dementia and palliative care Flashcards
1
Q
when to consider palliative care in dementia PT
A
when diagnosed
- can be considered a teminal diagnosis
2
Q
5 reasons to involve palliative care
A
- improve QOL
- decrease Sx burden
- less aggressive interventions at end of life
- improved satisfaction with care
- live longer
3
Q
3 parts of palliative care lens
A
- burden of Sx
- functionality
- goals of care/ACP
4
Q
when is most important point of palliative
A
last year
5
Q
types of dementia Sx
A
- aggression
- confusion
- hallucination
- disinhibition
- irritable/labile
- insomnia
- depression
6
Q
4 spheres of Tx
A
- environment
- psychosocial
- complementary
- PT
- massage - pharma
- PAIN MEDS
7
Q
what is relationship between pain and dementia
A
- pain under-recognized and under treated
- pain can trigger and worsen Sx
- agitated PTs respond to pain meds alone
- those with pain have the worst depression
8
Q
3 methods to measure pain
A
- pain scale
- faces
- PAINAD
- breathing
- vocal
- body lang
- facial expression
- consolability
9
Q
risks and benefits of opiods
A
risks - falls - confusion - sedation benfit - less pain - less agitation
10
Q
4 pain meds to use, and one not to
A
- aceto - 3g/day
- topical NSAID
- opiods - lower doses
- adjuvants
NOT
oral NSAID - renal
11
Q
what is good measure of funcitonality
A
palliatve performace scale
12
Q
3 parts of gold standard framework
A
- surprise question
- general indicators of decline
- specific indicators of decline
13
Q
what are general indicators
A
- unstable, deteriorating complex Sx burden
- decreasing response to Tx
- > 10% weight loss
- repeated admissions
- albumin
14
Q
specific indicators
A
- no meaningful conversation
- incontinence
- recurrent fever
- aspiration pneumos
- decreased oral intake
15
Q
6 practical comprehensive goals of care
A
- be cured
- live longer
- improve/maintain function
- be comfortable
- provide support ot fam
- acheive life goals
