Dying in a Hospital Setting
Acute hospitals play a significant role in end of life care, it is the place where most people die. Evidence suggests that end of life care in hospitals needs improvement. The purpose of this paper was to investigate patient and family experiences of hospital death, the weaknesses within the hospital setting and possible solutions to improve. A literature search identified common themes, these included:
* Hospitals are seen as a place of treatment and cure; death may be viewed as a failure.
* Good communication between physician and patient is vital for a patient to make an informed choice ...view middle of the document...
Search terms were undefined; however, the author focused on patient and family experiences at the end of life. The aim was to highlight challenges and possible solutions to improve patient care. Eight articles were evaluated; some were studies about end of life care. Research suggests that end of life care in hospital is inadequate and of poor quality (Al-Qurainy, Collis, & Feuer, 2009). The definition of ‘good death’ is discussed in many articles. Costello, (2006) states that open communication, relief of symptoms, dignity, respect and acceptance of death all help to achieve a peaceful death. After reviewing the information, common themes were identified.
Death has become Medicalized
Death is not always seen as part of a natural life cycle. Physicians can be preoccupied with active treatment. In the literature search, Al-Qurainy et al. (2009) found that hospitals were seen as a place of hope, not death. The hospital focus is on a cure; death is often viewed as a failure. American culture does not prepare people for the end of life (Paulus, 2008). Physicians can fail to recognize when continuing invasive treatments are not in a patient’s best interests (Gott et al., 2009). Society expects physicians to do all they can to prolong life; they are legally required to do that. Whoriskey, (2014) discusses a need to change the system of healthcare in the United States, stating that Medicare and Medicaid encourage providers to render more services.
Effective communication between patients, families and healthcare professionals gives patients autonomy and helps them to be involved in their plan of care. Studies show that dying people want to know what is happening to them so that they can prepare for death (Gibbins, McCoubrie, Alexander, Kinzel, & Forbes, 2009). In a study that involved in-depth interviews with family members of patients that had died, they found that patients and their families felt that information given to them was vague and unclear. Families wanted truthful disclosure about the prognosis of a loved one and detailed explanations from healthcare providers (Dose et al., 2015). A Literature review concluded that communication at the end of life was poor, that patients were not informed about their prognosis, insufficient explanations were given to patients and their families and that busy staff were unavailable. (Robinson, Gott, Ingleton,2014). Doctors are sometimes over optimistic in diagnosing end of life which does not give patients and their families adequate time to prepare for death (Al-Qurainy, Collis, & Feuer, 2009).
Diagnosing too Late
Paulus, (2008) discusses in her thesis that patients with chronic diseases need symptom control and pain management but are often referred to palliative care services too late and do not receive the care and support they need. Late decision making reduces patient autonomy; patients may become too unwell to...