End of life care (3rd year)

Question 1

what is meant by a life-limiting / palliative illness?

Answer 1

an incurable illness that will significantly reduce a persons life span though they may continue to live active lives for many years

Question 2

what support is available for patients and their relatives who have a palliative illness?

Answer 2

health and social care professionals (HSCP)
macmillan 
CLAN 
district nurses 
specialised GP's
pharmacists 
religious or cultural groups

Question 3

what is SPICT?

Answer 3

support and palliative care indicator tool

Question 4

what factors may indicate that a patient may be suitable for / require palliative care?

Answer 4

use SPICT - support and palliative care indicator tool

• cancer - too frail for treatment
• dementia / frailty
• respiratory disease - requiring long term oxygen
• kidney disease - stage 4 or 5 CKD
• heart failure with breathlessness or chest pain at rest
• severe, inoperable PVD
• unplanned hospital admission
• performance status poor or deteriorating
• progressive weight loss
• patient or family choses palliative care and refuses further treatment

Question 5

what are the WHO qualities of the health and social work professionals when providing palliative care ?

Answer 5

provide relief from pain or distressing symptoms
affirms life and regards dying as a normal process
intends neither to hasten or postpone death
integrates psychological and spiritual aspects of care
offers a support system to help patient lead an active life till death
offer a support system to the family during the patients illness and after the death
use a team approach to address the needs of patients and families including bereavement counselling if required

Question 6

what framework is followed by primary care which offers tool to deliver palliative care at home?

Answer 6

gold standard framework

Question 7

what are the types of euthanasia?

Answer 7

voluntary euthanasia
non-voluntary euthanasia
physician assisted suicide

Question 8

how should a physician respond to a patients request for euthanasia?

Answer 8

listen 
knowledge the issue
explore reasons for the request
explore ways of giving more control to the patient
look for treatable problems
remember spiritual issues
admit powerlessness

Question 9

what is used to measure the decline of a palliative patient?

Answer 9

palliative performance scale