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Question 1

8 Domains of Palliative Care

Answer 1

1. Structure and process of care: assure interdisciplinary assessment of patient/family, develop plan based on needs/goals of patient, provides care across the care continuum
2. Physical: obtain history and do physical exam, manage side effects based on best medical evidence, treat to minimize symptoms and maximize quality of life
3. Psychological and psychiatric: respond to psychological and social problems from patients/family, provide bereavement support to family
4. Social: identify social needs of patients and family, transportation and financial problems, stress of family caregivers
5. Religious, spiritual, and existential: FICA
6. Cultural
7. The imminently dying patient
8. Ethics and law

Question 2

Palliative Care

Answer 2

Improves the quality of life for patients and their family

Focuses on prevention and relief of suffering

Assessment of treatment and pain is multifaceted

Applicable early in course of illness

Question 3

Interdisciplinary vs. Multidisciplinary

Answer 3

Multidisciplinary: involves consultations with people of different expertise

Interdisciplinary: working together as a team to create individualized plan to care for patient

Question 4

Taking a spiritual history

Answer 4

FICA

F: faith and belief, do you consider yourself spiritual, if no then what gives your life meaning

I: importance, how has your beliefs influenced how you take care of this illness

C: community

A: address in care, how should I address your spiritual care

Question 5

Signs and symptoms of imminent death

Answer 5

Social withdrawal: from outside world then loved ones

Decreased appetite

Increased sleep

Disorientation

Restlessness

Decreased sensorium: hearing is one of last to go

Incontinence

Physical changes: stuff like change in blood pressure and respiration

Question 6

Hospice

Answer 6

Medicare benefit provided in last 6 months of life, form of palliative care

Palliative care can be done at any time