Trajectories of life and death

Question 1

What are the effects longer life expectancy has?

Answer 1

• more of a burden on healthcare systems- need more staffing, resources and training
• doesnt necessarily mean people are living healthier- many poeple spend around 10 years suffereing from a morbidity or multi-morbidity

Question 2

What are the leading causes of death in the 80+ age group?

(Global Burden of Disease study, 2019).

Answer 2

• cardiovascular diseases
• neurological disorders
• other NCDs

Question 3

What is bad news across the life trajectory?

(Fallowfield and Jenkins, 2004).

Answer 3

‘any bad, sad, or significant information that alters negativley people’s expectations or perceptions of their present or future.’

Question 4

What is the SPIKES strategy for breaking bad news?

(Bumb et al, 2017).

Answer 4

Setting- where we break it e.g. family roooms, quiet areas

Perception- understand what they already know, how much they dont know, dont make assumptions

Invitation/information- grasping what information you need to give them and doing so and inviting them to ask questions

Knowledge- ensure you know and have a good graspt of the information before going in to break the news

Empathy- make sure to be empathic, consider the persons feelings and break the news gently

Summarise/strategise- go over whats been spoken about and make sure they know/understand whats been said

Question 5

What are the consequences of not disclosing bad, sad, or diffuclt situations?

(Warnock, 2014)

Answer 5

• impacts treatment and decision making
• impact on end-of-life care
• impact on relationships between patient and healthcare team
• impacts on relationships if relatives are informed and patient is not
• impact on healthcare team

Question 6

Why is it important to use person-centered frameworks approaches to break bad news?

Answer 6

• different apporaches to tailor care to make it sensitive to people’s individual needs
• reduced emotional impact on patients and professionals

Question 7

What are the 6 senses in the senses framework to improve care for older people?

(Nolan, 1997).

Answer 7

1. Security
2. Continutiy
3. Belonging
4. Purpose
5. Fufillment
6. Significance

Question 8

What are the trends of death?

(Global Burden of Disease study, 2019).

Answer 8

• death rate per age group tends to increase after 55
• important to remeber deaths happen at all ages, not only in older years
• causes of death are different across age groups, cetrain diseases are more prominant in onlder/younger age groups
• in children leading cause of death is maternal and neonatal disorders
• NCDs are prominent cause of death across all age groups

Question 9

What is person centered care?

(McCormack’s,2017)

Answer 9

suggests nurses:

• work with the person’s beliefs and values
• implement shared decision making and hollistic working
• engage authentically
• be sympathtic and empatheic
• also consideres macro context- policy, training, resources

Question 10

How is person-centered care acheived?

(McCormack, 2017)

Answer 10

• a philosophy, way of thinking that shapes actions
• needs to be supported at different levels

e.g. institutions and policies that support that way of thinking, MDT, individual level

Question 11

What is the family nursing approach?

Answer 11

• the way of thinking that acknowledges that no one is isolated, everyone has a family around them
• family would be anyone the pateint defines, not necessarily next of kin.

Question 12

What are the palliative and and of life aims of the Scottish Government?

(Scottish Government, 2015).

Answer 12

• Access to palliative and end of life care is available to all who can benefit from it.
• people, families, and carers can have conversations with healthcare professionals to plan their care and get end of life support
• organ donation comes under palliative and end of life care

Question 13

What is the legislation regarding organ donation in Scotland?

(Organ Donation Scotland, 2024).

Answer 13

• opt-out programme
• everyone is an organ donor by default unless they say otherwise

Question 14

What types of transplants can people have?

Answer 14

• lung transplant
• kindey transplant due to failure
• diabetes resulting in pancreas and kindey transplant
• liver
• uterus

Question 15

What needs to happen to be accepted as an organ donor?

Answer 15

• have to die in a very specific way
• test must be run to detrmeine death
• conversations must happen with family members to confirm infomred decision is made

Question 16

How do nurses apply family nursing coversations in home health settings?

(Broekema, 2020)

Answer 16

• simulating conversations and communication between family members
• asking questions about family structure and relationships, getting to know each other
• setting joint goals and reflecting with the family on shared expectations
• praising strentgths, competicies and resources in the family
• challenging family members

Question 17

How are families impacted when approached to discuss organ donation after death of a loved one?

(Aviles, 2022)

Answer 17

• develop a highly complex grieving process which plays a significant role in the organ donation decision making process
• impeding loss –> confirming loss –> ambiguous loss –> organ donation decision-making –> organ donation
• there is a level of uncertainty present in the way families of organ donors perceive the life of the donor through the act of organ donation

Question 18

List some references for trajectories of life and death.

Answer 18

• (Aviles, 2022)
• (Broekema, 2020)
• (Organ Donation Scotland, 2024)
• (Scottish Government, 2015)
• (McCormack, 2017)
• (Global Burden of Disease study, 2019)
• (Nolan, 1997)
• (Warnock, 2014)
• (Bumb et al, 2017)
• (Fallowfield and Jenkins, 2004)