5.2 A Good Death Flashcards
What are the aims of hospices?
Symptom control and communicate
Facilitate ‘life until they die’
What is the principle of care given in hospices?
Hollistic
Care involves looking after the patient at every level
Why is facilitating a good death so difficult?
Death is taboo
Rare to see a dead body
Dying has been medicalised
What are the challenges to achieving a good death?
- Truthfulness
- Enabling informed consent
- Preparation time
- Avoiding isolation
- Overcoming a wall of silence
- Maintaining hope by accompanying them on the journey
What should NEVER be said to a patient?
There is nothing more to be done for you
There are always palliative care options
What is futility?
Curative treatment is continued with no chance of success
Just prolonging life
When does the transition from curing to palliative care occur?
Must obtain informed consent
Cure no longer possible
Help the patient accept death
Prepare loved ones
Why is review of care so crucial?
Once a patient dies they cannot say how their care was
Crucial to ensure care is as good as possible at the time
What pain is unmanagable?
Spiritual pain
e.g. family disagreements/ unresolved conflicts
What are some important points of good dying?
- Avoiding medicalisation
- Avoid medical captivity
- Agreed care plan
- Die in the way the patient wants
- Adequate symptom control
Who else must be considered in geriatrics?
Informal carer
Often neglected by professional carers
Give them a chance for respite care
Ensure they do not feel guilty they have failed their loved ones
What if there is suffering with death?
Inadequate palliative care
Thoughts of euthanasia are not signs of a good death
What are the principles of a good death?
- Warned when death is coming and what can be expected
- Retain control
- Dignity and privacy
- Control over pain relief and symptom control
- Choice and control over where death occurs
What is the double doctrine effect?
Something done with good intentions but poor outcomes
Such as giving morphine for symptom control which then causes respiratory depression leading to death
