Digital Commons Network^™

Improving Hospice Care Awareness In The Hispanic/Latino Community Of Monterey County, Dulce M. Cortez Cruz

Capstone Projects and Master's Theses

Montage Health is a nonprofit healthcare provider in Monterey County, offering many services, including the Hospice of the Central Coast. This hospice agency supports older adults and their families with end-of-life care. Although Monterey County has a large Hispanic/Latino population, only a small number use hospice services—mainly due to language barriers, lack of awareness, and insurance concerns. This project focuses on helping the Hispanic community learn more about hospice care through surveys and Spanish-language presentations in the future. The goal is to clarify misunderstandings and help more families feel comfortable using hospice when needed. By sharing information and building trust, …

Palliative Care Integration Into Critical Care In People With Terminal Conditions, Arielle Westfall

Honors Undergraduate Theses

Palliative care is of value to the quality of life in people with terminal conditions when initiated early. The purpose of this literature review was to identify barriers to early initiation of palliative care consultation. The secondary purpose was to examine characteristics that prompt palliative care consultation. The TLC model of palliative care was used to explore palliative care in the critical care setting in people with terminal conditions. The concepts of the model support optimal palliative care as collaborative and comprehensive, with shared decisions made by the patient, practitioners, and loved ones. A literature review was conducted to identify …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Hearing Aid Loan Program For Hearing Loss At The End Of Life, M. Courtney Hughes, Diane Schecklong, King Chung

Faculty Articles, Papers, and Other Scholarship

This article describes a hearing aid loan program to provide free amplification devices for patients at the end of life to help them communicate more effectively at this critical time. It includes steps for establishing such a program, addressing challenges, and the role of the informal caregiver throughout the intervention. Healthcare professionals and social workers are encouraged to develop similar programs and use the information here as helpful suggestions to consider for their programs.

Positive Ageing And Death Or Dying: A Scoping Review, Robin Otto

Social Work Theses - Archive

This scoping review aims to examine the extent and how research that utilizes successful, active, productive, and healthy ageing framework(s) include death or dying. An examination of peer-reviewed academic articles published between 1980 and 2021 were reviewed following Joanna Briggs Institute's methodological standards for scoping reviews and conforming to Arskey and O'Malley's five-stage framework. The initial search resulted in 1,759 articles for review, and following the rigorous screening, 35 studies were included for the final review. A thematic analysis was the qualitative method employed to identify how research utilizes the concepts of death and dying in the context of four …

Effective Hospice Chaplain Ministry, Dawn M. Linder

Doctor of Ministry

This project is a book which examines how Christian hospice chaplains can maintain and utilize their Christian identity and minister effectively to non-Christian/non-religious patients and their families without evangelizing them. It was determined that narrative, or story, is an essential part of each person's life, especially as a person looks back on their life while approaching death. A person's life goals change as death becomes imminent, and with change comes grief. Hospice chaplains can companion the patient as they navigate this unfamiliar territory and help them recognize new goals. Chaplains can help patients look back on their lives to see …

Cross-Sectional Nutrition Profile Of Palliative Home Care Clients In Ontario And Performance Of The Interrai Palliative Care Nutrition Clinical Assessment Protocol, Tara Stevens, Heather Keller, Nicole Williams, James Downar, Dawn M. Guthrie

Health Sciences Faculty Publications

Background: The nutrition profile of palliative home care clients is unknown. This study describes this group and their nutrition issues and evaluates the performance of the interRAI nutrition Clinical Assessment Protocol (CAP).

Methods: This was a cross-sectional secondary analysis using Ontario interRAI Palliative Care (interRAI PC) Assessment data. The sample represents 74,963 unique Ontario home care clients assessed between 2011 and 2018. Frequencies and standardized differences (stdiffs) of nutrition characteristics were presented for cancer (n = 62,394) and noncancer (n = 12,569) diagnostic subgroups. Rates of triggering the nutrition CAP were presented by nutrition issue to evaluate its performance.

Results: …

Factors Influencing Nurse Spiritual Care Practices At The End Of Life: A Systematic Review, Rita Mascio, Megan Best, Sandra Lynch, Jane Phillips, Kate Jones

IES Papers and Journal Articles

Objectives: The aim was to identify determinants of nurse spiritual/existential care practices toward end-of-life patients. Nurses can play a significant role in providing spiritual/existential care, but they actually provide this care less frequently than desired by patients.

Methods: A systematic search was performed for peer-reviewed articles that reported factors that influenced nurses’ spiritual/existential care practices toward adult end-of-life patients.

