Health care providers in nursing facilities face tough issues regarding their patient's end of life.
When an individual faces the end of his or her life, tough decisions often need to be made. While the individual's family has the responsibility of making those decisions, health care providers need to be aware of the potential issues. This fact is particularly true in nursing facilities.
Living Will
Health care providers must consider whether a patient has a living will. This document lets the person put into writing his or her health care wishes if they become unable to speak for themselves. Each state has its own rules regarding living wills. In some cases, they are only binding if notarized. In all states, the living will must be written and signed by the patient before he or she became incapacitated. If a valid living will is on file at the nursing facility, health care providers must abide by the wishes of the patient it details.
Durable Power of Attorney
In some cases, patients may legally appoint a family member to make health care decisions for them. To do this, they need a durable power of attorney for health care. The appointed individual must be consulted regarding health care decisions for the patient, including whether to remove ventilators or other forms of life support. If no power of attorney has been designated and the patient is still competent, health care providers may want to suggest taking this step.
Hospice
When a patient's condition deteriorates, he or she may choose hospice care instead of staying in the nursing facility. According to the Education for Physicians on End-of-Life Care, more than 80 percent of patients want to die at home. Hospice care can be provided at a patient's home or in a more home-like facility. Health care providers can offer this option to the families of patients when nothing more can be done to treat the patient's condition.
Palliative Care
Health care providers in nursing facilities working with patients at the end of their lives often make decisions regarding palliative care. This type of medical care involves relieving the patient's pain and discomfort even when nothing further can be done to treat the condition. In addition to pain medication and life support equipment, palliative care can also include psychological and spiritual support for the patient and the patient's family.
Life Support
Some patients are placed on life support, such as ventilators, to keep them alive. While some patients can be removed from the equipment, patients near the end of life usually die when removed. Health care providers need to discuss the decision to remove life support with the patient's family, particularly family members who have legal decision-making power for the patient. When the patient has no family members available, the health care providers must make that determination based on what is best for the patient.
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