Lecture 7 - Palliative care

Question 1

What do patient want?

Answer 1

• The best treatment
• Treated with dignity and care
• To be involved in decisions for treatment and care.
• Information about their condition, possible treatments and services
• To be offered optimal symptom control and physiological, social and spiritual support.
• To be able to die in the place of their choice
• Their families and carers to get support during their illness and if they die

Question 2

Define palliative care.

Answer 2

It is an approach to care that improves the quality of life of patients and their families facing problems associated with life threatening illness through the prevention and relief of suffering by early identification and impeccable assessment and treatment of pain and other problems such as physical, psychological, spiritual.

Question 3

What are the principles of palliative care?

Answer 3

1. Focus on quality rather than quantity of life
2. Life affirming but death accepting
3. Effective communication at all levels
4. Respect for autonomy and choice
5. Effective symptom management
6. Holistic, multi-professional approach
7. Caring about the person and those the person care about.

Question 4

Whose responsilibity is to give palliative care?

Answer 4

It is the responsibility of all healthcare and social care professionals delivering care.

Question 5

What is the specialist palliative care services?

Answer 5

It is reserved for patients with advanced cancer and complex symptoms that cannot be managed by generalist services.
Specialist palliative services include:
-advise on management of symptoms
-provide information on diagnosis, investigations and treatment
-offer emotional, spiritual and social support
-liaise closely to improve quality of life of patient
-offers support via education to healthcare staff

Question 6

What are the different symptom control?

Answer 6

Pain
Breathlessness
GI symptoms
Mental health/ psychological support

Question 7

How is pain managed?

Answer 7

Up to 67% of patients experienced have pain that require strong opioids and the pain is not always well managed.
Opioids used are buprenorphine, diamorphine, fentanyl, morphine and oxycodone. Doses must be titrated in each patient considering bioavailability, metabolism and response to opioids.
Overdosing will lead to side effects and toxicity.