Accepting Death by Family at the End of Life

Accepting Death by Family at the End of Life


The hospice development has advanced in the United States in the course of recent years. The concentration of hospice is on far reaching physical, psychosocial support and otherworldly care for ill-fated condition patients and their families. Hospice suppliers advance personal responsibility by shielding patients from wearisome intercessions and giving peaceful, painless consideration at home, at all possible moments, rather than the health facility (Dahlin, Coyne, & Ferrell, 2016).

Hospice nurses give mind essentially under the rules of the Medicare Benefit Act of 1983 (Mor, & Teno, 2016), a government program that enables patients to die peacefully in their homes with their families and companions next to them. Palliative care is the interdisciplinary concern for painless, comfortable measures for the patient as the patient is approaching death in an honorable manner (Kelley & Morrison, 2015). This objective is to facilitate the patient to accomplish the most personal comfort level through pain relief, control of side effects and retaining autonomy. The hospice nurse must remain personable to the patient help maintain social and religious esteems and practices. The care that both hospice and palliative care nurses give is essentially similar to the Hospice and Palliative Nurses Role Delineation Study. Be that as it may, hospice and palliative care medical nurses’ differ in their planning and practice settings (In Ferrell, 2015).


The challenge of the hospice nurses is to assist the family caring for terminally ill patient and cope with stressors, Additionally, the nurse assists them to maintain the integrity of their previous role that are important for them and the rest of the family.


Hospice and palliative care nurses work as a team with other disciplines. For example, doctors, social workers, chaplains, nurses, hospice aide, and clerk in the setting of an interdisciplinary group. The teams are holistically prepared experts and volunteers. The group combines their qualities to promote and address the issues of the patient and family encountering terminal illness and disease process.

Hospice and palliative nurses distinguish themselves from other nurse associates in their forte practices and their resolute concentration on end-of-life care. Hospice and palliative care incorporates 24-hour nursing accessibility, administration of medications for comfort, maintaining comfort care by relieving physical pain and suffering. Also the nurses extend their care by providing family support.

Familial systems assume different roles, which delineate their responsibility to the family structure. The coping roles are emotional and functional. When the patients are terminally ill or dying, some families are in denial and the interdisciplinary team led by the nurse educator assists the family to cope with the illness or impending loss. A strive for encouragement of coping via social involvement in groups and end of life care is one of the goal of this paper. Additionally, there is a proposal to create a support group to help the families that need further assisting with the passing of their love one.

Program Objectives

Coordinated care: The therapeutic direction is essential care over all components of the extensive health care system. This is including symptom management, home health and group support management. Patients with complex needs customarily require a broad scope of restorative management that is provided by team clinicians and healthcare providers. The interdisciplinary team will evaluate the families that are struggling and suggest participating in the inpatient unit group that is being created.

Superb access to care: The essential care needed at home conveys open administrations for comfort through prescribed care management. For complex patients, there is an accentuation on improved access to favorable therapeutic care in their homes. Patients approaching end of life are emotionally unsteady and require access to restorative measures to augment comfort and provide support to family. Elderly patients and others with physical impairments frequently have contractures and are unable to communicate their needs. These patients require additional means for assessment tools and family counseling.

A system based way to deal with quality and security: The essential health care exhibits a pledge to quality and expanding change. There is a large assembly of difficulties to address necessitating the better nature of care for patients with different terminal conditions. In order to deliver above par care to hospice and palliative patients, we are proposing the creation for a support group. This needed support group is to explore new and innovative ways to reach families in various settings and in different stages.

Summary of intervention program description

The program would incorporate assistance for bereaved loved one’s who have suffered the death or dealing with a patient in the end of life stages. The mission of this group will be assisting the members with adjusted roles and losses, allowing the families to assist reintegration within a system of choice, providing a supportive environment in which they can address their issues. The value for this pilot program will be intrinsic.

Educational intervention program

In this paper, we describe a creative usage system: Support group to help caregivers to copy with the illness or death of a love one. Since most people are not cognizant of the role they play in the family unit, they are unlikely to know how to address the loss of the roles when a family member die or is terminally sick, resulting in gaps in the family system and leads to a breakdown in family functioning.

Method of approach for the intervention

Recognizing need

The initial step of the pre-conditions stage is to recognize the needs of the families and the benefit of the support group to help them to copy with the situation. The pilot support group program to help people on a journey will last for three years, starting in University of Miami Hospital in the auditorium with the families of 10 patients of hospice and palliative care, that are in denial.


The question that we will ask the family is all about their knowledge concerning end of life care. Accepting death is another question we are planning to ask the family being interviewed, their feelings towards dying and thereafter. The support group will facilitate questions as to what are the family needs.  Where do you acquire this assistance? And how would you benefit this support group to do?



Distinguishing implementation boundaries

To assure the interventions are attainable, the group should meet with the staff and administration, present the intercession, and lead an appraisal of potential obstructions to its usage. Such meetings may encourage stakeholders for interest in purchase. This is not our stance. Encouraging donation for a non-profit organization is the method we plan to utilize.


Drafting the intervention package

An intervention package is then drafted that is reasonable for implementation in the group-based organization. Preparing and specialized help designs are additionally drafted amid this stage (In Ferrell, In Coyle, & In Paice, 2015). Essentially a package should be assembled supporting the need for the group. The package must include evidenced based need to be effective and to provide inspiration to move forward with the project.

Ideally the bundle ought to be drafted by the designers of the intervention, yet altered by non-specialized journalists to guarantee that the intervention package materials are free of specialized language. However, this being academically based, we would require further skilled assistance. Accepting Death by Family at the End of Life.

Hypothetically, the budget for the program in the first year, will be created based on the needs of the 10 family members that will be coming to the group every Wednesday to the auditorium of the University of Miami Hospital for one hour, starting the first year, and after assessing the group needs, we will increase the time to two hours, after the three first months. We will provide refreshments to the participants. The pilot program proposal is to be functioning for 3 consecutives years where nurses, social workers, hospice aids, chaplains and doctors will be the facilitators of this pilot program that in collaboration with the University of Miami Hospital we will provide education and support to all the families in needs, and we will be evaluating the outcomes in 3 years.

Item 1st Year 2nd Year 3rd Year
Orientation $200 $250 $250
Brochures $350 $300 $400
Refreshments $150 $200 $250
Travel $200 $200 $230
Parking $60 $60 $60
Equipment $250 $350 $300



When providing End of Life services, or someone in a close passes, the family maintains a resistance to change. Change is viewed as a disruptive to the existing family system with the little knowledge of how to manage the changes encountered. Insecurity causes the family members to seek support only with others who reinforce their belief and values. Due to the functional and emotional suffering, patients and families are in need of psychosocial and spiritual support provided by the interdisciplinary team.  Opening a support group to assist them in their time of hardship is an intended goal. At the end of the six months of this pilot program of support group, we will evaluate the outcome of the family members of the ten patients in hospice and palliative care receiving education and support. The group will be based on assistance that identify their new family role, to cope with the care of a terminally ill patient, discuss potential interventions with the family, to ascertain if they are necessary and attainable. Finally, to evaluate if the are being realistic in view of the strengths, abilities and present situation.  Accepting Death by Family at the End of Life.



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