For terminal or ill patients in hospital, palliative care or aged care facilities, often nurses have an incredibly vital role in discussing end-of-life planning with their patients. As for the patients, they might not know who to turn to to ask questions about end-of-life planning, so their nurse is their best resource.
Keep reading to find out more about end-of-planning for Nurses and patients, with checklists for each.
Checklist for Nurses.
An end-of-life planning checklist is an important tool for nurses, as it helps ensure that patients receive the care they want, reduce decision-making burdens for families, ensure continuity of care, and reduce healthcare costs.
Nurses can use the checklist to facilitate conversations with patients and their families, document these preferences in the patient's medical record, and ensure that the patient's care is aligned with their values and preferences.
As a nurse, the following checklist can guide you in providing comprehensive end-of-life care:
- Discuss end-of-life wishes with patients and their families. Assess the patient's understanding of their condition and prognosis. Talk about the patient's objectives and preferences. Discuss medical interventions, treatments, end-of-life care, and options for advanced care planning, such as a healthcare directive or power of attorney.
- Document end-of-life wishes. Ensure the patient's end-of-life wishes are documented in their medical record, update it with any changes, and make it accessible to other healthcare providers involved in the patient’s care.
- Coordinate care with the healthcare team. Collaborate with the healthcare team to ensure the patient's end-of-life wishes are met, symptom management and comfort care are provided, and spiritual and cultural needs are met.
- Provide emotional support to patients and families. Offer patients and families emotional support, information on support groups and counselling services, as well as guidance on coping with grief and loss.
- Ensure ethical and legal considerations are addressed. Consult ethical and legal issues pertaining to end-of-life care with your healthcare team and the proper resources. This includes informed consent and withholding or withdrawing life-sustaining treatments.
- Support family caregivers. Provide family caregivers assistance and education, offer advice on self-care and coping mechanisms, and make sure they have access to resources and support services.
Download the image below and print out for a physical checklist.
Checklist for patients.
As someone getting closer to death, end-of-life planning can be an emotional and challenging process, but it can also be a helpful way of making sure that your wishes are carried out and that your loved ones are prepared.
Here is an end-of-life planning checklist for patients:
- Appoint a medical decision-maker. Appoint someone you trust to make decisions on your behalf if you become incapable of making them yourself. This person will act as your substitute decision-maker and can be a family member or close friend. To appoint a substitute decision-maker in Australia, you can complete an Enduring Power of Attorney (EPA) form. This legal document allows you to appoint someone to make decisions on your behalf if you become incapable of doing so.
- Create an Advance Care Directive. Consider your values and preferences for medical treatment and end-of-life care, and discuss them with your substitute decision-maker and healthcare provider. Complete an Advance Care Directive form, which can be obtained from the relevant government agency or downloaded from their website. This document outlines your wishes for medical treatment and end-of-life care. Have the form witnessed by a qualified witness, distribute copies of the form, and provide copies to family members or caregivers.
- Review your Will. Reviewing your Will regularly is vital as it outlines how your assets will be distributed after your death, particularly after significant life events like marriage, divorce, the birth of a child, or the acquisition of significant assets. Checking it over in the final weeks or months of your life, as long as you are of sound mind, can ensure your circumstances have not changed and your Will is up to date.
- Consider funeral arrangements. Think about the type of service you would like, whether you would prefer a burial or cremation, and any other special requests you might have for your funeral or burial. Research funeral homes and services, and discuss your wishes with close family and friends. Consider paying for your funeral in advance and writing down your final desires. Provide copies to your family members and executor.
- Review your financial affairs. Make sure your financial affairs are in order and that your loved ones know how to access important documents such as bank accounts, insurance policies, prepaid funeral fund and superannuation funds. Also think about access to other important information like logins for social media accounts
- Consider organ donation. To consider organ donation in Australia, it is important to learn about the process, register your wishes, discuss your wishes with loved ones, carry a donor card, and consider becoming a living donor. Research the process and speak with your doctor to determine if it is a viable option. Keep your medical history up-to-date to ensure it is accurate and suitable for donation.
- Discuss your wishes with your healthcare provider. Make sure your healthcare provider is aware of your end-of-life wishes and that they are documented in your medical records. This may include discussions around resuscitation, life support, and palliative care.
- Seek emotional support. It is important to communicate with loved ones, get medical assistance, join a support group, seek spiritual or religious direction if needed, and engage in self-care. While healthcare professionals can provide direction and help, family and friends can provide emotional support and comfort. Support groups can give you a sense of belonging and understanding while also making you feel less alone. Self-care might include taking time to rest, participating in activities that offer joy, and seeking assistance when necessary.
Download the image below and print out for a physical checklist.
To ensure that your wishes are honoured, keep in mind that end-of-life planning is a continuous process. As such, it is important to regularly review and update your plans.
At Bare, we’re focused on more discussions and thought towards end-of-life, so our handy tools such as the Final Wishes Planner and Digital Vault allow you to think about your end-of-life and store important documents in a safe and secure place.