End-of-Life

Patients’ experiences, self-awareness, self-confidence, dignity, and personal integrity represent the fundamental obligations of psychosocial care, according to John Wynn, MD, DFAPA, Clinical Professor, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Medical Director, PsychoOncology & Supportive Care, Swedish Cancer Institute, Seattle, WA. Dr Wynn went on to describe the significant role of oncology psychosocial care during his keynote address at the 2015 Association of Oncology Social Work 31st Annual Conference in Seattle, WA.

A report on the important role of nurse navigation in supporting advanced-stage cancer patients in preparation for end of life.

Nurse navigator Cheryl Bellomo discusses the essential role of navigators in ensuring that quality survivorship care begins at diagnosis and continues throughout the balance of a patient’s life.


The authors present a case addressing the importance of understanding issues facing cancer survivors in order to provide effective patient-centered survivorship care.

Cancer patients must juggle doctor appointments; combat treatment side effects, while trying to maintain a sense of normalcy; and handle financial struggles.

The survivorship care plan (SCP) is used to assist cancer survivors with the transition from active treatment to the survivorship phase; all nurses play a significant role in the delivery of this vital aspect of survivorship care.

A recent survey by Consumer Reports shows that nearly 90% of Americans would prefer to die at home, focused on comfort, and yet, two-thirds of Americans over the age of 65 years end up dying in a healthcare setting, intubated, and in considerable pain.


Studies demonstrate that many gynecological (Gyn) cancer patients are reluctant to exercise during and after treatment due to fatigue and general weakness. This is the most distressing symptom affecting their quality of life.

Our team implemented a survivorship needs assessment in the Dallas-Fort Worth area to determine the specific needs of the cancer survivors in a specified geographic area.

The Academy of Oncology Nurse & Patient Navigators (AONN+) promotes the goal to share best practices for survivorship and to address the question “Does the Survivorship Care Plan (SCP) Meet Patient Goals?” (Staci Oertle, RN, MSN, APN, AOCNP, AONN+ Survivorship Committee).


Survivorship care plans (SCPs) have played an important role in cancer care for over a decade and are included in the quality metrics or accreditation standards of several institutions, including the American College of Surgeons Commission on Cancer (ACS CoC).




Timely integration of palliative care (PC) in the management of patients with advanced cancer is a quality benchmark in oncology. PC is often underutilized due to delayed identification and referral of appropriate patients.

Throughout the seasons of survival, healthcare providers should continually offer the components of survivorship care in the forms of prevention through health and wellness promotion, surveillance for recurrence and screening for new cancers, intervention for management of lasting physical and psychosocial effects, and coordination of care for the cancer survivor.

Currently, there are 16.9 million cancer survivors in the United States.

Guided Dying” is a practice that can help the families of terminally ill patients to come to terms with the active dying process in a relatively short time, according to Kerry Forrestal, MD, MBA, an emergency medicine physician in Salisbury, MD.


Journal of Oncology Navigation & Survivorship
JONS

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