Das Lebensende zwischen Ökonomie und Ethik

2019 ◽  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Quality Care ◽  
Death And Dying ◽  
Technological Advancement ◽  
Life Care ◽  
Instrumental Reason ◽  
High Quality ◽  
High Quality Care ◽  
Entrepreneurial Spirit

Healthcare at an advanced age and at the end of one’s life is increasingly characterised by an entrepreneurial spirit, which in turn is guided by economic principles. It remains questionable whether organising the end of one’s life based on efficiency criteria leaves sufficient room for personal encounters and individualism. As indisputable as the significance of high-quality care is, especially at the end of someone’s life, the constant progression of technological advancement and economisation in dealing with death and dying is nevertheless endangered by the dominance of ‘instrumental reason’, which often leaves little room for holistic and individual approaches. The contributions to this volume explore ethical and existential realities at the end of a life and economic rationalities in providing end-of-life care. With contributions by Stefan Dinges, Angelika Feichtner, Gerald Gredinger, Olivia Kada, Franz Küberl, Christian Lagger, Claudia Lohr, Sylvia Reitter-Pfoertner, Corinna Schmohl, Patrick Schuchter, Willibald J. Stronegger, Christine Trischak Preface: Willibald J. Stronegger und Kristin Attems

scholarly journals Improving End-of-Life Care for Diverse Populations: Communication, Competency, and System Supports

2019 ◽  
Vol 36 (6) ◽  
pp. 453-459 ◽  
Author(s):  
Sara G. McCleskey ◽  
Cindy L. Cain
Keyword(s):  
African American ◽  
End Of Life ◽  
End Of Life Care ◽  
Quality Care ◽  
Life Care ◽  
High Quality ◽  
High Quality Care ◽  
Provider Characteristics ◽  
Care Groups ◽  
Effective Care

Background: While disparities in end-of-life care have been well-documented, explanations for the persistence of disparities are less clear. This study sought to examine diverse perceptions of end-of-life care, especially regarding how medical professionals can better serve all populations. Objective: To investigate similarities and differences in end-of-life care preferences, across racial and ethnic groups. Design: This work consists of a qualitative study utilizing in-depth focus group discussions. Setting/Participants: Six community-based focus groups were conducted with a total of 39 participants. Two groups were composed of African American participants, 2 had Latino participants, and 2 groups had white participants. Results: Analysis produced 3 major themes: (1) clear, comprehensive, and culturally relevant provider–patient communication regarding serious illness; (2) provider characteristics and competency; and (3) health system supports and barriers. Although all groups had individuals who expressed a strong preference for direct communication, individuals varied within groups. All groups discussed concerns that the costs of care are high and that financial considerations are given more importance than high-quality care. Groups diverged in their focus on provider characteristics and feelings of marginalization. African American and Latino groups emphasized a desire to match characteristics with providers, and African American groups discussed that their marginalization in the health-care system requires hypervigilance to receive high-quality care. Conclusions: Improvements in care would come from acknowledging diversity within groups, provider demonstration of comfort and competence, more effective care coordination, and recruitment of providers who share similar characteristics with the communities they serve.

Experiences of a Group of Senior Nursing Students with End of Life Care and Death in Turkey

2020 ◽  
pp. 003022282096123
Author(s):  
Deniz Sanli ◽  
Fatma Iltus
Keyword(s):  
Nursing Students ◽  
End Of Life ◽  
End Of Life Care ◽  
Quality Care ◽  
Death And Dying ◽  
Life Care ◽  
Death Attitudes ◽  
Positive Attitudes ◽  
Dying Patients ◽  
And Behaviors

Nursing students may feel unprepared to manage the care of dying individuals and may experience anxiety and fear related to death and dying. Preparing nursing students for this situation can help them provide quality care to dying patients. This study aimed to examine the end-of-life care values and behaviors and death attitudes of senior nursing students. In examining these variables, the Values and Behaviors of Intensive Care Nurses for End-of-Life Instrument and the Death Attitude Profile-Revised Scale were used. It was found that the students developed positive attitudes and behavior towards end-of-life care, and that they believed death to be a natural part of life and there is life after death. Students who felt that the information they received during their education was partially sufficient were more likely to have negative death attitudes. It can be recommended that teaching strategies in the education of the nursing students be developed.

scholarly journals An Integrated Literature Review of Death Education in Pre-Registration Nursing Curricula: Key Themes

