Lee Geropalliative Caring Model

The current ANS featured article comes with Continuing Education, and addresses one of the most pressing, and important challenges in nursing – end-of-life care.  The article is titled “Lee Geropalliative Caring Model: A Situation-Specific Theory for Older Adults,” authored by Susan M. Lee, PhD, RN, NP-C, ACHPN, FAAN.  The article is available to download at no cost while it is featured.  Here is a message from Dr Lee about her work:

As a nurse scientist at Massachusetts General Hospital, my nurse colleagues taught me that they face daily challenges with aggressive end-of-life treatments, particularly among older adults, that do not make a difference.  In fact, the treatments that nurses are called upon to deliver caused more suffering. They looked for direction, language, frameworks that would give them a more credible voice on behalf of patients and families. With HRSA funding, we were able to bring novel education in ethics, geropalliative care, and evidence-based practice that helped to build moral courage and knowledge.  Ultimately, these programs and their extraordinary faculty, helped them to be more effective in the murky crossroads of humans and healthcare.

One education program, AgeWISE, was disseminated nationally to determine its transferability to nurses in other hospitals. It yielded similar outcomes among rural and urban nurses. Universally, nurses want guidance. The model presented in ANS this month is a synthesis of research, ANA standards, ethics, and nursing theory that can help nurses focus on what is most important. These are tough situations that are fraught with emotion, competing values, power imbalances, and ego. Even in situations where nurses cannot change the plan of care, the model reminds nurses that there are are almost limitless opportunities to make a difference to patients and families by comforting body/mind/spirit and helping families transition to a new reality.

Theory-guided practice is more important than ever. It is intimately linked to our disciplinary values. Situation-specific theories can help nurses navigate situations that are difficult to sort out. I welcome conversation at susan.lee@umb.edu