Final answer:
The nurse should begin a conversation about the goals of care at the end of life by discussing the patient's preferences and values, which may include hospice care and considerations of dying with dignity.
Step-by-step explanation:
To answer the question about the best way for a nurse to begin a conversation about goals of care at the end of life when a patient's chronic illness worsens, option B is the most appropriate: Initiate a discussion about the patient's preferences and values. It is essential for healthcare providers to engage in conversations with patients and their families regarding end-of-life care wishes, which can include exploring hospice care options, discussing living wills and advanced directives, and understanding the patient’s specific desires for their care as their illness progresses. Such discussions ensure that the patient's wishes are honored and that they are provided with care that aligns with their values and goals, contributing to a sense of dying with dignity.
Hospice care is particularly relevant as research has highlighted its benefits both for the patient and family members, offering greater comfort, emotional support, and often extending the patient's life compared to non-hospice alternatives. Hospice also reflects societal shifts towards more humane and patient-centered approaches to end-of-life care, highlighting the importance of passing away in a comfortable and peaceful environment, which for many is their own home.