Lecture 14 - Death and dying

Question 1

Key elements to palliative care

Answer 1

• symptoms relief
• holistic approach
• support for patients and families
• teamwork

Question 2

When should it be started?

Answer 2

-early in course of illness, alongside other therapys to try and prolong life

Question 3

6 major components identified to a good death

Answer 3

• pain and symptom management
• clear decision making
• preperation for death
• completion
• contributing to others
• affirmation of hte person as a wole

Question 4

Patients perspective

Answer 4

Safety (to feel secure)
 Belonging(to feel needed & not to feel a burden)
 Love(expressions of affection - human contact (touch))
 Acceptance(regardless of mood, sociability and appearance)
 Understanding(symptoms and nature of disease as well as the process of dying)
 Self-esteem(involvement indecision-making)
 Spirituality(explanation of meaning and purpose)
 Hope(expectations greater than zero)

Question 5

what is palative care

Answer 5

-specialised practice to look after people who have a life-limiting illness

Question 6

What is the family perspective ?

Answer 6

• end of life discussion skills rarely come naturall
• discomfort with death and dyign cased by sens eof failure, ineperience
• needs to bebale to acknowledge and process their feeligns - support programmes

Question 7

Healthcare professionals perspective

Answer 7

• enable others
• reduce fear - allow patient and family in decision making
• maintain dignity - patient in control of decision making
• maintain hope - make realsisitc and achievable goals

Question 8

Why is it important to recognise dying?

Answer 8

Allow patients and families to have time to adjust to news and realign priorities
Review care needs and goals of care with patients/families
Manage symptoms appropriately
Withdraw treatments that are no longer appropriate or benefiting the patient
Provide counselling and support for patients and families

Question 9

Symptoms of a person dying

Answer 9

• not eating or drinking (no appetite)
• changes in breathing
• changes in cognition
• skin colour
• agitation and restlessness

Question 10

Timeframe of the dying process

Answer 10

Disease relentless (6-12 months, may live for years)
-progression is less reverisble, treatments benefits can prolong life - optiimal time for advance care planning, patient has time and capacity to refeclt and disccus wha ttheir wishes and preferences are 

Change underway (2-9motnhs)
-benefit of treatment less evidence, harmd of treatment less tolerant - durign this phase cna have cognitie nad physical decline

SHort weeks - recovery lesleikley
-risk of death is increased - patients gold of care should be revisited