End-of Life Care Flashcards
assisted suicide
providing another person the means to end their own life
autonomy
self-determination; in the health care context, the right of the individual to make choices about the use and discontinuation of medical interventions
bereavement
period during which mourning for a loss takes place
euthanasia
Greek for “good death”; has evolved to mean the intentional killing by act or omission of a dependent human being for their alleged benefit
grief
personal feelings that accompany an anticipated or actual loss
Hospice
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
Interdisciplinary collaboration
communication and cooperation among members of diverse health care disciplines jointly to plan, implement, and evaluate care
Medicare Hospice Benefit
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
mourning
individual, family, group, and cultural expressions of grief and associated behaviors
palliative care
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
palliative sedation
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
prognosis
the expected course of an illness and the chance for recovery
spirituality
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
terminal illness
progressive, irreversible illness that despite cure-focused medical treatment will result in the patient’s death
Ethical and legal aspects of care
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.
Care of the patient at the end of life
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.
Cultural aspects of care
The palliative care program assesses and attempts to meet the needs of the patient, family, and community in a culturally sensitive manner.
Spiritual, religious, and existential aspects of care
Spiritual and existential dimensions are assessed and responded to based on the best available evidence, which is skillfully and systematically applied.
Social aspects of care
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.
Psychological and psychiatric aspects of care
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.
Physical aspects of care
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.
Structure and processes of care
The timely plan of care is based on a comprehensive interdisciplinary assessment of the patient and the family.
Closed awareness:
The patient is unaware of their terminal state, whereas others are aware.
Suspected awareness
The patient suspects what others know and attempts to find out details about their condition.
Mutual pretense awareness
The patient, the family, and the health care professionals are aware that the patient is dying, but all pretend otherwise.
Open awareness
The patient, the family, and the health care professionals are aware that the patient is dying and openly acknowledge that reality.
4 types of Hospice care
Routine home care, inpatient respite care, continuous care, general inpatient care
What are the 3 most common hospice diagnoses?
Dementia, Heart disease and lung disease
5 types of “methods of stating end-of-life preferences”
Advanced directives, Do not resuscitate, durable power of attorney for health care, living will, Physician orders for life-sustaining treatment (POLST)
what does the acronym COMFORT stand for?
Communication Orientation Mindfulness Family Openings Relating Team
Hope and end-of-life care
encourage realistic hope specific to patient needs. expectations for future
values and preferences.
What is the most feared and common response by terminal patients?
Pain
