5 End of Life Care

Question 1

Define Palliative Care

Answer 1

the treatment, care, and support for people with a life-limiting illness, and their family and friends

Question 2

Define Supportive Care

Answer 2

Helping patients and their family to cope with their condition and its treatment from pre-diagnosis, through the process of diagnosis and treatment, to cure, continuing illness to death and bereavement

Question 3

Define End of Life care

Answer 3

The treatment, care, and support for people who are nearing the end of their life. (usually the last year)

Question 4

What 4 factors contribute to ‘total pain’?

Answer 4

physical
social
spiritual
psychological

Question 5

What are the 4 different death patterns we usually see?

Answer 5

sudden death
terminal illness
organ failure
frailty

Question 6

How does the old concept of palliative care differ from the new?

Answer 6

palliative care is gradually phased in as the patient nears the end of their life

Question 7

What is the relationship between DiUPR and hospital deaths?

Answer 7

DiUPR is increasing at the expense of hospital deaths

Question 8

Why might someone want to die in hospital?

Answer 8

better pain / symptom management to make death less stressful

Question 9

How many of those who need it receive palliative care?

Answer 9

8% according to the Worldwide Palliative Care Alliance

Question 10

What were the 3 aims of the End of Life Care Policy NHS 2008?

Answer 10

improve Quality of Care
enhance choice at EoL
deliver government manifesto commitment to double investment into palliative care

Question 11

What did a 2013 July review suggest about the use of LCP?

Answer 11

it should be phased out for a more individual care pathway
only a senior clinician should put someone on the LCP
a decision to withdraw / no start life prolonging treatment should not be made in an ‘out of hours’ period
an urgent call for the Nursing and MIdwifery Council to issue guidance on end of life care
end to incentive payments to use LCP

Question 12

What were the 6 ambitions for Ambitions for Palliative and EoL care?

Answer 12

each person is an individual
each person gets fair care access
maximising comfort + wellbeing
care is coordinated
all staff are prepared to care
each community is prepared to help

Question 13

What are the 3 facets to Advanced Care Planning?

Answer 13

Statement of Wishes and Preferences
Advance Decisions to refuse treatment
Lasting Power of Attorney