End of Life Care COPY Flashcards

1
Q

What is the most common cause of death?

A

Most common causes of death are cancer and IHD.

Since 1995 cancer has outstripped IHD.

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2
Q

What is the emphasis of palliative care?

A

Improving quality of life

pain and symptom relief, spiritual and psychosocial support

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3
Q

Who provides palliative care?

A

GP’s

Multi-disciplinary team

Primary care mostly - palliative care units (hospices)

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4
Q

What might be in anticipatory care planning?

A

Where do they want to be cared for?

Do they want to be resuscitated in the event of cardiac arrest? Or do they want to be allowed to 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?

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5
Q

How is the anticipatory care plan inmplemented?

A

Patient is placed on the palliative care register

Plan should be sent ot hte out of hours service - so that anyone who is involved in the patients care is aware of the patients wishes.

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6
Q

What are the domains of the palliative performance scale?

A

Ambulation

Activity and evidence of disease

Self - care

Intake

Conscious level

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7
Q

What are the goals of palliative care according to WHO?

A

Affirms life and regards dying as a normal process

Intends neither to hasten nor postpone death

Integrates the psychological and spiritual aspects of patient care

Offers a support system to help patients live as actively as possible until death

Offers a support system to help the family cope during the patients illness and in their own bereavement.

Uses a team approach to address the needs of patients and their families, including bereavement counselling if indicated.

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8
Q

Which professionals might be involved in palliative care situations?

A

Macmillan Nurses (liase with palliative medicine and provide support to patient and family)

CLAN

Marie Curie Nurses

Religious or Cultural Groups amongst other support networks.

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9
Q

What makes a good death?

A

Pain-free death

Open acknowledgement of the imminence of death

Death at home surrounded by family and 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 that resonates with the person’s individuality

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10
Q

What might help GP’s offer end of life care at their homes?

A

Gold Standards Framework

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11
Q

Important pointers for breaking bad news

A

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

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12
Q

What are the different reactions to bad news?

A

Shock

Anger

Denial

Bargaining

Relief

Sadness

Fear

Guilt

Anxiety

Distress

SADBRSFGAD

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13
Q

What is the definition of voluntary euthanasia, non-voluntarty euthanasia and physician assisted suicide?

A

Voluntary Euthanasia – patients request

Non Voluntary Euthanasia – no request

Physician assisted suicide – Physician provides the means and the advice for suicide.

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14
Q

If someone expresses the wish to die, how should you respond?

A

Listen

Acknowledge the issue

Explore the reasons for the request

Explore ways of giving more control to the patient

Look for treatable problems

Remember spiritual issues

Admit powerlessness

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