Evolution of the Palliative APRN Flashcards
Dame Cicely Saunders
Sure, social worker and physician.
Dedicated career to improving care of dying in England
Concept of “total pain” - physical psychosocial, spiritual, focus on whole person through expert pain and symptoms control.
Foundation of modern hospice care.
Taught at Yale
Medicare Hospice Benefit
1982
Medicare definition of Hospice
A program of care and support that focuses on comfort, not cure of illness, appropriate for terminally ill patients who have a prognosis of 6 months or less and their families.
Palliative care
Balfour Mount - 1970’s
Care of patients that focuses on comfort for patients with life threatening illnesses from diagnosis to time of death
SUPPORT study
Study to UnderstandPrognoses and Preferences for Outcomes and Risks of Treatment - advanced cause of palliative care.
Pervasive lack of communication about end of life care, poorly managed pain in the advanced illness, difference between stated end of life goals and continued aggressive measures.
National Consensus Project for Quality Palliative care (NCP)
coalition of the HPNA, AAHPM, NHPCO and CAPC. made clinical practice guidelines for palliative care and hospice.
NCP definition of palliative care
Operationalized through effective management of pain and other distressing symptoms which incorporating psychosocial and spiritual care with consideration of patient/family needs, values and preferences. Evaluation and treatment should be patient centered and focus on the family unit as he central unit in decision making. Affirms life by supporting the patient and families goals for the future including hope for a cure or life-prolongation, hopes for peace and dignity throughout the illness, dying process and death. It is interdisciplinary
Primary Palliative Care
All healthcare professionals
Includes basic symptom management, communication, advanced directives.
