End of Life Flashcards
Define palliative care
It is the approach that improves quality of life of patients and families facing issue with life-threatening illness via prevention and relief of suffering by early identification, impeccable assessment and treatment of relief and other problems, physical, psychosocial and spiritual.
Define end of life
- Likely to die in next 12 months,
- Advanced progressive, incurable conditions,
- risk of dying from sudden crisis of condition or,
- life threatening conditions caused by trauma.
What are the principles of good end of life care?
- Open lines of communication,
- Anticipating care needs and encouraging discussion
- Effective multidisciplinary team input,
- symptom control,
- preparing for death,
- providing support for relative before and after death.
What are the two types of palliative care given?
Generalised - \integral part of care delivered by all health care professionals.
Specialised - (consultants) deals with more complex palliative care needs
Name members of the multidisciplinary team
Specialised nurses, palliative care docs, GPs, secondary care docs, district nurses, OTs, dieticians, physiotherapists and counsellors etc.
What is the importance of psycho-spiritual distress?
It can exacerbates physical symptoms
What is advance and anticipatory care planning?
Ongoing process of discussion between the patient, those close to them and their care providers focusing on patients wishes.
What should be discussing palliative care?
- Wishes and preferences,
- Feelings/beliefs/ values,
- who should be involved in making decisions,
- Emergency interventions,
- Preferred place of care
- religious or spiritual,
- ## Need of advance and anticipatory care plan?
What is the difference between advance statement and advance decision?
Statement - What care you do want to receive.
Decision/directive - What treatment you do not want to recieve.
In more detail, explain advance statement?
- Setting down preferences, wishes, beliefs and values regarding future care.
- Provides guidance if patient loses capacity.
- Future decisions can’t be bound by their statement and,
- Treatment must be of overall benefit to patient.
In more detail, explain advance decision?
- Decision to refuse specific type of treatment at some point in future.
- Validity and applicability need to be concerned.
How do you know if an advance decision is valid?
- Is it clearly applicable?
- When was it made?
- Did the patient have capacity at the time?
- Was it an informed decision?
- Were there any undue influences made?
- Has the decision been withdrawn?
- Are more recent actions inconsistent?
What are the pros and cons of advance statements and decisions?
Pros - enhances autonomy, improve end of life decisions, avoid breaching patients personal beliefs and death with dignity.
Cons - may not be valid, not applicable, may change, may be advances in medicine since being made.
What are the principles for care in the last days and hours of life?
1) Informative, timely and sensitive communication is essential.
2) Decisions about person’s care made on muilti-disciplinary discussion.
3) Individual physical, psychological, social and spiritual needs recognised.
4) Consideration to wellbeing of relatives.
What is the recognition of death?
The simultaneous and irreversible onset of apnoea and unconsciousness in the absence of circulation. For 5 mins.
