Advanced Directives
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The document discusses end-of-life care and strategies for discussing care options with patients and families. It covers the Transtheoretical Model of behavior change, including the stages of change and processes of change. It also discusses the Relapse Prevention Model and how motivational interviewing can be used to have empathetic conversations about values and care preferences. The goal is to help patients and families make informed decisions that are consistent with the patient's goals and values near the end of life.
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Practice Reflective Listening and Speaking
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Identify, Describe How Clients and Families Come to your Practice
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2) Setting boundaries regarding physical, emotional, and spiritual interactions helps define appropriate relationships. Ambivalence about changes needs to be explored to increase commitment.
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DQ 1 Response 1 As health care is advancing, there have been man.docx
DQ 1 Response 1
As health care is advancing, there have been many essential right concerning patients. The process of dying is very complex and it consequences are complicated. If one dies, the individual will not come back again. Therefore, individual with living will may promote care providers’ guideline to their destiny. It will prevent any litigation that may affect the care provider and the organization. Healthcare industry has now got involved or it is now involving spiritual treatment. Spiritual health care may have close relationship with end of life. The essential aspect to spiritual health care may include emotions, feelings, and assumptions of an individual. Therefore, it is very important to guide such essential concerning patient desire to have evidence. Sometimes patient do not want their family members to witness such desire because of the emotional consequences. Every patient knows the kind of pain their feeling and if this individual desire to end this suffering, others may not understand. Hence parent and family of a patient should not interfere in such situation. I can imagine a patient with a serious accident and is subjected to life support machine based on the patient’s unresponsive reaction. This patient has gone through treatment day and night for more than years. Such situation worsens the patient pain and suffering but who else can feel what the patient is feeling? Parent should decide on what they would do to their child regardless. In my opinion, the child will depend on the parent to survive living healthy. It would be very painful if the parent income -wise is poor. Which will lead the child to go through painful life. Therefore, parent knows their situation at hand and they need to make their own decision regardless.
Reference
Balk, E. D: Closing the gaps on efforts to improve healthcare quality at the end-of-life.
Russell, D: Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life by the Committee on Approaching Death: Addressing Key End of Life Issues. Washington, DC: National Academies Press, 2014. 638 pages.
Response 2
Assess the ethical issues surrounding end-of-life decisions. How has the living will affected medical response and why is this important for guiding end-of-life decisions? Should families be able to impact how and if a person's living will is carried out? Should parents have the right to choose to end the life of their child if the child has Down Syndrome?
Living wills are very important. They are legal documents that lay out decisions that the patient has made for their health care in the event that they are unable to make decisions anymore. Decisions that are made could include if the patient wants to be resuscitated or kept on life support. Furthermore, a living will can have the patients in regards to pain management or organ donation. (Mayo Clinic Staff, 2017) This is way if the patient’s family or friends do not agree it goes back to the patient’s .
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**PLEASE NOTE that video slides have been removed to reduce file size**
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
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Describe the primary categories of smells and the concept of odor blindness.
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Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
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Quality of a Good Odorant:
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O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
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Advanced Directives
- 1. It’s not what you say, but how and when you say it End-of-life Care Raymond Zakhari, NP MetroMedicalDirect.com Raymond Zakhari The Adult Health Nurse Practitioner of New York, LLC New York Presbyterian- Weill Cornell Medical Center Metro Medical Direct
- 2. Sigy getting ready for Bourbon St. Raymond Zakhari The Adult Health Nurse Practitioner of New York, LLC Metro Medical Direct
- 3. Sigy after Bourbon St. Raymond Zakhari The Adult Health Nurse Practitioner of New York, LLC Metro Medical Direct
- 4. Sigy sleeps it off Raymond Zakhari The Adult Health Nurse Practitioner of New York, LLC Metro Medical Direct
- 13. TTM: Stages of Change Precontemplation No intention No problem Contemplation Problem Pro’s & Con’s Preparation to take Action I need to do something Action Doing something about problem Maintenance Trying to keep the action going
- 22. Craving mediated by Expectancies For immediate effect Rationalization, Denial, and apparently irrelevant decisions Lifestyle imbalance (Shoulds> wants) Desire for indulgence or immediate gratification (I owe myself) Precursors to High Risk Situations
- 23. High Risk Situation Coping Response No Coping Response Increased Self-Efficacy Decreased Self-Efficacy Decreased probability of relapse Lapse Abstinence Violation Effect Relapse Cognitive Behavior Model of the relapse process
- 25. What might this sound like in terms of end-of-life care?
- 30. It’s not what you say but how you say it: Motivational Interviewing as your counseling style
- 40. Reflective Listening Validate & Affirm Explore a Menu of Options Explore the Pro’s and Con’s Where are they on the SOC continuum? Ask permission Set an Agenda Ambivalence is Normal Resist the Righting Reflex Consider life balance High Risk Situations Explore Coping Create Discrepancy Readiness to Change? What is the motivation Abstinence Violation Effect Empathy Promote Self-Efficacy Use Rulers What’s Next? Listen for and try to do these things : Raymond Zakhari The Adult Health Nurse Practitioner of New York, LLC Metro Medical Direct
Editor's Notes
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