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Quality improvement strategies are helping to identify and remedy system problems that impede
good care. The LCP has since been championed within the National Institute for Clinical Excellence
(NICE) Guidance for Supportive and Palliative Care (2004) and recently within the White Paper
“Our Health, Our choice, Our Say” (2006) as a pathway for guaranteeing the needs of patients, their
informal carers are identified and addressed (Gambles and Ellershaw, 2006). This has been attributed
to the effectiveness of cardiological treatments and risk factor trends accounting for the decline in
CHD mortality in England and Wales between 1981-2000. 58% of this mortality rate decline in
Britain was suggested to be as result of reductions in the main risk factors, which primarily involved
smoking. Currently he provides academic writing service at Total Assignment Help and gives
guidance to students all over the world. The Institute of Medicine committee appointed to undertake
the study prepared this report with the objectives of stimulating discussion, encouraging consensus
on how care for those approaching death can be improved, and galvanizing action to implement that
consensus. Using the LCP: bereaved relatives’ assessment of communication and bereavement. Since
the NFS began, every year amendment have been addressed the current available NSF is 2009 and
available for the DoH (Department of Health, 2004)(Department of Health, 2000). Statistics collated
by the British Heart Foundation data also reflect regional, national and socioeconomic variances, a
primary concern when attempting to address this fatal disease (British Heart Foundation, 2010). As a
nurse and her caregiver, I had to accept what was happening including my role as a caregiver with
new demands and duties; making her comfortable. Overall, increased health care spending is
primarily accounted for by population growth, general inflation in the economy, and additional
medical care inflation. Hospital and emergency department use in the last year of life: a baseline for
future. These reasons range from the examples of well-known men and women facing death with
grace to the focus on deficiencies in care. System change requires the involvement of public and
private purchasers of care, regulators, and others whose policies and practices may create incentives
for inappropriate care and barriers to excellent care. Journeys into end of life research: some
methodological - CIES - iscte. Though contradictory, child patients nearing their death can benefit
from the curative aspects of wound healing. Therefore art, music and play therapy will help the
children and families explore and express their feelings about one another. Our heavy discount
programs could be utilized by you t gain a very high-quality solution paper at a very low price. It is
essential to state that cognitively impaired children sometimes referred to as having intellectual
disabilities, and in earlier times as the feeble-minded, have intellectual levels of functioning and
adaptive abilities which are significantly below those of the average for a child of their chronological
age. Four key phases have been outlined which reflect the transferable nature of the LCP into other
specific diagnostic areas including pediatrics’ neurological conditions, heart failure, advanced
chronic kidney disease, intensive care unit and care homes (MLPCIL, 2009). Nonetheless, the
committee tried to learn from the experience of other countries and to develop a report that would be
useful beyond this nation's boundaries. Before I give you a blanket list of thesis statement examples,
let’s run through what makes for a good thesis statement. Patient and family expectations and
understanding will be aided by advance care planning that considers needs and goals, identifies
appropriate surrogate decisionmakers, and avoids narrow preoccupation with written directives.
Some people believe that the end of life care is a form of suicide which is unethical in the society.
Dying is too important a part of life to be left to one or two required (but poorly attended) lectures,
to be considered only in ethical and not clinical terms, or to be set aside on the grounds that medical
educators are already swamped with competing demands for time and resources. Principle results
from EUROASPIRE II Euro Heart Survey Program, European Heart Journal, Vol. 22, pp. 554-572.
Although efforts to reduce the entertainment and news media's emphasis on violent or sensational
death and unrealistic medical rescue have not been notably successful, a modicum of. Objectives are
likewise varied as illustrated below and in later chapters and Appendix C. It is a dual perversity that
interest in assisted suicide sometimes reflects anxiety about overly aggressive medical treatment,
sometimes dread about abandonment, and sometimes fear that dying people may suffer
simultaneously or sequentially from both misfortunes. The author would have to travel through its
multitude aspects which would make the whole task of writing a dissertation on it a very
cumbersome task. Children generally prefer to be at home among their own toys, pets, family
members and friends.
