culture 3 dementai and lgbtq Flashcards
Considerations at the end of life lgbtq
- Being aware of the historical stigmatisation that the GLBT community have experienced.
- Being educated about the specific diseases that may make this community more
vulnerable. - Being careful of their own reactions to the person disclosing their sexuality and being
sensitive to it. - Respecting that their sexuality is part of who they are.
- Understanding the difficulties they and their partners may experience with end of life care
decision making, especially if the relationship has been hidden from family members.
Compared to the general population, the GLBTI community have higher rates
of alcohol and drug consumption, and higher rates of mental illness and
suicide risk.
They also have higher rates of certain cancers: cervical, anal, breast and
ovarian cancer.
GLBTI fear of stigmatisation and discrimination cause
they tend to attend
medical treatment too late.
Many people who are LGBTIQ+ may feel pressurised
to deny their sexuality
when entering end of life care.
If they do not have a “formalised relationship” LGBTIQ+
there may be conflict
between their partners and their family members
if LGBTIQ+do not have an Advanced Care Directive, or an enduring guardian and have no protection of marriage
there may be conflict in who has the right to make their medical
decisions for them.
They may not have the legal protection that marriage gives heterosexual
couples
By telling a health care worker their sexuality and these health worker should not
people are placing a great
deal of trust in the person and nurses may not handle this well, due to their
own cultural/ religious background.
Ethically responsible health care workers need to ensure that their own
attitudes do not lead to further discrimination and sometimes even
substandard care
Dementia
a terminal illness and is now the second leading cause of death in Australia.
The trajectory of illness with dementia
is characteristic and predictable.
he cornerstone of high quality palliative care
for patients with dementia
Advance care planning
The patient’s wishes and the appointment of a proxy carer should occur
PRIOR to significant cognitive decline
Having a written advanced care directive prevents
unwanted and
unnecessarily burdensome treatments.
Patients with dementia are often not referred for palliative care
because health care providers find prognostication difficult.
Symptom management for patients with dementia requires
an
active approach to assessment, based on routine and ongoing
use of assessment tools and protocols, as part of a treatment
plan that is focused on the person’s needs and wishes.
they are at risk dementia
under-treatment of distressing symptoms,
which can greatly reduce their quality of life
. These include pain,
nausea, dyspnoea, delirium, depression, and skin and bowel
problems.
