End of Life Care Flashcards
In the 1850s what was a huge contributor to dying?
Perinatal mortality with 150 death per 1000 births
In the mid 19th century how many death were a result of infectious disease?
1 in 3 deaths
In 1918-1919 what resulted in 21, 000, 000 deaths?
Influenza pandemic
Overall, what are the most common causes of death in modern day?
Cancer and ischaemic heart disease
Since 1995 cancer has outstripped IHD
What are one of the most common causes of death in the young within modern day?
In the young, accidents account for 38% of deaths in boys and 23% in girls.
What are is the most common causes of death in men between 15-34 within modern day?
In men age 15-34 suicide is the main cause.
Since 1861 how much has the life expectancy increased in Scotland?
> 32.3 years for men
> 34.1 years for women
What is associated with unexpected death?
Profound sense of shock
What is meant by terminal care?
Terminal care is the last phase of care when a patients condition is deteriorating and death is close.
What is used prior to terminal care?
Palliative care is a more helpful term for the management of conditions until the terminal phase (When death is close) is reached.
What does the WHO state about palliative care?
‘Palliative care improves the quality of life of patients and families who face life- threatening illness, by providing pain and symptom relief, spiritual and psychosocial support… from diagnosis to the end of life and bereavement.”
What is palliative care?
A philosophy of care that emphasises quality of life.
Is performed by a multi disciplinary team.
Communication between members is essential.
Most provided in primary care with support from specialist practitioners and specialist palliative care units (or hospices).
GP’s can act as companions on a journey for patients undergoing palliative care.
In 2008 the Scottish Government developed a national action plan for palliative and end of life care, ‘Living and Dying Well’, what does it state?
‘Palliative care is not just about care in the last months, days and hours of a person’s life, but about ensuring quality of life for both patients and families at every stage of the disease process from diagnosis onwards…. Palliative care focuses on the person, not the disease, and applies a holistic approach to meeting the physical, practical, functional, social, emotional and spiritual needs of patients and carers facing progressive illness and bereavement.’
What modern concepts are applied in palliative care?
By identifying early which patients are likely to need palliative care we can discuss patient’s wishes with them and try where possible to care for them where they want to be treated and in a way that they want to be.
This allows planning and treatment from early on in their illness.
What is the supportive and palliative care indicators tool?
It is a guide for doctors to consider their patients who have a life-limiting diagnosis (eg. Cancer), or a worsening chronic condition (e.g. COPD), and highlight if they are at a stage where supportive and palliative care should take place. This starts with ‘Anticipatory Care Planning’, planning with the patient and their Carers what they want for their future care.
It encompasses:
1) Asking whether the patient is likely to die within the next 6-12 months
2) Looks for 2 or more general clinical indicator:
- Performance status poor
- Progressive weight loss over 6 months
- Two or more unplanned admission within 6 months
- A new diagnosis of a progressive, life limiting illness
- Patient is in a nursing car home or NHScontinuing care unit or needs care at home
3) Two or more disease related indicators:
- Heart disease
- Respiratory disease
- Kidney disease
- Liver disease
- Neurological disease
- Dementia
- Cancer
4) Asess patient and family for supportive and palliative care needs. Review treatment/medication. Plan care
