E. L. is an 88-year-old widow who has advanced dementia. She is a retired secretary and is cared for in the home of her divorced daughter, who is her power of attorney for health affairs. E. L. requires assistance with all activities of daily living. She spends most of the day sitting in her orthopedic recliner (she has had bilateral hip replacements) or lying-in bed. She does not speak or acknowledge the presence of others. Recently, E. L. has stopped eating all meals except for small banana slices. She resists a spoon when it is brought to her mouth, and she pockets food in her cheeks without swallowing. E. L. was admitted to the hospital several months ago for influenza and bilateral pneumonia. She was treated in the intensive care unit for three days and then sent home. The possibility of a feeding tube insertion was discussed during her hospitalization. E. L.’s daughter is seeking guidance on artificial nutrition and hydration.
Assignment
Use the assigned readings to guide you in the development of five discussion points
Discussions points should reflect best practices that you will include as you speak with E. L.’s daughter regarding her mother’s end-of-life care.
Reference:
American Association of Colleges of Nursing. (2017). CARES: Competencies and recommendations for educating undergraduate nursing students. Preparing nurses to care for the seriously ill and their families. Retrieved from
CPH and Associates. (2015). Who can give informed consent and what is the nurse’s role in obtaining consent for treatment? Retrieved from
Fitch, M. I., Fliedner, M. C., & O’Connor, M. (2015). Nursing perspectives on palliative care 2015. Annals of Palliative Medicine, 4(3). Retrieved from
Hackethal, V. (2015). End-of-life care: 40 years of incremental progress. Medscape. Retrieved from
Hebert, K., Moore, H., & Rooney, J. (2011). The nurse advocate in end-of-life care. Ochsner Journal, 11(4), 325–329. Retrieved from
Miller, B.J.(2015). What really matters at the end of life [Video File]. Retrieved from
Mirarchi, F. L. (2016). Interpreting end-of-life documents. Medscape. Retrieved from M. (2014). On the ethics of withholding and withdrawing medical treatment. Multidisciplinary Respiratory Medicine, 9, 39. Retrieved from