Review: Factors Relating to Nurses\u27 Caring Behaviors for Dying Patients

Background: Nowadays, caring for patients at the end of life becomes an indicator of the quality of care in a hospital. Nurses are the key people to provide care for dying patients, therefore caring behaviors of nurses could affect the quality of care. To attain and maintain the quality of care at the end of life, factors that contribute to nurses\u27 caring behaviors for dying patients needs to be addressed.Purpose: The purpose of this article is to review factors relating to nurses\u27 caring behaviors for dying patients from existing literature.Method: Relevant literature from electronic databases, including CINAHL, PubMed, Science direct, OVID, Proquest, and The Cochrane Library during the year 1990-2010, was examined, synthesized, and categorized systematically.Result: The results showed that factors related to a nurse\u27s caring behavior for a dying patient can be classified into three groups. These include; Nurse\u27s personal factors, Technological influencing factors and Environmental factors.Conclusion: The three factors related to nurses\u27 caring behaviors for dying patients in the current review could serve as a valuable database to implement in nursing practice, education and research, in order to achieve quality of end-of-life care

Race & Ethnicity and Death & Dying in California

Racial and ethnic minorities are fast becoming a larger share of the U.S. population, and California is on the forefront of this change. Culture and ethnicity can play a crucial role in the type of care a person receives towards end-of-life. This factsheet provides an overview of who is dying in California and attitudes and experiences with death and dying in the state

Planning for the End of Life for People with Dementia - Part 2

This publication is a discussion about additional end-of-life options which may become legally available at some time in the future, i.e., assisted death (usually called euthanasia or assisted suicide). Alzheimer's Australia is not advocating that such options become available and takes a neutral position about them. However, there is a need for an informed debate on the issues, given that well-conducted research indicates that a significant proportion of the community supports making such options available.Some people believe that they should have the right to make decisions about their own bodies and about the way they die; in other casespeople see the current legal and medical options as inadequate. While Australia was the first place in the world to pass legislation allowing both euthanasia and physician-assisted suicide (i.e. the Northern Territory Rights of the Terminally Ill Act (1995)), that legislation was overturned by the Commonwealth's Euthanasia Laws Act (1997) and at present these options are illegal throughout Australia. However, given that assisted dying Bills are regularly presented to state/territory parliaments in Australia it is possible that, at some time in the future, legislation will be passed that allows such options. It is therefore important for the arguments for and against assisted dying to be understood and for open debate to be encouraged. We hope that the information provided in this document will contribute to that debate.Section 2 of Part 2 asks: What is doctor-assisted dying*? and identifies what isand what is not euthanasia. In Section 3, arguments for and against doctor-assisted dying are provided and in Section 4 some issues which relate specifically to assisted dying for people with dementia are considered

The ‘regulated death’: a documentary analysis of the regulation and inspection of dying and death in English care homes for older people.

In England, processes of regulation and inspection have been established to ensure that older people living in long-term care settings receive quality care. This paper describes how dying and death in care homes for older people is regulated and inspected. A documentary analysis was undertaken of the standard that addresses dying and death in the 2001 Care Homes for Older People: National Minimum Standards. Present in the standard is a ‘good death’ template drawn from constructions of best practice in palliative care. The way in which this national standard is enacted in the inspection process is described using a content analysis of the inspection reports from 226 care homes for older people. These present a narrow focus on dying and death, one that emphasises the older person's wishes and the degree of adherence to policies and procedures concerned with the dying and death event. A regulated death attenuates the ‘good death’ template and reflects both the inspection process and capabilities of the residents of care homes. If the regulation and inspection process is to integrate dying with living, a broader conception and regime of inspection is required. Only then will end-of-life care be provided that meets the diverse needs of older people who live in care homes

Dying Dyons Don't Count

The dyonic 1/4-BPS states in 4D string theory with N=4 spacetime supersymmetry are counted by a Siegel modular form. The pole structure of the modular form leads to a contour dependence in the counting formula obscuring its duality invariance. We exhibit the relation between this ambiguity and the (dis-)appearance of bound states of 1/2-BPS configurations. Using this insight we propose a precise moduli-dependent contour prescription for the counting formula. We then show that the degeneracies are duality-invariant and are correctly adjusted at the walls of marginal stability to account for the (dis-)appearance of the two-centered bound states. Especially, for large black holes none of these bound states exists at the attractor point and none of these ambiguous poles contributes to the counting formula. Using this fact we also propose a second, moduli-independent contour which counts the "immortal dyons" that are stable everywhere.Comment: 27 pages, 2 figures; one minus sign correcte

