Home Health & Palliative Care Flashcards
What is Home Health Care?
- includes chronic and rehabilitative healthcare
- Helps patients maintain independence
- Delivered in homes, schools, workplaces, long-term care facilities, clinics, and community settings.
- 70 % is funded by the government
Why do people remain in the home?
- they are more comfortable
- remaining in their environment allows for changes to be made within that existing environment
○ Ex. If they are eating certain meals at the hospital, they will likely change their diet once they get home
What is Home Health Nursing?
Home health nurses mobilize resources to support health by:
- coordinating care
- planning services, programs, and policies with individuals, caregivers, families, other members of the interprofessional team, organizations, communities, and governments
What is a Home Health Nurse?
- focus on prevention, health, restoration, maintenance, or palliation
- initiates, manages, and evaluates the resources needed for the client to reach optimal well-being and function (ie. decides that certain tests need to be done, medication should be changed, other supports that are needed)
What are the 3 Home Health Nursing Competencies:
1) Elements of home health nursing
- surrounding activities, function, goals and outcomes crucial for home health nurse
2) Foundations of home health nursing
- Primary care philosophy relating to home health nursing
3) Quality and Professional Responsibility
- Strategies for home health nurses to promote the quality of care and demonstrate responsibility
What are the 8 Elements of Home Health Nursing:
1) Assessment, Monitoring, and Clinical Decision Making
2) Care Planning and Care Coordination
3) Health Maintenance, Restoration, and Palliation
4) Teaching and Education
5) Communication
6) Relationships
- Working non-judgmentally to establish relationships with the family
7) Access and Equity
- culturally appropriate care when working with diverse client groups
8) Building Capacity
- Recognizing their capacity to manage the illness, work with their strengths, adapt and be flexible to changing needs of the client
What are the 2 Foundations of Home Health Nursing:
1) Health promotion
- How systemic factors; social determinants have impacted their life to lead them to the current situation they are in
- Helping people to change successfully within their environment
- including awareness of the context of their situation
2) Illness prevention and Health Protection
- Take action to protect clients from unsafe circumstances
What is Quality Care and Professional Responsibility:
1) Quality Care
- Participate in risk management and quality improvement.
- Evaluate programs in relation to the determinants of health and health outcomes.
2) Professional Responsibility
- Demonstrates professionalism and accountability.
- Performs continuous reflective practice.
- Integrates multiple ways of knowing into practice
Who is Eligible for Homecare?
Individuals of any age:
- with long-term care needs due to a disability or frailty,
- who require care in their home, at school, or in the community
What is involved in the transition to homecare?
- Patients transitioning into home care are assessed in the hospital for the appropriate type, amount, and timing of home care and community support services.
- The amount of support a patient need can be short (days-weeks) or long (> several weeks)
What is Chronic Care:
Chronic Care: care provided to patients with chronic conditions who require comprehensive, coordinated healthcare services from healthcare professionals
- A chronic condition is a persistent diagnosis that requires ongoing medical management for several years. Ex. Dementia Cardiovascular disease, Diabetes, COPD, HIV/ AIDS
Palliative Care is __________.
Developmental
Palliative Care Vs. End-of-Life Care
Palliative Care
- both a philosophy and approach to care
- aims to improve the quality of life for those suffering life-limiting illness
- partial relief of suffering through treatment of symptoms
End-of-Life Care
- improving QOL for people who are expected to die in the upcoming future
- the nurse ensures that the patients’ comfort and support is consistent with their goals of care
Qualities of Palliative Care Nurses
- Care and respect for human dignity.
- Utilize holistic care prioritizing the psychical, psychological, spiritual, and social needs of the client.
- Support the client and their families.
- Must always be respectful.
- Value the ethical principles of autonomy, justice, confidentiality, and truth.
- Work well with the interprofessional team.
Roles of a Palliative Care Nurse
- Improve quality of life
- Relieve suffering
- Help the family to prepare for the dying process, and cope with the grief they will experience
- Address the physical, psychological, spiritual, and social needs of the patient
What is the Palliative Performance Scale?
- Developed by the Victoria Hospice Society, in British Columbia
- 11-point scale including 5 observable parameters in the functional assessment:
1) Degree of ambulation
2) Ability to do activities.
3) Ability to do self-care.
4) Intake
5) Level of consciousness
What is Hospice Palliative Care?
- Offered in the patient’s home, hospitals, long-term care facilities, or hospices.
- uses a holistic approach to address:
1) Pain management
2) Symptom management
3) Social, psychological, emotional, and spiritual support
4) Caregiver support
What is MAID?
- initiated in 2016
- Performed by NPs and physicians
- drugs used in the procedure are commonly prescribed to the general public (in smaller doses) for nausea, pain control, and anesthesia purposes
What are the 2 Types of MAID:
1) Physician or NP directly administers a substance causing death
2) Physician or NP prescribes a drug that the patient administers themselves to induce death
Who is Eligible for MAID:
- Be eligible for health services funded by the federal government.
- Be at least 18 years old.
- Be mentally competent (capable to make health care decisions).
- Have a grievous or irremediable medical condition
- Make a voluntary request for MAID with the absence of pressure and influence.
- Provide informed consent to MAID to your practitioner after one has received all the information one needs to make the decision including:
1) Your medical diagnosis
2) Available forms of treatment
3) Available options to relieve suffering, including palliative care.
__% of Individuals Receiving Long-Term Care have an unpaid caregiver.
96%
More than ____ in these caregivers are distressed.
1/3
How do you Support Family Caregivers Through the Dying Process?
- Communication
- Emotional support
- Therapeutic, trusting relationship
Symptoms dying persons may experience at the end of life
- Activity level decreases significantly
- Interest in surroundings fades
- Desire for food and drink is reduces
- Bowel and bladder changes
- VS decrease
- Increases in pain due to progression of disease, worsening of chronic conditions such as arthritis or stiff/inflamed joints, or increase in pressure wounds to skin
- Skin of the knees, feet, and hands may become purplish, pale, grey, and blotchy or mottled
- Periods of rapid breathing, and no breathing for brief periods of time, coughing or noisy breaths, or increasingly shallow respirations, especially in final hours or days of life
- Consciousness fades
- Sensory changes - ie. illusions, hallucinations, or delusions
