The document discusses the advancements in hospice care in the U.S., emphasizing comprehensive physical, psychosocial, and spiritual support for terminally ill patients and their families. It proposes the creation of a support group aimed at aiding families coping with the end-of-life process, providing them with education and emotional support to navigate their roles and grief. The interdisciplinary team, including nurses and social workers, seeks to enhance access to care and quality of life for patients and their families during this critical time.

1. Running head: ACCEPTING DEATH BY FAMILIES
1
ACCEPTING DEATH BY FAMILY
2
Accepting Death of the Love One at the End of Life
Name
University
Introduction
The hospice development has advanced in the United States in
the course of recent years. The concentration of hospice is on
far reaching physical, psychosocial support and otherworldly
care for ill-fated condition patients and their families. Hospice
suppliers advance personal responsibility by shielding patients
from wearisome intercessions and giving peaceful, painless
consideration at home, at all possible moments, rather than the
health facility (Dahlin, Coyne, & Ferrell, 2016).
Hospice nurses give mind essentially under the rules of the
Medicare Benefit Act of 1983
(Mor, & Teno, 2016), a government program that enables
patients to die peacefully in their homes with their families and
companions next to them. Palliative care is the interdisciplinary
concern for painless, comfortable measures for the patient as
the patient is approaching death in an honorable manner (Kelley
& Morrison, 2015). This objective is to facilitate the patient to
accomplish the most personal comfort level through pain relief,
control of side effects and retaining autonomy. The hospice
nurse must remain personable to the patient help maintain social
and religious esteems and practices. The care that both hospice
and palliative care nurses give is essentially similar to the
Hospice and Palliative Nurses Role Delineation Study.

2. Be that as it may, hospice and palliative care medical nurses’
differ in their planning and practice settings (In Ferrell, 2015).
The challenge of the hospice nurses is to assist the family
caring for terminally ill patient and cope with stressors,
Additionally, the nurse assists them to maintain the integrity of
their previous role that are important for them and the rest of
the family.
Roles
Hospice and palliative care nurses work as a team with other
disciplines. For example, doctors, social workers, chaplains,
nurses, hospice aide, and clerk in the setting of an
interdisciplinary group. The teams are holistically prepared
experts and volunteers. The group combines their qualities to
promote and address the issues of the patient and family
encountering terminal illness and disease process
.
Hospice and palliative nurses distinguish themselves from other
nurse associates in their forte practices and their resolute
concentration on end-of-life care. Hospice and palliative care
incorporates 24-hour nursing accessibility, administration of
medications for comfort, maintaining comfort care by relieving
physical pain and suffering. Also the nurses extend their care by
providing family support.
Familial systems assume different roles, which delineate their
responsibility to the family structure. The coping roles are
emotional and functional. When the patients are terminally ill or
dying, some families are in denial and the interdisciplinary team
led by the nurse educator assists the family to cope with the
illness or impending loss. A strive for encouragement of coping
via social involvement in groups and end of life care is one of
the goal of this paper. Additionally, there is a proposal to create
a support group to help the families that need further assisting
with the passing of their love one.
Program Objectives

3. Coordinated care: The therapeutic direction is essential care
over all components of the extensive health care system. This is
including symptom management, home health and group support
management. Patients with complex needs customarily require a
broad scope of restorative management that is provided by team
clinicians and healthcare providers. The interdisciplinary team
will evaluate the families that are struggling and suggest
participating in the inpatient unit group that is being created.
Superb access to care: The essential care needed at home
conveys open administrations for comfort through prescribed
care management. For complex patients, there is an accentuation
on improved access to favorable therapeutic care in their homes.
Patients approaching end of life are emotionally unsteady and
require access to restorative measures to augment comfort and
provide support to family. Elderly patients and others with
physical impairments frequently have contractures and are
unable to communicate their needs. These patients require
additional means for assessment tools and family counseling.
A system based way to deal with quality and security: The
essential health care exhibits a pledge to quality and expanding
change. There is a large assembly of difficulties to address
necessitating the better nature of care for patients with different
terminal conditions. In order to deliver above par care to
hospice and palliative patients, we are proposing the creation
for a support group. This needed support group is to explore
new and innovative ways to reach families in various settings
and in different stages.
Summary of intervention program description
The program would incorporate assistance for bereaved loved
one’s who have suffered the death or dealing with a patient in
the end of life stages. The mission of this group will be
assisting the members with adjusted roles and losses, allowing
the families to assist reintegration within a system of choice,
providing a supportive environment in which they can address
their issues. The value for this pilot program will be intrinsic.

4. Educational intervention program
In this paper, we describe a creative usage system: Support
group to help caregivers to copy with the illness or death of a
love one. Since most people are not cognizant of the role they
play in the family unit, they are unlikely to know how to
address the loss of the roles when a family member die or is
terminally sick, resulting in gaps in the family system and leads
to a breakdown in family functioning.
Method of approach for the intervention
Recognizing need
The initial step of the pre-conditions stage is to recognize the
needs of the families and the benefit of the support group to
help them to copy with the situation. The pilot support group
program to help people on a journey will last for three years,
starting in University of Miami Hospital in the auditorium with
the families of 10 patients of hospice and palliative care, that
are in denial.
Questions
The question that we will ask the family is all about their
knowledge concerning end of life care. Accepting death is
another question we are planning to ask the family being
interviewed, their feelings towards dying and thereafter. The
support group will facilitate questions as to what are the family
needs. Where do you acquire this assistance? And how would
you benefit this support group to do?
Distinguishing implementation boundaries
To assure the interventions are attainable, the group should
meet with the staff and administration, present the intercession,
and lead an appraisal of potential obstructions to its usage. Such
meetings may encourage stakeholders for interest in purchase.
This is not our stance. Encouraging donation for a non-profit
organization is the method we plan to utilize.
Drafting the intervention package

