End of life care Flashcards
1
Q
What is the hierarchy for needs-based palliative care model?
A
2
Q
What are the principles of advanced care planning?
A
- It is defined as the opportunity for people to think, discuss and plan for the medical treatment they would prefer if they become too ill in the future to express their wishes
- It involves completing a legally binding document called the advance health directive (AHD) or living will
- There is evidence that it leads to more satisfied bereaved carers who experience less anxiety and depression
- PEPSI COLA framework can be used for planning
- Co-ordinated care reduces hospital admission by 30% and improves functioning persistently and improves quality of life in the last month
3
Q
What are the solutions to improved end of life care planning?
A
- Advanced care planning
- Palliative specilaist team support for GPs
- Accessible to patients
- Caring for the carer
- Training young GPs
4
Q
What are some useful resources for end of life care?
A
eTG Palliative care
EVIq cancer treatments online (EVIQ.org.au)
GP pain help
ACCRRM I tunes
Flinders University GP hub
Advance care planning Australia
UQ needs assessment tool-for carers
5
Q
What are the medico-legal issues involved with ACD?
A
- If an ACD is made by a capable adult and is clear and unambiguous, and extends to the situation at hands, it must be respected
- It would be battery to administer medical treatment to a person when prohibited by ACD
- There is a presumption that an adult is capable of deciding whether to consent to or refuse medical treatment; however the presumption is rebuttable
- If there is doubt about the validity of an ACD, the GP should apply to court; emergency principle can be used to treat the patient until court gives permission for further management
- ACD as long as it is made voluntarily in the absence of vitiating factor such as misinterpretation does not need to be supported by any scientific information
6
Q
What are the code of ethics for ACDs?
A
- Respct for persons autonomy
- Competent adults are autonomous individuals
- Autonomy can be exercised in different ways depending on culture,background, religious and spiritual beliefs
- Adults are presumed competent
- Directions in ACDs may reflect broad concept of health
- It can relate to any time in future
- The substitute decision maker has the same authority as the person when competent
- If valid, ACD can be relied upon
- A refusal of a health related intervention in an ACD must be followed
- A valid ACD that expresses preferences or refusals relevant and specific to the situation at hand must be followed
7
Q
What are the problems and challenges with ACDs?
A
- The person may lack the information required to make an informed choice
- An individuals treatment choices can change over time such that an ACD may not accurately reflect the persons choices at a later date
- The persons wishes may not be able to be accurately ascertained fro an ACD
- An ACD may not be located when needed
- Each state and territory has a different legislative framework for ACDs
8
Q
What are the state and territory restrictions on ACDs?
A