Results: The review identified 42 studies and included the views of 4,712 nurses across a range of hospital and community settings. The most frequently reported factors/domains that influenced nurse practice were patient-related social influence, skills, social/professional role and identity, intentions …

Physician Behaviors, Nursing, And Other Obstacles In End-Of-Life Care: Additional Critical Care Nurse Perceptions, Elizabeth Elouise Willmore

Theses and Dissertations

Background: Critical Care Nurses (CCNs) frequently provide end of life (EOL) care in intensive care units (ICUs). Barriers to EOL care in ICUs exist and have been previously published, but qualitative reports from CCNs themselves remain scarce. Qualitative data exploring barriers faced during ICU EOL care may increase awareness of obstacles and help remove them. Objective: Excluding family experiences, what are the major themes recounted by CCNs when asked to share common obstacles experienced in providing ICU EOL care? Methods: Members of the American Association of Critical-Care Nurses were randomly surveyed and responses to a single qualitative question were used. …

Cultural Aspects Of End Of Life Advance Care Planning For African Americans: An Ethnonursing Study, John Collins

Electronic Theses and Dissertations

Introduction: Advance directive completion rates among the general population are low. Studies report even lower completion rates among African Americans are impacted by demographic variables, cultural distinctives related to patient autonomy, mistrust of the healthcare system, low health literacy, strong spiritual beliefs, desire for aggressive interventions, importance of family-communal decision making, and presence of comorbidities. End of Life (EOL) advance care planning (ACP) promotes patient and family centered care. The purpose of this study was to identify culturally based meanings, expressions, and traditions of EOL ACP and decision making among African Americans, to better understand and provide culturally congruent nursing …

Removing Obstacles To A Peaceful Death, Kathy L. Cerminara, Barbara A. Noah

Faculty Scholarship

We all will die, but the American health care system often impedes a peaceful death. Instead of a quiet death at home surrounded by loved ones, many of us suffer through overutilization of sometimes-toxic therapeutic interventions long past the time when those interventions do more good than harm. This article proposes revisions to health professional training and payment policy to eliminate as much as possible physical and existential suffering while progressing through the terminal phase of illness. The solution lies in seamless progression from treatment with integrated palliative care to hospice before death, but provider attitudes and payor practices must …

Cross-Cultural Dynamics In Palliative Care: The Emerging Canadian Scenario, Chidi Oguamanam

Dalhousie Law Journal

As modern technologies leverage medical sciences, life expectancy is on the rise in Canada, and indeed globally with a remarkable increase in the elderly population in need of health care. The same is true of the diversity of cultural groups who are now patrons and stakeholders in Canada's health care landscape. An emergent feature ofthis landscape is the complexity ofcontexts for negotiating and mediating medical care delivery at the end of life. This paper examines the gaps in regulatory and legal interventions as well as the gaps and opportunities to negotiate the transition to palliative care in cross-cultural contexts that …

Choices Related To Maximizing Quality Of Life At End Of Life, Theresa Lynn

Dissertations

Humans, including those residing in the United States, can live in denial of their own mortality. Because of this, futile care is sometimes provided, often at great monetary expense and for little or no return in terms of quality or length of life. At least two opportunities exist for making choices regarding care at the end of life in the U.S.: completing advance directives and choosing hospice care. This dissertation consists of three studies related to this topic. The first is a quantitative study about advance directives and attitude toward death. The advance directive completion rate among adults in the …

Reaching The End : An Exploration Of Attachment And Existential Theory As A Path To Assist In The Dying Process, Jillian Debenedetto

Theses, Dissertations, and Projects

In this exploration I will utilize the theory of Attachment as well as Existential Theory to assist in expounding upon available paths to assist elderly individuals in their journey at the end of life. I will present an overview of the two selected theories of Attachment as well as Existential Theory and argue that such approaches honor the venerable end stage of life. A discussion pertaining to these two theories will shed light on the question of how a clinician can seek to improve the quality of life for an individual during the end of life process and therefore assist …

The Role Of Race In End-Of-Life Care, Barbara A. Noah

Faculty Scholarship

This essay focuses on one important aspect of racial disparities that has received comparatively little attention in the legal literature--the existence and causes of racial differences in end-of-life decision making and in the utilization of palliative and hospice care. African Americans and other racial minorities in the United States utilize palliative care and hospice less frequently than white Americans. These minority populations also tend to resist advance care planning and instead opt to receive more life-prolonging care at the end of life, even when quality of life and prognosis are poor. After a lifetime of limited access to health care …

Predictors Of Cancer Caregiver Depression Symptomatology, Henry R. Rivera

USF Tampa Graduate Theses and Dissertations

While the duration of the cancer illness may be shorter than that of other serious diseases, such as Alzheimer's disease, cancer caregivers provide many more hours of care during a week. Research directed at the intensive experience of caregiving of hospice cancer patients is needed as there is limited research of predictors of hospice cancer caregiver depression symptomatology. The purpose of the study was to examine predictors of depression symptomatology in caregivers of hospice cancer patients. A secondary analysis was conducted using baseline assessment data of patients and caregivers from a larger study of patient/caregiver dyads from two large hospices …