Much of the responsibility for keeping the public discussion going will rest not with the media but
with public officials, professional organizations, religious leaders, and community groups. Therefore
art, music and play therapy will help the children and families explore and express their feelings
about one another. For example, since the first U.S. hospice was founded in Connecticut in 1974,
clinicians, patients, families, community volunteers, and policymakers have mobilized under the
hospice banner to design and implement ways of reducing suffering and improving the quality of life
for dying patients and those close to them. Indeed, it is inhumane to artificially extend the life of
individuals when one knows that it would just prolong the life and not the quality of life. Her lack
of autonomy in her final days was difficult for her to accept. Although this report often refers to
patients and those close to them, it also uses the term family in a general sense to include not only
the traditional family (e.g., spouse, children, parents, siblings) but also others such as lovers, friends,
and godparents who are significant and close to patients in an emotional, spiritual, or sometimes
fiduciary sense. A grantmakers group including these and other organizations is also meeting to
encourage knowledge sharing, coordination, and identification of neglected issues. Journalists,
television producers, and others involved in mass communications are also being encouraged to
present a less skewed portrayal of death with less emphasis on heroic but implausible resuscitations
and violent but impersonal deaths that have few lasting effects on survivors. We have described some
of the frequent challenges that a student faces while selecting the dissertation topics. Overall,
increased health care spending is primarily accounted for by population growth, general inflation in
the economy, and additional medical care inflation. We use cookies to create the best experience for
you. In this, the Institute acts under both the Academy’s 1863 congressional charter responsibility to
be an adviser to the federal government and its own initiative in identifying issues of medical care,
research, and education. The objective of this theory is to bring health care services in human action
and denote that individuals can benefit from nursing when they are experiencing conditions that will
limit their actions in everyday life. So people due to their religious beliefs may not go for such
equipments in order to prolong their life. Nonetheless, the committee tried to learn from the
experience of other countries and to develop a report that would be useful beyond this nation's
boundaries. This is 100% legal. You may not submit downloaded papers as your own, that is
cheating. Also you. A living will usually explains what the doctor must do in case the patient
happens to be in a critical stage. Euthanasia also allows for organs such as livers, hearts and kidneys
to be harvested for transplant into otherwise healthy individuals with a potential for many more
years of life. Quality improvement strategies are helping to identify and remedy system problems that
impede good care. Despite encouraging signs of change, most clinicians-in-training experience and
learn too little of the caring that helps people to live well while dying. While caring for Mr. K, I
observed that his wife was present beside the patient all the time. Legal change should help—but
cannot be relied upon alone—to correct undertreatment. Funding comes from diverse internal and
external sources including government agencies and several private foundations such as the Open
Society Institute's Project on Death in America, the Robert Wood Johnson Foundation, the
Commonwealth Fund, the Greenwall Foundation, the Culpeper Foundation, and the Milbank
Memorial Fund. This Institute of Medicine report is intended to support such action by strengthening
popular and professional understanding of what constitutes good care at the end of life and by
encouraging a wider societal commitment to caring. Fifty conferences were audiotaped, transcribed,
and analyzed by using the principles of grounded theory. From this point, it is evident that caring,
which is the core principle of nursing is possible. When good practice is hindered by organizational,
financial, or legal impediments, health professionals have the responsibility as individuals and
members of larger groups to advocate for system change. Other valuable assistance in understanding
research questions and priorities was provided by Kathryn Foley, M.D. and William Breitbart, M.D.,
of Memorial Sloan-Kettering Cancer Center, and Gary Bennett, Ph.D., of Allegheny University of
the Health Sciences. Messerli, Joe. (March 4, 2007). “Should an incurably-ill patient be able to
commit physician-assisted suicide?” Balanced Politics. Even the contentious and often bitter debate
over the legality or morality of physician-assisted suicide has had positive benefits in forging
agreement that deficiencies in care for dying patients may contribute to demands for assisted suicide
and that such deficiencies need to be remedied.
