1. Death and palliative care Flashcards
What are the commonest causes of death?
• Most common cause of death are:
1. Cancer
2. Ischaemic heart disease
• In young, most common cause of death: accidents
• In men, most common cause of death is suicide
What do unexpected deaths cause?
- Sense of shock
- No chance to say goodbye or take back said words
- Multiple deaths ore legal/press involvement
What are involved in expected deaths
- Terminal care = last phase of care when patient’s condition is deteriorating, often misleadingly associated with cancer.
- Palliative care = management of conditions until terminal phase is reached
What is palliative care?
- Philosophy of care that emphasises QUALITY of life and performed by MDT (communication is essential)
- Most provided in primary care with specialist practitioners and specialist palliative care units or hospices
- WHO state: palliative care improves QoL of patients and families
providing pain and symptom relief, spiritual and psychosocial support, from diagnosis to end of life and bereavement
- Scottish government developed national action plan for palliative care called Living and Dying Well- makes sure patients wishes are met
What different aspects does palliative care apply to?
- Physical needs
- Practical needs
- Functional needs
- Social needs
- Emotional needs
- Spiritual needs
How does palliative care achieve its goals?
- Early identification
- Impeccable assessment
- Treatment of pain and other problems (physical psychosocial, spiritual)
How do you know if a patient is ready for palliative care?
• Supportive and Palliative Care Indicators Tool (SPCIT)-
Antecepatory care plans
What is involved in an anticipatory care plan?
- Where do they want to be cared for?
- Do they want to be resuscitated in event of cardiac arrest? Or die naturally?
- Who do they want to be informed about their condition/ changes to condition?
- Are they fully aware of their prognosis?
- Is family aware of prognosis?
Once discussions have been made; patient should be placed on practice’s Palliative Care Register who inform out of hours services involved in patient’s care of patient’s wishes.
What is the palliative care performance stage?
- Used to evaluate how quickly the situation is changing for patient and see if care needs to be re-evaluated.
What are some common symptoms that can be overlooked when delivering anticipatory care plans?
- Insomnia
- Anxiety/ depression/ distress
- Nausea
- Incontinence
What are the goals of palliative care?
- Provides relief from pain and other distress
- Affirms life and regards dying as normal process
- Intends to neither hasten/hurry nor postpone death
- Integrates psychological and spiritual aspects of care
- Offers support system to help PATIENT live as actively as possible until death
- Offers support system to help FAMILY cope during patient’s illness and bereavement
Who may be involved in the palliative care team?
- MacMillan nurses
- CLAN
- Marie Curie nurses
- Religious or cultural groups
What are the aspects of a good death?
- Pain-free death
- Open acknowledgement of imminence/proximity of death
- Death at home surrounded by family and friends
- An aware death where personal conflicts and unfinished business are resolved
- Death as personal growth
- Death according to personal preference and in a manner that resonates with person’s individuality
