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.
- 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.
- Cite your references in proper APA Style.
- Review the rubric for more information on how your assignment will be graded.
- Submit as an attachment to the assignment area.
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
Reichlin, M. (2014). On the ethics of withholding and withdrawing medical treatment. Multidisciplinary Respiratory Medicine, 9, 39. Retrieved from
Expert Solution Preview
Introduction: In this scenario, E. L. is an 88-year-old widow with advanced dementia who has stopped eating all meals except for small banana slices. Her daughter, who is also her power of attorney for health affairs, is seeking guidance on artificial nutrition and hydration. As a healthcare professional, it is essential to provide best practices while speaking with E. L.’s daughter regarding her mother’s end-of-life care. The following are five discussion points to consider, guided by the assigned readings and proper APA style references.
1) Discuss and assess E. L.’s current physical and mental status to determine the appropriate course of action. Consider the patient’s history, current health issues, advance directives, and family input.
2) Educate E. L.’s daughter on the benefits and risks of artificial hydration and nutrition. Explore alternative options, such as comfort measures or hospice care.
3) Respect the patient’s autonomy and involve the patient and family in decision-making. Establish a rapport and communicate transparently about the end-of-life care plan.
4) Provide support to the family emotionally and spiritually. Address their fears and anxieties and connect them with appropriate resources such as support groups and chaplaincy.
5) Be aware of the legal and ethical implications of withholding or withdrawing medical treatment. Involve a multidisciplinary team, such as a palliative care team or ethics committee, to review the circumstances and make appropriate recommendations.
References:
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
Reichlin, M. (2014). On the ethics of withholding and withdrawing medical treatment. Multidisciplinary Respiratory Medicine, 9, 39. Retrieved from