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present. In the real
world, it is more likely that an individual will opt first to save the young child from an oncoming bus
rather than an old man. Mrs. K showed a distinct lack of trust in health care providers; as she said
nobody listened to her concerns properly. Register for a free account to start saving and receiving
special member only perks. Decisions by health plan managers, institutional administrators, and
governmental officials shape and often impede the ability of patients, families, and clinicians to
construct a care plan that serves the dying person well. The developing fields of outcomes
measurement can make important contributions to the care of the dying by teaching us how to
conceptualize and measure quality of life and well-being for those approaching death. Her lack of
autonomy in her final days was difficult for her to accept. For those who seek to build public
understanding of dying as a part of life and to generate public demand for better supportive services,
one model can be found in the perspectives, spirit, and strategies that have guided efforts to promote
effective prenatal care and develop mother and family-oriented arrangements for childbirth. Mrs C
may require more community-based support and health services to manage her care at home and
avoid. Chapter four and ten were great examples of how pain and dignity. The research
establishment includes the National Institutes of Health, other federal agencies (e.g., the Agency for
Health Care Policy and Research, the Health Care Financing Administration, the National Center for
Health Statistics), academic centers, researchers in many disciplines, pharmaceutical companies, and
foundations supporting health research. A bad death, in turn, is characterized by needless suffering,
dishonoring of patient or family wishes or values, and a sense among participants or observers that
norms of decency have been offended. The research delves on nursing roles during end of life
situations. It may occur suddenly, for example, from a superimposed viral illness, or it may come
after an extended but clearly evident physical decline. Problem areas include insufficient numbers
and types of properly trained personnel, nonexistent or inadequate protocols for symptom
assessment and management, and poor procedures for evaluating the need for patient transfers or
referrals and for carrying out such transfers without harm to patients. The committee supports the
development of guidelines for clinical practice that assist clinicians in preventing and relieving
symptoms and in managing the end stages of specific diseases. Immigrants, who tend to be young
and have more children than native-born Americans, have been a major source of growth in the total
U.S. population (NRC, 1997). Palliative and End of Life Research Priority Setting Project for
Northern. You could approach at any time with your daunting academic concerns. During this
period, people may continue many ordinary activities of daily life while coping with the prospect of
death and preparing. You could approach the academic service of totaassignmenthelp.com so that you
could submit a quality solution on a timely basis. Changes occurring in Health care delivery and
Medicine are the result of social, economical, technological, scientific forces that have evolved in the
21st century. We identified family conferences in the ICUs of 4 Seattle-area hospitals. Information
about the workshop is included in Appendix F. The cost of health care overall would be reduced as
people with no hope of survival no longer drain the available resources and manpower which
translates to lower insurance rates. In this, the Institute acts under both the Academy’s 1863
congressional charter responsibility to be an adviser to the federal government and its own initiative
in identifying issues of medical care, research, and education. A further step is to support more
research on the physiological mechanisms and treatment of symptoms common during the end of
life, including neuropsychiatric problems. Pain research appears to supply a good model for this
enterprise to follow. In addition, pathways need to be developed to further the dissemination and
replication of proven health care interventions and programs. Demonstration projects to test new
methods of financing and organizing care should be a priority for the Health Care Financing
Administration. They also talk about how to begin dialogues about death and to consider the
patient’s fear and hopes regarding care of loved ones. These changes will help in improving the
quality of life of doctors.
It seeks to build understanding of what constitutes good care for the dying and offers
recommendations to decisionmakers that address specific barriers to achieving good care. Despite
some reforms, outdated and scientifically flawed drug-prescribing laws, regulations, and
interpretations by state medical boards still frustrate and intimidate physicians who wish to relieve
their patients' pain. In any case the patient should have the adequate mental and physical health at
the time of changing his advance directives. The wider problem here is that acknowledgement of the
inevitability of death. System changes—not just changes in individual beliefs and actions—are
necessary. For instance, let us assume that the student has selected the topic of pollution for the
dissertation task. One of these expectations is that policymakers and others will need to prepare
during this period for the final demographic consequences of the post-World War II baby boom. To
undertake the study, the IOM appointed a 12-member committee of experts in medical and nursing
care for chronically and severely ill patients, ethics, quality of care, health policy, health services
research, law, economics, social services, and related fields. There is a plan for community support
services to assess her needs. Mrs C may require more community-based support and health services
to manage her care at home and avoid. Second, a hospice may be an organization or program that
provides, arranges, and advises on a wide range of medical and supportive services for dying patients
and their families and friends. This training can be achieved through preparing professionals for
possible negative outcomes and encouragement in incorporating palliative care into their delivery
approach adhering to guidelines set out in the LPC. According to World health organization (WHO),
palliative care should not be offered just before death but it should be offered years before to help
people who need help along the way (2005). TotalAssignmenthelp Affiliate program is the best
choice for you. The “ end of life care support” is a controversial medical issue. A dying person who
experiences few if any physical symptoms may suffer greatly if he or she feels that life has lost any
meaning. Difficult decisions and troubling questions about care for those approaching death are not,
however, limited to certain age groups, clinical. In our today's article, you can find great PhD
dissertation topics. To avoid this situation, older adults should discuss their end-of-life wishes with
family members and health care providers well before the onset of a serious illness, and they should
designate a surrogate decision maker for health care” (Planning for the End of Life—An Emerging
Public Health Priority) Britain’s famous celebrity Joe Goody is who has passed away recently
because of blood cancer is the best recent example we can remember regarding this topic. Due to the
lack of proper information and resources, Mrs. K was not prepared for the dying process and was not
aware of the signs and symptoms of the end stage. There is an opportunity for the team and the
family to consider the different options for care at home for Mr A in the future as his. Admitting
nurses and doctors could ask Mrs C if she has any form of ACP documented. They also argue that
the sentiment of humane treatment afforded animals that are terminally ill or injured and are
suffering should be given to humans as well. Thomas also likes to explore wildlife and learn about
the diversity in flora and fauna in different countries. It has also highlighted the reasons for believing
that professionals, policymakers, and the public are ready to support such steps. Most care for
hospice patients in the United States is, however, provided in the home by family members. To many,
it is unimaginable to allow anyone, for example, a sweet old grandmother who has spent her life
caring for others to spend the last six months of their life enduring constant pain, unable to control
bodily functions, convulsing, coughing, vomiting, etc. Effective advance care planning is important
in providing good care at the end of life because it enhances a discussion of end-of-life issues
between the patient, physician, and caregivers. These are, of course, only a part—often a minor
part—of the dying process as experienced by patients and those close to them. Finally no targets for
Northern Ireland (British Heart Foundation, 2010).
