Elderly, Neuro & MSK Flashcards
1
Q
Describe the types of euthanasia
A
- Deliberately ending someone’s life, in hopes to end suffering.
- Assisted suicide: deliberately assisting or encourging suicide.
- Both illegal in UK.
Types:
- Passive: withholds life saving treatment (advanced directives?).
- Active: actually administering drug, etc.
- Voluntary: when person dying consents.
- Non-voluntary: cannot consent.
- In-voluntary: murder.
2
Q
Outline the arguments for and against euthanasia
A
ARGUMENTS FOR:
- Allows patient autonomy and control over death.
- Acts in beneficence to patient.
ARGUMENTS AGAINST:
- Religious - only God can choose who lives and who dies.
- Change attitude towards human life - hinder research.
- Violates non-maleficence.
- Does palliative care reduce risk for euthinasia - they are no longer suffering like they used to?
- How do you make a criteria for euthanasia - grey area.
- Patient might change their mind but are unable to communicate their wishes.
3
Q
What is the doctor’s role in assisted suicide? What should a doctor do if they’re asked by patients?
A
- Physician associated suicide: suicide by patient facilitated by means i.e. drug presciption or information provided by physician who is aware of patient’s intent.
- Listen and discuss patients request and reasons for request.
- Limit info on = criminal offence.
- Respectful and compassionate.
- Explore patients understanding of current condition and care plan.
- Look for anything missing in care plan, including psychological support and unmet palliative care needs.
4
Q
Be aware of multidisciplinary working in the rehabilitation of neurological conditions
A
- Neurologists: review patient, medications.
- Specialist nurses.
- Occupational therapists: assess individual’s ability to participate in ADLs such as personal care, kitchen tasks and ability to manage in the home environment.
- Physiotherapist: aims to re-educate movement, sensation and balance in order to enable the patient to reach their potential for recovery of mobility and independence.
- Speech and language therapist: assess all aspects of communication and will advise how best to help the patient and their family, assess difficulty swallowing and advise on the most appropriate way to keep a patient’s swallow safe.
- Dietician: explains how food can help post-stroke, assessing nutritional requirements for each individual depending upon their needs, support the team in assessing for tube feeding when appropriate, can discuss the role of nutrition in secondary and primary prevention, aim that food should remain enjoyable for all concerned.
- Clinical neuropsychologist: sees people who are having problems with their thinking, emotions or behaviour after a stroke or other neurological condition, complete assessments and may carry out therapeutic interventions or advise on rehabilitation strategies to help people cope better.
- Stroke liaison sister: provides support and advice to pts and their families regarding a patient’s diagnosis and their care needs, secondary prevention and rehabilitation within the hospital setting, support the team with complex issues such as discharge planning or mental capacity issues.
- Care navigator: can advise on services to provide personal care, domestic help, respite care, meal services and benefits.
5
Q
Discuss the ethical issues that may be raised in the care of a patient with a stroke
A
- Autonomy and restraint e.g. with NG tubes.
- Capacity decisions with dysphasia.
- Maintaining patient dignity.
- End of life decisions.
- Safeguarding and best interests.
6
Q
Outline the importance of teamwork in palliative care
A
- Macmillan nurses
- Palliative care doctors
- Psychologists
- Involving people into the team who can fulfil patients wishes e.g. cooking, art, animals etc.
7
Q
Demonstrate an understanding of how doctors can best contribute to multidisciplinary team care (palliative care)
A
- Broad knowledge
- Long-standing relationships with patients
- Coordinate care
- Symptom management
