The recent discussion about health care reforms has established questions regarding the value of advance directives. The methods used data from a survey in health and retirement study. The study involves adults sixty years of age or older who had died due to lack of good health care. The use of advance directives is recommended so that people can know and determine the medical care they will be given when they are no longer competent. The advance directives for treatment may be documented in a living will or written an advance directive. The advance directives are effective to the bereaved family when a member of the family dies in a nursing home, hospital or at home. Directive and patient-centered care help to assess the effectiveness of written advance director in the care of seriously ill, hospitalized patients. The study of advance directives has analyzed the influence of the race and ethnicity on the knowledge and attitudes of patient concerning their life-prolonging therapy. The increased interest in advance directives and decision making for critically ill persons led to the patient's self-acceptance of their right to accept or refuse medical care and to execute an advance directive. Advance directive and patient-centered care have focused improve the state of medicine. The advance directives and patient-centered care have helped to reduce the traumatic stress, anxiety, and depression and also can reduce internally consistent, with an improvement in knowledge of patients wishes and also the family wishes about their sick person.
According to the case study between Ms. Y who is a thirty-four-year-old and being under medical server ere seizure disorder. She takes her mother to be her designee on her durable power of attorney health care form. The issues related to the patient , including the crisis , notes special warnings ,adverse reactions and advance directives for institutional care for many who are frail from chronic illness or either advanced age .The veterans' Health Administration is the United States largest integrated health system shows that the advance directive and patient-centered care helps the doctors to follow the family wish and will to their sick person. . The physicians in the case study are trying to help MS Y by placing her on a ventilator to make her comfortable but her mother refuses to say that it will not help to support her life. According to report by Rao, 2014 ,the Veterans Health Administrators has recognized for leadership in clinical informatics and performance improvement , cares for more patients with proportionally fewer resources and sets a national benchmarking in patient satisfaction and the quality in disease prevention and treatment.
Advance directive and patient-centered care planning can improve the patient health and potentially reduce intensification of care planning activities before the hospitalization and preferences for care from the perspectives of patient and family members. It can as well measure real-time concordance between expressed preferences for care and documentation of the preferences in the medical record. In the case study Mrs. X is influenced by factors such as, the situation may be morally charged, there may be a lot of costs incurred, the daughter may have a coma with a chance of recovering and loose the self-rated of state of health which may counter to the wishes of her daughter to her health hence act in her daughter best interest. The caregiver is endorsed to the attention of the family member who is the mother of the patient and hence cannot place the ventilator to the daughter to make her feel comfortable. Due to respecting and satisfaction of the mother wishes it has contributed to the suffering of her daughter .The ventilator could have made MS Y comfortable reducing the chances of being in much pain and distress. The physicians according to research have incorporated the patient's centered care in support of the view that reflects a broad professional shift (Fine, 2016). The consequences of Mrs. X not allowing the physician to place MS Y has made her suffer a lot and her health to be endangered. Patient advance care planning helps to respect to the promotion of shared decision making outcomes congruence between patient and surrogate patients decisional and knowledge of advance care planning as In the case of MS Y. The physician treatment preferences indicate congruence in the decision making for the medical treatment of MS Y which is significantly higher than their control. When the patients speak out their wish regarding their treatment it makes the family members have less stress even when their patient dies. It makes the surviving relatives be satisfied with the outcome of the treatment reducing their depression. Mrs. X uses directive for the treatment of the daughter as a way of extending the autonomy of her daughter. MS Y is incompetent and has revoked considerable interest to make the way her health care treatment should be done. The mother's preference is based on a durable power of attorney (Garrido, 2015). Despite the compelling reasons for an advanced directive and their public and professional endorsement it makes the physicians not often know much about their patients. The feasibility of using a particular document or the medical directive , the attitudes of the patients towards planning perceives barriers to the planning , treatment preference in hypothetical scenarios and when the patient is in a state where they can no longer participate in decision making about their health care ( Nicaise, 2015). MS Y behavior shows that she was willing to die and had no hope of getting well again. The nursing interventions show how determined they were to support her and care for her health but they are left with no otherwise when she refuses the ventilator to be placed on her.
In summary, the case study presents how advanced care planning can improve end life to make the patient and the family satisfied. The satisfaction of the family helps to reduce stress, anxiety and depression in the surviving relatives. The patient-centered care can be medical education research and quality assessment. Advance directive and patient-centered care promote shared decision between the patients and their surrogate in producing greater satisfaction with the process of decision making and less decisional conflicts. Advance directive and patient-centered care help the doctors to partner with the patient in order to provide a solution for them. Advance directive and patient care are important to help in caring for the patient and hence it should be well developed in medical places to help provide care to a patient who is in their end life stages. It is crucial for patients confronting incurable, debilitating or terminal diseases. In discussing the end of life issues helps to reduce overtreatment and undertreatment of the patient and improve satisfaction with care.
Fine, R. L., Yang, Z., Spivey, C., Boardman, B., & Courtney, M. (2016). Digital Advance Care Planning and Directives: Early Observations of Adoption Statistics and Responses from an All-Digital Consumer-Driven Approach. World Academy of Science, Engineering and Technology, International Journal of Law and Political Sciences, 3(6).
Garrido, M. M., Balboni, T. A., Maciejewski, P. K., Bao, Y., & Prigerson, H. G. (2015). Quality of life and cost of care at the end of life: the role of advance directives. Journal of pain and symptom management, 49(5), 828-835.
Nicaise, P., Soto, V. E., Dubois, V., & Lorant, V. (2015). Users' and health professionals' values in relation to a psychiatric intervention: the case of psychiatric advance directives. Administration and Policy in Mental Health and Mental Health Services Research, 42(4), 384-393.
Rao, J. K., Anderson, L. A., Lin, F. C., & Laux, J. P. (2014). Completion of advance directives among US consumers. American journal of preventive medicine, 46(1), 65-70.
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