5. An intervention package is then drafted that is reasonable for
implementation in the group-based organization. Preparing and
specialized help designs are additionally drafted amid this stage
(In Ferrell, In Coyle, & In Paice, 2015). Essentially a package
should be assembled supporting the need for the group. The
package must include evidenced based need to be effective and
to provide inspiration to move forward with the project.
Ideally the bundle ought to be drafted by the designers of the
intervention, yet altered by non-specialized journalists to
guarantee that the intervention package materials are free of
specialized language. However, this being academically based,
we would require further skilled assistance.
Hypothetically, the budget for the program in the first year, will
be created based on the needs of the 10 family members that
will be coming to the group every Wednesday to the auditorium
of the University of Miami Hospital for one hour, starting the
first year, and after assessing the group needs, we will increase
the time to two hours, after the three first months. We will
provide refreshments to the participants. The pilot program
proposal is to be functioning for 3 consecutives years where
nurses, social workers, hospice aids, chaplains and doctors will
be the facilitators of this pilot program that in collaboration
with the University of Miami Hospital we will provide
education and support to all the families in needs, and we will
be evaluating the outcomes in 3 years.
Item
1st Year
2nd Year
3rd Year
Orientation
$200
$250
$250

6. Brochures
$350
$300
$400
Refreshments
$150
$200
$250
Travel
$200
$200
$230
Parking
$60
$60
$60
Equipment
$250
$350
$300
Conclusion
When providing End of Life services, or someone close passes,
the family maintains a resistance to change. Change is viewed
as a disruptive to the existing family system with the little
knowledge of how to manage the changes encountered.
Insecurity causes the family members to seek support only with
others who reinforce their belief and values. Due to the
functional and emotional suffering, patients and families are in
need of psychosocial and spiritual support provided by the
interdisciplinary team. Opening a support group to assist them

7. in their time of hardship is an intended goal. At the end of the
six months of this pilot program of support group, we will
evaluate the outcome of the family members of the ten patients
in hospice and palliative care receiving education and support.
The group will be based on assistance that identify their new
family role, to cope with the care of a terminally ill patient,
discuss potential interventions with the family, to ascertain if
they are necessary and attainable. Finally, to evaluate if the are
being realistic in view of the strengths, abilities and present
situation.
References:
Catania, G., Bagnasco, A., Signori, A., Pilastri, P., Bottino, M.,
Cervetti, C., … Sasso, L. (2017). A phase 2 quasi-experimental
trial evaluating the feasibility, acceptability, and potential
effectiveness of complex nursing intervention focused on QoL
assessment on advanced cancer patients with palliative care
needs: study protocol. Pilot and Feasibility Studies, 3
(1). https://doi.org/10.1186/s40814-017-0196-x
Dahlin, C., Coyne, P. J., & Ferrell, B. R. (2016). Advanced
practice palliative nursing. New York: Oxford University Press.
Glare, P. A., Semple, D., Stabler, S. M., & Saltz, L. B. (2011).
Palliative Care in the Outpatient Oncology Setting: Evaluation
of a Practical Set of Referral Criteria. Journal of Oncology
Practice, 7
(6), 366–370. https://doi.org/10.1200/jop.2011.000367
Hudson, P., Trauer, T., Kelly, B., O’Connor, M., Thomas, K.,
Zordan, R., & Summers, M. (2014). Reducing the psychological
distress of family caregivers of home based palliative care
patients: l
onger term effects from a randomised controlled trial
. Psycho-Oncology, 24
(1), 19–24. https://doi.org/10.1002/pon.3610

8. Kelley, A. S., & Morrison, R. S. (2015). Palliative Care for the
Seriously Ill
. New England Journal of Medicine,373(8), 747-755.
doi:10.1056/nejmra1404684
In Ferrell, B. (2015). Structure and processes of care.
In Ferrell, B., In Coyle, N., & In Paice, J. A. (2015). Oxford
textbook of palliative nursing.
In Matzo, M., & In Sherman, D. W. (2015). Palliative care
nursing: Quality care to the end of life.
Mor, V., & Teno, J. M. (2016). Regulating and Paying for
Hospice and Palliative Care
: Reflections on the Medicare Hospice Benefit. Journal of
Health Politics, Policy and Law, 4
1(4), 697–716. https://doi.org/10.1215/03616878-3620893
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paper. For example, “The purpose of this paper is to present an
advanced practice nursing intervention project on end of life
that will pertain to assisting family’s with accepting the death
of their love one.
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possible.

9. �In what way? Explain the Palliative Nurses Role Delineation
Study
�Please provide ciations to support statements concerning the
palliative and hospice nurses’ roles.
�Please provided scholalrly citation to support the intervention
program goals. What model or theory will you use to guide the
processs in terns of the objectives, end of life, and development
of the intervention to assist individuals with sccepting the death
of a loved one? Please cite the theory and or modelt you will
use to guide the process.
�Please use a health promotion and education planning method
or tool to guide the role out of the implementation process.
�Please select a valid and reliable pre and post questionnaire as
a tool to evaluate the effectiveness of the intervention.
�Great effort, however please see my previous comments.
�The budget is quite good
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to the revisions to the paper previously requested (See previous
comments)
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