Death in Numbers, Death in Art and The Last Hours Flashcards
1
Q
Do most americans want high-intensity EOL care and hospitalization?
A
No, 80% want to die at home
2
Q
What does average last month of life look like?
A
- 50% ED visit
- 30% ICU admission
- 20% inpatient sufgery
3
Q
Where do the majority of people die?
A
Hospital
4
Q
Death in hospital vs home hospice
A
- Dec quality of life
- Increased physical and emotional distress
Caregivers:
- Increased risk PTSD
- Increased risk of prolonged grief
5
Q
How do you improve QOL at death?
A
- Home hospice death
- > 3 days hospice care
- Religious prayer, meditation, pastoral visit
- Patient-physician therapeutic alliance
6
Q
Worse QOL at death?
A
- Hospital/ICU death
- Late or no specialized palliative care
- Patient worried
- Life-prolonging procedures
7
Q
Most important aspects of dying include:
A
- Dedicated decision maker
- Financial affairs in order
- Knowing what to expect about prognosis
- Knowing what to expect about physical condition
- Maintain dignity
- Pain control
8
Q
Palliative Care fills the GAPS (what does GAPS mean)?
A
G = Goals of care A = Advance Directives P = Psycho-social spiritual support S = Symptom control
9
Q
What is palliative care?
A
- Specialized medical care for people with serious illness
- Team
- Improve QOL
- Independent of prognosis
10
Q
What is hospice?
A
Specialized form of palliative care focused at EOL care
Dependent upon prognosis (
11
Q
Take home points for QOL
A
- Patients prefer to die at home but actually die in the hospital
- Hospital stay at EOL is associated with worse QOL and bereavement
- Palliative care increases QOL in seriously ill
- Hospice increases QOL at end of life
