End-of Life Care

Question 1

assisted suicide

Answer 1

providing another person the means to end their own life

Question 2

autonomy

Answer 2

self-determination; in the health care context, the right of the individual to make choices about the use and discontinuation of medical interventions

Question 3

bereavement

Answer 3

period during which mourning for a loss takes place

Question 4

euthanasia

Answer 4

Greek for “good death”; has evolved to mean the intentional killing by act or omission of a dependent human being for their alleged benefit

Question 5

grief

Answer 5

personal feelings that accompany an anticipated or actual loss

Question 6

Hospice

Answer 6

a coordinated program of interdisciplinary care and services for terminally ill patients and their families that in the United States is provided primarily in the home

Question 7

Interdisciplinary collaboration

Answer 7

communication and cooperation among members of diverse health care disciplines jointly to plan, implement, and evaluate care

Question 8

Medicare Hospice Benefit

Answer 8

a Medicare Part A entitlement that provides for comprehensive, interdisciplinary palliative care and services for eligible beneficiaries who have a terminal illness and a life expectancy of less than 6 months

Question 9

mourning

Answer 9

individual, family, group, and cultural expressions of grief and associated behaviors

Question 10

palliative care

Answer 10

philosophy and system for delivering care that expands on traditional medical care for serious, progressive illness to include a focus on quality of life, function, decision making, and opportunities for personal growth

Question 11

palliative sedation

Answer 11

the use of pharmacologic agents, at the request of the terminally ill patient or the patient’s legal proxy, to induce sedation, or near-sedation, when symptoms have not responded to other management measures; the purpose is not to hasten the patient’s death but to relieve intractable symptoms

Question 12

prognosis

Answer 12

the expected course of an illness and the chance for recovery

Question 13

spirituality

Answer 13

personal belief systems that focus on a search for meaning and purpose in life, intangible elements that impart meaning and vitality to life, and a connectedness to a higher or transcendent dimension

Question 14

terminal illness

Answer 14

progressive, irreversible illness that despite cure-focused medical treatment will result in the patient’s death

Question 15

Ethical and legal aspects of care

Answer 15

The patient’s goals, preferences, and choices are respected within the limits of applicable state and federal law, within current accepted standards of medical care, and form the basis for the plan of care.

Question 16

Care of the patient at the end of life

Answer 16

Signs and symptoms of impending death are recognized and communicated in developmentally appropriate language for children and patients with cognitive disabilities with respect to family preferences. Care appropriate to this phase of illness is provided to the patient and the family.

Question 17

Cultural aspects of care

Answer 17

The palliative care program assesses and attempts to meet the needs of the patient, family, and community in a culturally sensitive manner.

Question 18

Spiritual, religious, and existential aspects of care

Answer 18

Spiritual and existential dimensions are assessed and responded to based on the best available evidence, which is skillfully and systematically applied.

Question 19

Social aspects of care

Answer 19

Comprehensive interdisciplinary assessment identifies the social needs of patients and their families, and a plan of care is developed to respond to these needs as effectively as possible.

Question 20

Psychological and psychiatric aspects of care

Answer 20

Psychological status is assessed and managed based on the best available evidence, which is skillfully and systematically applied. When necessary, psychiatric issues are addressed and treated.

Question 21

Physical aspects of care

Answer 21

Pain, other symptoms, and side effects are managed based on the best available evidence, with attention to disease-specific pain and symptoms, which is skillfully and systematically applied.

Question 22

Structure and processes of care

Answer 22

The timely plan of care is based on a comprehensive interdisciplinary assessment of the patient and the family.

Question 23

Closed awareness:

Answer 23

The patient is unaware of their terminal state, whereas others are aware.

Question 24

Suspected awareness

Answer 24

The patient suspects what others know and attempts to find out details about their condition.

Question 25

Mutual pretense awareness

Answer 25

The patient, the family, and the health care professionals are aware that the patient is dying, but all pretend otherwise.

Question 26

Open awareness

Answer 26

The patient, the family, and the health care professionals are aware that the patient is dying and openly acknowledge that reality.

Question 27

4 types of Hospice care

Answer 27

Routine home care, inpatient respite care, continuous care, general inpatient care

Question 28

What are the 3 most common hospice diagnoses?

Answer 28

Dementia, Heart disease and lung disease

Question 29

5 types of “methods of stating end-of-life preferences”

Answer 29

Advanced directives, Do not resuscitate, durable power of attorney for health care, living will, Physician orders for life-sustaining treatment (POLST)

Question 30

what does the acronym COMFORT stand for?

Answer 30

Communication
Orientation
Mindfulness
Family
Openings
Relating
Team

Question 31

Hope and end-of-life care

Answer 31

encourage realistic hope specific to patient needs. expectations for future
values and preferences.

Question 32

What is the most feared and common response by terminal patients?

Answer 32

Pain