End of Life Care Flashcards
What is the most common cause of death?
Most common causes of death are cancer and IHD.
Since 1995 cancer has outstripped IHD.
what is the emphasis of palliative care?
improving quality of life
pain and symptom relief, spiritual and psychosocial support
who provides palliative care?
GP’s
multi-disciplinary team
primary care mostly - palliative care units (hospices)
What might be in anticipatory care planning?
- where do they want to be cared for?
- resuscitated or die naturally?
- who to inform of their care and changes in condition?
- aware of prognosis?
how is the anticipatory care plan implemented?
- patient placed on the palliative care register
- plan sent to out of hours service - so that anyone who is involved in the patients care is aware of the patients wishes.
what are the domains of the palliative performance scale?
- ambulation
- activity and evidence of disease
- self-care
- intake
- conscious level
what are the goals of palliative care according to WHO?
life and dying is a normal process - not to hasten nor postpone death
integrates the psychological and spiritual aspects of patient care
- support system for patients/family to live/cope
- team approach to address needs of patients and their families (bereavement counselling)
which professionals might be involved in palliative care situations?
- macmillan nurses (liase with palliative medicine and provide support to patient and family)
- CLAN
- Marie Curie Nurses
- Religious or Cultural Groups amongst other support networks.
what makes a good death?
pain-free
surrounded by friends and family
aware, open acknowledgement
according to personal preference
what might help GP’s offer end of life care at their homes?
Gold Standards Framework
important pointers for breaking bad news
listen
set the scene
find out what the patient understands
find out how much the patient wants to know
share information using a common language
review and summarise
allow opportunities for questions
agree follow up and support
what are the different reactions to bad news?
- shock
- anger
- denial
- bargaining
- relief
- sadness
- fear
- guilt
- anxiety
- distress
SAD BRSF GAD
what is the definition of voluntary euthanasia, non-voluntarty euthanasia and physician assisted suicide?
voluntary euthanasia – patients request
non voluntary euthanasia – no request
physician assisted suicide – physician provides the means and the advice for suicide.
If someone expresses the wish to die, how should you respond?
- listen
- acknowledge the issue
- explore the reasons for the request
- explore ways of giving more control to the patient
- look for treatable problems
- remember spiritual issues
- admit powerlessness