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(BQ) Part 2 book “Health policy and advanced practice nursing” has contents: Health policy implications for advanced practice registered nurse s related to end-of-life care, health policy implications for advanced practice registered nurses related to oncology care, the american nurses association, and other contents. | CHAPTER 18 Health Policy Implications for Advanced Practice Registered Nurses Related to End-of-Life Care Judy Lentz The process of dying and the ultimate death experience over the past 100 years has changed dramatically (Table 18.1). In the early 20th century, generally deaths followed short-term illnesses such as pneumonia, end-stage cancers, strokes, and so on. In the 21st century, those diseases are either cured or controlled for prolonged periods of time. In 1900, the average life span was 48.23 years as compared with 78.3 in 2010, more than a century later (Bakitas et al., 2010; Centers for Disease Control and Prevention [CDC], 2012a; Infoplease, 2012). Only 4% of Americans in the early 1900s were over 65 years of age (Hoefler, 2010). Today, more than 12.8% of Americans are 65 years and over, and this percentage is projected to increase to 19.3% by 2030, more than quadrupling in the past 100 years (Jackson et al., 2012). Again, in the early 20th century, the dying trajectory was short term following an acute illness. However, in mid-century, a short 50 years later, circumstances changed. With the advent of antineoplastics, antimicrobial agents, and technological advances, acute illnesses were treatable and life-threatening illnesses could be ameliorated. Many life-threatening acute illnesses became chronic in nature and Americans began to believe most diseases could be cured or at least controlled for long periods. The extended life span in the 21st century has confirmed this belief. As a result of these advances, illnesses progressed more slowly, treatment options caused more suffering, pain was frequently unrelieved, and the dying process became protracted. Physicians who had taken the Hippocratic Oath sought to prolong life and family members became death-denying by urging the medical staff to try “one more’” approach. Dying with dignity became an unfulfilled wish. In its place was isolation, pain, and suffering. Today, more than 2.5 million people die
