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Geriatrics 2 > End of Life > Flashcards

End of Life Flashcards

1
Q

What is the Patient Self Determination Act (PSDA)?

A

It required every health care institution to have a mechanism to inform patients of how it was going to honor an AD

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2
Q

What are the 3 types of ADs?

A
  • Oral AD
  • Living Will
  • POA
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3
Q

What is an oral AD

A

Family and friends all state that patient would prefer…If everyone agrees, this arrangement works

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4
Q

Why does HCW not prefer oral ADs

A

They are are much more comfortable

with a written document

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5
Q

What is a living will?

A

This is a direct statement from the patient to the HCP to forego life sustaining treatment when the patient is in a terminal condition

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6
Q

How is “terminal condition” defined?

A

The pt. has less than 6 months to live or is in an Unaware Wakefulness Syndrome (UWS)

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7
Q

Living wills are especially good for…..

A

Pts. at the end of life with no family or friends left who are willing to engage in advocating for the patient

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8
Q

Do family wishes trump living wills in regards to end of life decisions?

A

LW should be respected over the family claims of knowing what the patient would want

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9
Q

What is a POA?

A

A document that allows for the appointment of an agent who can then advocate for the patient’s goals and values as the HCP works to craft a plan of care that is as respectful of those goals and values

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10
Q

Is a POA more or less flexible than a living will?

A

More

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11
Q

What is Physicians Orders for Life Sustaining Treatment (POLST)

A

An initiative that when accepted, has both requests for treatment limitations as well as requests for continuation of maximal therapeutic interventions

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12
Q

Other strategies that patients can use to communicate their wishes

A
  • Videos
  • Letters
  • “Go wish” cards
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13
Q

What is the completion rate of advanced directives worldwide?

A

25-30%

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14
Q

What is a common misconception about ADs?

A

There are only for those who wish treatment limitations

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15
Q

What does WH stand for?

A

Witholding treatment

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16
Q

What does WD stand for?

A

Withdrawing treatment

17
Q

WD treatment is done for 2 reasons

A

The treatment is expected to work and it doesn’t OR the patient or agent request removal

18
Q

If there is no guidance about what the patient would want if regards to WH or WD treatment, the HCP….

A

Does a benefit/burdens analysis and bases a decision on the analysis

19
Q

_______ _______ is the phenomenon that WH/WD will end with the death of the patient

A

Proximate cause

20
Q

What is the chance of success of a resuscitation with CPR?

A

10-15%

21
Q

What should not be considered a comorbidity?

A

Age alone

22
Q

A DNR pertains to only what?

A

CP arrest

23
Q

Why is a DNA order written?

A

Because a patient/agent requests it OR you believe that CPR would be medically inappropriate or ineffective

24
Q

What are the two ways to declare death?

A

Cardiopulmonary criteria OR neurologic criteria

25
Q

In WI, who can declare the death of hospice patients?

A

Hospice nurses

26
Q

Does the state WI permit physician assisted suicide?

A

No

27
Q

What state has the longest track record with physician assisted suicide?

A

Oregon

28
Q

Physician assisted suicide is also called

A

Death with dignity

29
Q

Common reasons for requesting physician assisted suicide include

A

Loss of control, loss of dignity and loss of the ability to enjoy formerly pleasurable activities

30
Q

The most common diagnosis associated with request for physician assisted suicide is

A

Cancer

31
Q

Physician assisted suicide has allowed for a slightly more open discussion of…

A

The existence of rational suicide

32
Q

What is a mechanism of suicide in older adults?

A

Voluntary stopping of eating and drinking (VSED)

Geriatrics 2 (4 decks)

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