the patient and the family. Other aspects to look at include values, preferences, culture and beliefs. Patient evaluation and treatment needs to be patient-centred and comprehensive with a focus on the family central role in decision making as is the simplest unit of the community. So as to ensure respect and integrity, a medical practitioner needs to support the patient and his family’s goals future goals, which include their cure hopes or prolongation of life as well as their hope for dignity and peace throughout the illness course, the process of death up to death itself. Palliative care requires a practitioner to provide adequate assessment and treatment of the needs that are complex for ill patients as well as their families. To achieve respect and high levels of integrity in the community, aspect of collaboration, leadership, communication and coordination have to be incorporated (Preston & Kelly, 2006).
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Sulmasy D.P, et al,(2008).Beliefs and attitudes of nurses and physicians about do not resuscitate ordersand who should speak to patients and families about them. Crit Care Med. Print.
Rydvall A.,& Lynoe N.(2008).Withholding and withdrawing life-sustaining treatment: a comparative study of the ethical reasoning of physicians and the general public. Crit Care. Print.
Preston T., &Kelly M.,A.(2006).Medical ethics assessment of the case of Terri Schiavo.Death Stud.Print.