E. L. is an 88-year-old widow who has advanced dementia. She is a retired secretary and is cared for in the home of her divorced daughter, who is her power of attorney for health affairs. E. L. requires assistance with all activities of daily living. She spends most of the day sitting in her orthopedic recliner (she has had bilateral hip replacements) or lying in bed. She does not speak or acknowledge the presence of others. Recently, E. L. has stopped eating all meals except for small banana slices. She resists a spoon when it is brought to her mouth, and she pockets food in her cheeks without swallowing. E. L. was admitted to the hospital several months ago for influenza and bilateral pneumonia. She was treated in the intensive care unit for three days and then sent home. The possibility of a feeding tube insertion was discussed during her hospitalization. E. L. hasn’t eaten anything but small banana slices for the past few weeks. She doesn’t want to eat when a spoon is put to her mouth, and she keeps food in her cheeks instead of swallowing it. E. L. went to the hospital a few months ago because she had the flu and both types of pneumonia. She was cared for in the ICU for three days before being sent home. During her time in the hospital, they talked about the possibility of putting in a feeding tube. E. L.’s daughter is seeking guidance on artificial nutrition and hydration.

Use the assigned readings to guide you in the development of five discussion points
Assignment help – Discussions points should reflect best practices that you will include as you speak with E. L.’s daughter regarding her mother’s end-of-life care.
Cite your references in proper Help write my thesis – APA Style.
Review the rubric for more information on how your assignment will be graded.
Submit as an attachment to the assignment area.
American Association of Colleges of Nursing. (2017). CARES: Competencies and recommendations for educating undergraduate nursing students. Preparing nurses to care for the seriously ill and their families. http://www.aacnnursing.org/Portals/42/ELNEC/PDF/New-Palliative-Care-Competencies.pdf?ver=2017-07-27-151036-973 (Links to an external site.)CPH and Associates. (2015). Who can give informed consent and what is the nurse’s role in obtaining consent for treatment? https://www.cphins.com/who-can-give-informed-consent-and-what-is-the-nurses-role-in-obtaining-consent-for-treatment/ (Links to an external site.)Fitch, M. I., Fliedner, M. C., & O’Connor, M. (2015). Nursing perspectives on palliative care 2015. Annals of Palliative Medicine, 4(3). http://apm.amegroups.com/article/view/7034/7817 (Links to an external site.)Hackethal, V. (2015). End-of-life care: 40 years of incremental progress. Medscape. https://www.medscape.com/viewarticle/839629#vp_1 (Links to an external site.)Hebert, K., Moore, H., & Rooney, J. (2011). The nurse advocate in end-of-life care. Ochsner Journal, 11(4), 325–329. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241064/ (Links to an external site.)Miller, B.J.(2015). What really matters at the end of life [Video File]. https://www.ted.com/talks/bj_miller_what_really_matters_at_the_end_of_life?utm_source=tedcomshare&utm_medium=referral&utm_campaign=tedspread (Links to an external site.)Reichlin, M. (2014). On the ethics of withholding and withdrawing medical treatment. Multidisciplinary Respiratory Medicine, 9, 39. https://doi.org/10.1186/2049-6958-9-39
Rubric
NURS_498L – Knowledge Assignment Rubric

Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent

4 pts
Highly Proficient

Content is clearly written, thorough, and organized effectively. The paper includes all criteria required in assignment.

3.4 pts
Mostly Meeting Expectations

Content is mostly clear, thorough, and organized effectively. Some points are well supported. The paper includes all criteria required in assignment.

3.04 pts
Developing

Content is somewhat clear, but may not be thorough, or organized ineffectively. Main points may not be well supported. Includes all criteria required in assignment.

2.6 pts
Novice

Content is

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