2014 ◽  
Vol 2014 ◽  
pp. 1-19 ◽  
Author(s):  
Joyce Cavaye ◽  
Jacqueline H. Watts
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Quality Care ◽  
Death And Dying ◽  
Bibliographic Databases ◽  
Life Care ◽  
Death Education ◽  
Organisation Of Care ◽  
Nursing Curricula ◽  
Dying Patients

Recent policy has raised the profile of end-of-life care internationally, with the aim of increasing access to quality care for everyone experiencing life-limiting illness. This reflects an international shift in the provision of palliative care to encompass chronic conditions other than cancer. Nurses have an important role in delivering this care and need to be equipped with particular knowledge and skills. However, pre-registration nursing curricula have traditionally had a limited emphasis on death and dying and nurses report feeling unprepared to care for dying patients. This has led to claims that death education in pre-registration curricula is inadequate. This integrated review explores the published literature that reports on death education within pre-registration nurse education. Presenting an international overview, the aim of the review is to contribute to knowledge about the nature and extent of death education in pre-registration curricula. In the context of this paper, death education encompasses both palliative and end-of-life care. Electronic searches of major bibliographic databases found inconsistencies across educational provision with variations in quantity, content, and approach. Despite an increasing amount of death education in pre-registration curricula, there remains a deficit in key areas such as knowledge, skills, organisation of care, and teamwork.

Managing ICU staff welfare, morale, and burnout

2016 ◽  
Author(s):  
Gavin G. Lavery ◽  
Linda-Jayne Mottram
Keyword(s):  
Critical Care ◽  
Adverse Events ◽  
End Of Life ◽  
End Of Life Care ◽  
Quality Care ◽  
Scientific Basis ◽  
Care Staff ◽  
Life Care ◽  
High Quality ◽  
Degree Of Control

Low morale, stress, and burnout are significant and under-recognized in critical care staff. The link between these conditions is complex and not fully only understood with burnout as a potential end result. Conflict and lack of clear protocols regarding end-of-life care appear to be particularly prone to generate stress and potentially burnout. We have little scientific basis to design interventions, but expert opinion suggests multiple approaches at individual, departmental, and organizational levels. Many are based on giving workers a degree of control and flexibility where possible, and a feeling that their contribution is valuable and valued. Engagement (with an organization and its aims) is now viewed as the antithesis of burnout and only staff who are engaged can deliver high quality care. It is increasingly recognized that organizations that actively manage staff welfare are more likely to provide care that is safe, effective, and patient-centred, and less likely to error and adverse events.

scholarly journals Conversations About Death and Dying, End-of-Life Care Plans and Preferences Between Aging Parents and Adult Children

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 417-417
Author(s):  
Hyo Jung Lee ◽  
Jacobbina Jin Wen Ng
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Adult Children ◽  
End Of Life Care ◽  
Death And Dying ◽  
Family Members ◽  
Life Care ◽  
Joint Decision ◽  
Aging Parents ◽  
Care Plans

Abstract This study aims to investigate whether attitude and perception on late-life death and dying, end-of-life care plans and preferences could be better understood from current values shared between aging parents and their adult children in the multi-cultural city-bound country, Singapore. We are in the process of interviewing 20 aging parent-adult child dyads. Up to date, six semi-structured interviews were completed and transcribed. We performed Content analysis to analyze the transcripts. Preliminary findings showed that both aging parents and adult children rarely discussed this issue, although parents had their own plans or preferences. The major barriers against open conversations about death and dying of aging parents include: the perception of not-yet time to talk about this issue (without knowing when the right time is) and tendency to have conversations about death in tandem with finances, but not death itself. Although specific end-of-life care plans or arrangements were not thought out thoroughly, aging parents expressed a high level of trust and reliance on close family members’ decisions regarding their end-of-life care. They tended to agree on joint decision-making process within family, even though adult children had no or unmatched ideas about their aging parents’ end-of-life wishes. This did not necessarily align with previous findings in Western countries, underscoring individuals’ control over their own death and dying process. Open conversation within family, family-involved advance care planning, or joint decision-making processes may be warranted to promote quality of life and death in older Singaporeans and well-being of their family members of all ages.

scholarly journals Before the 2020 Pandemic: an observational study exploring public knowledge, attitudes, plans, and preferences towards death and end of life care in Wales

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ishrat Islam ◽  
Annmarie Nelson ◽  
Mirella Longo ◽  
Anthony Byrne
Keyword(s):  
Social Media ◽  
End Of Life ◽  
Health Professionals ◽  
End Of Life Care ◽  
Public Attitudes ◽  
Death And Dying ◽  
Service Utilisation ◽  
Life Care ◽  
Manner Of Death ◽  
Attitudes Towards Death

