Lewis Kellie
University of Portland, Oregon, United States.
Nurs Older People. 2013 Oct;25(8):22-6. doi: 10.7748/nop2013.10.25.8.22.e479.
Moving from curative to palliative care is often difficult for patients, families and healthcare providers, because hospice or end of life care can be seen as a failure of healthcare teams or as patients having given up. Nurses' role in this transition is to provide care, educate and advocate for patients, and encourage reflection on the implications of end of life. Providers face challenges in identifying when end of life begins, impaired communication in healthcare teams and feelings of guilt. Patients and families must come to terms with the idea of death while maintaining dignity. Ensuring older patients are included in discussions can improve their quality of life and sense of dignity. Nurses can help by enabling conversations about the end of life to take place early on, improving communication between staff, and encouraging reflection by healthcare providers.
对患者、家属和医护人员来说，从治愈性护理转向姑息治疗往往很困难，因为临终关怀或生命末期护理可能被视为医疗团队的失败或患者放弃了治疗。护士在这一转变过程中的作用是为患者提供护理、教育并为其代言，同时鼓励对生命末期的影响进行反思。医护人员在确定生命何时结束、医疗团队沟通不畅以及内疚感等方面面临挑战。患者和家属必须在保持尊严的同时接受死亡的观念。确保老年患者参与讨论可以提高他们的生活质量和尊严感。护士可以通过促使尽早开展关于生命末期的对话、改善医护人员之间的沟通以及鼓励医护人员进行反思来提供帮助。
