271. Principles of Palliative Care Flashcards
1
Q
Define Palliative Care (5)
A
- Approach guided to improving quality of life
- Prevention and relieve of suffering
- Treating pain and other problems, physical, psychosocial and spiritual
- Offers support system to help family cope
- Team approach
- Applicable early in course of illness in conjunction with other therapies intended to prolong life
2
Q
What are 3 elements of Hospice Care
A
- Expected prognosis of 6mo or less (challenge: prognostication, discussing with pt and family)
- Capacitated/managed system (challenge: more expensive therapies may be harder for individual hospices to provide
- Focus on comfort and not cure (challenge: hard to distinguish between comfort and curative for each tx)
3
Q
What are the two most common etiologies for hospice care?
A
- Cancer
- Heart Disease
(even though heart disease more common cause of death than cancer)
4
Q
What are the 3 domains that palliative care hopes to impact?
What are proposed benefits to palliative care?
A
- Sx Control: physical and non-physical
- Overall quality of life
- Cost of care
- No difference in mortality b/w palliative and life-extending care
- End-of-life discussions assoc with earlier hospice referrals, lower rates of resuscitation/ICU admission/ventilation, NOT assoc with more worry and depression
- End-of-life discussions assoc with LOWER cost
- Palliative care had positive impact on family coping (less PTSD, anxiety, depression, need for meds)
- Palliative care conferred SURVIVAL ADVANTAGE (less aggressive care, longer survival), and improvements in quality of life and mood
5
Q
What are 3 challenges to palliative care?
A
- Caring vs. Curing
- “Winning”: media overrepresents the power of resuscitative care (75% survival of cardiac arrest vs. 6-35% survival in hospitals)
- Predicting Prognosis: limited by overly optimistic inaccuracy, ambivalence (not sure), Hesitance (often problematic and unwelcome by pts and families - they want to know their own prognosis)