Abstract Background Understanding public attitudes towards death and dying is important to inform public policies around End of Life Care (EoLC). We studied the public attitudes towards death and dying in Wales. Methods An online survey was conducted in 2018. Social media and the HealthWiseWales platform were used to recruit participants. Data were analysed using descriptive statistics and thematic analysis. Results 2,210 people participated. Loss of independence (84%), manner of death, and leaving their beloved behind were the biggest fears around death and dying. In terms of EoLC, participants sought timely access to care (84%) and being surrounded by loved ones (62%). Being at home was less of a priority (24%). Only 50% were familiar with Advance Care Planning (ACP). A lack of standard procedures as well as of support for the execution of plans and the ability to revisit those plans hindered uptake. The taboo around death conversations, the lack of opportunities and skills to initiate discussion, and personal fear and discomfort inhibited talking about death and dying. 72% felt that we do not talk enough about death and dying and advocated normalising talking by demystifying death with a positive approach. Health professionals could initiate and support this conversation, but this depended on communication skills and manageable workload pressure. Participants encouraged a public health approach and endorsed the use of: a) social media and other public platforms, b) formal education, c) formal and legal actions, and d) signposting and access to information. Conclusions People are ready to talk about death and dying and COVID-19 has increased awareness. A combination of top-down and bottom-up initiatives across levels and settings can increase awareness, knowledge, and service-utilisation-drivers to support health professionals and people towards shared decisions which align with people’s end of life wishes and preferences.

“Is there no Balm in Gilead?”: Health, Illness, Death, and Dying in the Hebrew Bible and Today

2021 ◽  
Vol 75 (3) ◽  
pp. 196-206
Author(s):  
Joel S. Kaminsky
Keyword(s):  
End Of Life ◽  
Hebrew Bible ◽  
End Of Life Care ◽  
Death And Dying ◽  
Life Care ◽  
The U.S ◽  
Conceptual Resources

This essay argues that the Hebrew Bible contains conceptual resources that can contribute to and enrich the ongoing discussions surrounding healthcare in the U.S. and in other modern Western societies. These biblical ideas may help us reframe our understandings of sickness and health, something urgently needed if we wish individuals and their families to have less medically invasive and less alienating experiences of illness, most especially during end of life care.

scholarly journals Are Transfusions a Barrier to High-Quality End-of-Life Care in Hematology?

2018 ◽  
Vol 15 (4) ◽  
Author(s):  
Mark R. Litzow ◽  
Thomas W. LeBlanc
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
High Quality

Managing End-of-Life Care

2012 ◽  
Author(s):  
John W. Albarran ◽  
Marika Hills
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Care Delivery ◽  
Symptom Relief ◽  
Death And Dying ◽  
Past Century ◽  
Life Care ◽  
Care Needs ◽  
Definition Of ◽  
The Uk

This chapter addresses the fundamental nursing role of managing end-of-life care. Death is as fundamental a part of life as living, and while caring for a dying patient and their family is demanding, complex, and emotionally exhausting, it can also be a gratifying and privileged experience for nurses. Specifically, nurses have a centre-stage role in leading and informing care delivery at the end of life. Care will typically embrace assessing the needs of the patient and family, providing symptom relief and comfort care, and providing cultural and spiritual support. Additionally, caring functions should also extend following death to caring for the deceased in a dignified manner and supporting the newly bereaved, demonstrating genuine concern, compassion, and effective communication skills (Hills and Albarran, 2010a; Maben et al., 2010). To examine the key themes and challenges of practice, it is important to understand the political, professional and societal influences, and contextual nature of death and dying in the UK. At present, there is neither a clear nor universally accepted definition of end-of-life care, but it is generally understood to be the care of a person who is identified as having failing health and who is in a progressive state of decline (Shipman et al., 2008). Establishing the last phase of a patient’s life can be a difficult and complex process, and this might occur:…● after the diagnosis of a life-limiting condition; ● during the transition or deterioration of a chronic disease illness; ● when there is an increasing frailty combined with greater dependence on care provision, particularly in the older adult; ● following a sudden infective episode, cardiac event, or a life-threatening accident….The last phase of end-of-life care is referred to as the dying phase. Consideration of the end-of-life care needs of people with chronic terminal conditions should begin at diagnosis, and must embrace after-death care and family support. Over the past century, progress and advancement in disease management, together with improvements in living standards, have resulted in changes to the national death profile, with currently two-thirds of the 0.5 million annual deaths in the UK occurring in people over 75 years of age.

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