The Changing Narratives of Death, Dying, and HIV in the United Kingdom

Death and infection were closely linked from the start of the HIV epidemic, until successful treatments became available. The initial impact of mostly young, gay men dying from HIV was powerful in shaping UK responses. Neoliberal discourses developed at the same time, particularly focusing on how citizens (rather than the state) should take responsibility to improve health. Subsequently “successful ageing” became an allied discourse, further marginalising death discussions. Our study reflected on a broad range of meanings around death within the historical UK epidemic, to examine how dying narratives shape contemporary HIV experiences. Fifty-one participants including people living with HIV, professionals, and activists were recruited for semistructured interviews. Assuming a symbolic interactionist framework, analysis highlighted how HIV deaths were initially experienced as not only traumatic but also energizing, leading to creativity. With effective antiretrovirals, dying changed shape (e.g., loss of death literacy), and better integration of palliative care was recommended

Dying well

This paper recommends more public discussion, including an education campaign, about the limits of health care as death approaches and the need to focus on end-of-life care. Overview This report is about how, where and with whom we die. The baby boomers are growing old, and in the next 25 years the number of Australians who die each year will double. People want to die comfortably at home, supported by family and friends and effective services. But dying in Australia is more institutionalised than in the rest of the world. Community and medical attitudes plus a lack of funds for formal community care mean that about half of Australians die in hospital, and about a third in residential care. Often they have impersonal, lingering and lonely deaths; many feel disempowered. Seventy per cent of people want to die at home, yet only about 14 per cent do so. People are twice as likely to die at home in countries such as New Zealand, the United States, Ireland and France. Increasingly people die when they are old. They are also more likely than their forebears to know that they are going to die in the relatively near future. But we are not taking the opportunity to help people plan to die well. In the last year of life, many experience a disconnected, confusing and distressing array of services, interventions and relationships with health professionals. Many do not get enough palliative care. Often, this is because people do not discuss the support they would like as they die. When asked, most people have clear preferences for the care they want at the end of their life. But rarely do we have open, systematic conversations that lead to effective end-of-life care plans. A good death gives people dignity, choice and support to address their physical, personal, social and spiritual needs. This would happen more often with three reforms. First, we need more public discussion about the limits of health care as death approaches, and what we want for the end of life. Second, we need to plan better to ensure that our preferences for the end of life are met. Third, services for those dying of chronic illness need to focus less on institutional care and more on people’s wishes to die at home and in homelike settings. For more people to die at home, investment in community-based support is needed. Doubling the number of people who are able to die at home will cost $237 million a year, but the same amount could be released from institutional care funding to pay for it. Despite widespread assumptions about the cost of end-of-life care, only about$5 billion a year is spent on the last year of life for older people in a health budget of $100 billion. But only about$100 million is spent on helping people to die at home. A change in focus will not save much, but will help more people to die well. The voluntary euthanasia debate often clouds this issue. But voluntary euthanasia and assisted suicide are rare, even in jurisdictions that permit them. Instead, this report is about ensuring that when death inevitably comes for each of us, we die comfortably, in surroundings we would choose. We need the courage to promote mature discussions about a topic that many dislike, but that we cannot avoid.       &nbsp

Talking about end-of-life care: the perspectives of older South Asians living in East London Journal of Research in Nursing

The National End-of-life Care Strategy for England identifies that a lack of open discussion about death and dying can be a barrier to achieving good quality end-of-life care. South Asians constitute the single largest ethnic minority group in the United Kingdom, yet little is known about their attitudes and expectations towards the discussion of death and dying. In this study, set in East London, five focus groups and 29 in-depth, semistructured interviews were conducted with total of 55 older adults aged between 52 and 78 years. Participants from six South Asian ethnic groups were recruited from 11 local community organisations. Constructive grounded theory was used as data analysis approach. Findings revealed two key themes which capture the perspectives older South Asian study participants had towards end-of-life care discussions. The theme ‘avoidance as a cultural norm’ relates to the relative absence of discussions around death and dying experienced participants. Participants neither expected to have discussions about their own death and dying within their family, nor to assume any involvement in related issues of decision making. The second theme ‘avoidance as protection’ relates to beliefs and experiences about the delegation of decision making to family members. Future research should explore the perspectives of second-generation adult children towards end-of-life care discussions