WISH TO DIE AT HOME CASE

Wish to Die at Home Case

Wish to Die at Home Case

Introduction

In this essay, I would be going to discuss what measures a nurse can take to aid the comfort of a patient who wishes to die at home. Nursing is a challenging, rewarding and exciting career. The nurse's role is not limited to changing bandages, giving needles and offering support, as the past has indicated. The role of the modern nurse is one of advocate, caregiver, teacher, researcher, counselor, and case manager. The caregiver role includes those activities that assist the client physically and psychologically while preserving the client's dignity. In order for a nurse to be an effective caregiver, the patient must be treated as whole. Patient advocacy is another role that the modern nurse assumes when providing quality care. Advocacy is defined as the active support of an important cause, supporting others to act for themselves or speaking on behalf of those who cannot speak for themselves.

Over the last century, the evolution of the UK health service has witnessed wide-ranging changes to the social organisation of healthcare work, which has had profound implications for the caring division of labour. Historically the majority of health care was provided in the home, either by (the predominantly female) members of the household or, for the wealthier middle classes, by domestic servants. With 'advances' in medical knowledge, the hospital increasingly came to be regarded as the preferred site for the provision of care and in the UK, for the best part of a century, care has been provided by waged nurses in institutional settings. Reflecting these broader trends, the evolution of the licence and mandate of the nursing professions has been reformulated around claims about their distinctive caring contribution to the healthcare division of labour. However, over 60 years on since the inception of the National Health Service, when the delivery of care became firmly focussed on the hospital, the UK caring division of labour—between 'professional' and 'lay' nurse—is currently undergoing a process of (re)domestication in which functions are being redistributed back to family members and/or significant others (throughout the remainder of this discussion we use the term 'family' to include both relatives and significant others) and/or social care providers. This began with the opening up and democratisation of institutional settings and was driven forward by the emergence of caring philosophies which encouraged family participation in the care of their loved ones and more recently has resulted in a redrawing of the boundaries between 'nursing' and' social' care; 'nursing' care is freely available under the National Health Service, whereas 'social' care is provided by Social Services and is means-tested. These changes reflect a convergence of economic and humanitarian concerns which gained momentum with successive government policies and have coalesced in the philosophy of 'home care'. Drawing on end of life care as an illustrative case, in this paper we examine the unacknowledged contradictions and strains contained within 'home care' policies and the challenges these create for ...