This paper will also talk about the relevant gaps and implications for nursing practice; and how it will
influence my practice as a future nurse. It seeks to build understanding of what constitutes good care
for the dying and offers recommendations to decisionmakers that address specific barriers to
achieving good care. Each is intended to contribute to the achievement of a compassionate care
system that dying people and those close to them can rely on for respectful and effective care.
Medical technology, meanwhile, has continued to advance, and the temptation remains great to
ignore its limits and to evade the uncomfortable and emotionally challenging demands of facing
these limits. It also conducted two public meetings, one in Washington, D.C., and another in Irvine,
California. The research establishment includes the National Institutes of Health, other federal
agencies (e.g., the Agency for Health Care Policy and Research, the Health Care Financing
Administration, the National Center for Health Statistics), academic centers, researchers in many
disciplines, pharmaceutical companies, and foundations supporting health research. Many adults,
even in middle age, have not lived with or cared for someone who was dying. Surgical procedures
are employed in advanced cases of angina and include bypass surgery, coronary artery angioplasty
and coronary stenting (British Heart Foundation, 2010). A doctor’s involvement in the procedure
could be to either prescribe a lethal dose of drugs with the express intent of ending a life or by
intravenously inserting a needle into the terminal patient who then activates a switch that administers
the fatal dose (Naji et al, 2005). On the one hand, discoveries and innovations in public health,
biomedical sciences, and clinical medicine have brought remarkable advances in our abilities to
prevent, detect, and treat many illnesses and injuries. As such, there has been an increased interest in
the media and public discussions which have undoubtedly raised serious questions about its efficacy
in providing high quality care for the dying patient. They also suggest that orientation regarding
communication skills to new nurses on the floor can help in providing better end-of-life care. They
should, for example, not be allowed to believe that pain is inevitable or that supportive care is
incompatible with continuing efforts to diagnose and treat. We used qualitative methods to identify
and categorize missed opportunities, defined as an occurrence when the physician had an
opportunity to provide support or information to the family and did not. Methods of identifying and
supporting carers within a range of services, including palliative care have emerged as the DoH has
created 25 Carers Demonstrator sites (LCP, 2008). The members of the committee responsible for
the report were chosen for their special competences and with regard for appropriate balance.
Opportunities to improve quality of care prior to this admission. Chapter four and ten were great
examples of how pain and dignity. We developed 2 frameworks for describing and understanding
this communication. Discussion Nurses play a vital role in the patients' end of life care. The
technology offered by the startup is not only ingenious and one-of-a-kind, but extremely valuable to
utility industry players as it represents. Like the mythic king Tantalus, who reached for fruit and
water just beyond his grasp, the dying person has too often been destined to seek but not find a pain-
free and peaceful death. There are common diagnoses that affect the length of life of children
including prematurity, chromosomal defects, cancer, AIDS, congenital anomalies among others. The
research delves on nursing roles during end of life situations. It seeks to build understanding of what
constitutes good care for the dying and offers recommendations to decisionmakers that address
specific barriers to achieving good care. Feature article: population by age and sex, Australia, States
and Territories. Children requiring palliative care need to be in a familiar environment in order to
maintain a normal life for as long as possible. Widely publicized—albeit not necessarily
typical—instances of patient and family powerlessness to stop what they see as futile and painful
treatments reflect a lack of such consensus. Other valuable assistance in understanding research
questions and priorities was provided by Kathryn Foley, M.D. and William Breitbart, M.D., of
Memorial Sloan-Kettering Cancer Center, and Gary Bennett, Ph.D., of Allegheny University of the
Health Sciences. When good practice is hindered by organizational, financial, or legal impediments,
health professionals have the responsibility as individuals and members of larger groups to advocate
for system change.