End of Life Care Flashcards
WHO definition of palliative care
Improves the quality of life of patients and families who face life-threatening illness
by providing pain and symptom relief, spiritual and psychological support…
from diagnosis to end of life and bereavement
What does the WHO believe should be included in palliative care (7)
- Relief from pain and distressing symptoms
- Affirm life, regards dying normal
- Neither hasten nor postpone death
- Integrate psychological & spiritual aspects of patient care
- Support so patients can live as active as possible til death
- Support to help the family cope
- Team approach to address the needs of patients and their families including bereavement counselling if indicated
Team involved in palliative care (5)
- Health and social care
- MacMillan nurses
- CLAN
- Maries Curie Nurse
- Religious / Cultural Groups
What aspects makes a “good death” (6)
- Pain-free
- Open acknowledgement of imminence of death
- Death at home surrounded by family / friends
- An ‘aware’ death in which personal conflicts and unfinished business are resolved
- Death as personal growth
- Death according to personal preference and in a manner which resonates with the person’s individuality
Aspects to consider when breaking bad news (8)
- 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
Reactions to bad news (10)
Shock Anger Denial Bargaining Relief Sadness Fear Guilt Anxiety Distress
Different types of euthanasia (3)
Deliberate ending of a persons life
Voluntary - patient request
Non-voluntary - no request
Physician Assisted Suicide - physician provides the means and advice for suicide
Doctor response to end of life care (euthanasia request) (7)
- Listen
- Acknowledge the issue
- Explore the reasons for the request
- Explore the ways of giving more control to the patient
- Look for treatable causes
- Remember spiritual issues
- Admit powerlessness
Factors experienced in an unexpected death
Profound shock No chance to say goodbye Accidents can involve multiple deaths Legal involvement Press coverage Stigma of parental blame in childhood death
What is the difference between terminal and palliative care
Terminal - last phase of care when a patients condition is deteriorating and death is close
Palliative - management until terminal phase is reached
What are the concepts of palliative care
Encompasses end of life care regardless of illness
Consider which patients would benefit
Discuss patients wishes
Try to care for them where and how they want to be treated
How do you know if a patient is at a palliative stage
The Supportive and Palliative Care Indicators Tool
Palliative Performance Scale
What is the supportive and palliative care indicators tool
What factors does it consider
A guide for doctors to consider patients who have a life-limiting diagnosis or worsening chronic condition that needs palliative care and to evaluate how quickly the situation is changing to see if care needs re-evaluated
- Where do they want to be cared for
- Do they want resuscitated or die naturally
- Who do they want to be informed of their care and any changes in their condition
- Are they fully aware of their prognosis
- Is their family aware of their prognosis
- Placement on Palliative Care Register
What is the palliative performance scale
A score determined by level of:
- Ambulation
- Activity and evidence of disease
- Self-care
- Intake
- Conscious level
In what ways does primary care manage palliative care patients
Practices have a register of palliative patients
The practice team meet regularly to discuss the cases
Enhances communication between team members
OOH notified of all palliative cases
