Lecture - Intro to Palliative Care

Question 1

1. What is palliative care?
2. What does ‘total care’ refer to?
3. Affirms life and regards ______ as a normal process
   • Aims neither to hasten or postpone _____
   • Provides ______ from distressing symptoms
   • Integrates the physical (tinana), social (whanau),
   emotional (hinengaro)and spiritual (wairua)
   dimensions of human caring to _____ the person and
   their family attain an acceptable quality of life
   • Supports the family/whanau/carers during the person’s ____ and in their ______

Answer 1

1. Total CARE of people who are dying from advanced diseases when curative or disease-modifying treatment is no longer appropriate
2. Total care = hollistic so not only attending to physical needs but their cultural, social and other needs etc
3. Affirms life and regards dying as a normal process
   • Aims neither to hasten or postpone death
   • Provides relief from distressing symptoms
   • Integrates the physical (tinana), social (whanau),
   emotional (hinengaro)and spiritual (wairua)
   dimensions of human caring to help the person and
   their family attain an acceptable quality of life
   • Supports the family/whanau/carers during the person’s illness and in their bereavement

Question 2

So we’ve established that death is part of life. But death if often seen as “_____ ____”

Answer 2

Medical failure

Question 3

When death is expected and inevitable, what is a ‘good death’ made possible through?

Answer 3

Excellent symptom management, emotional, social and spiritual
support, in comfort and with dignity, in the place of
their choice.

Question 4

How was there the ‘death’ of death in the 20th century?

Answer 4

• Mass mortality and psychological trauma = desensitisation & normalisation of death - no expectations to living to ripe old age bc didnt happen

• Rise of biomedical reductionism = huge
advances in medical technology

• Increasing life expectancy and associated expectations = medicalisation of death (You’ll have people hooked up to tubes and all up until death whereas we could have stopped that and got them home sorta thing for a dignified death)
• Trivialisation: death as entertainment

Question 5

What’s changed:

• Increased acknowledgment of the _____ of curative treatment
and ______ of the palliative approach to care.

• Open communication with patients & families about _____ of care and treatment-related decisions.

• Increased _______ to patients’ emotional, social, spiritual &
cultural needs.

• Better at diagnosing ______ ie recognising the terminal phase
• Introduction of _____ ______ ________
• Development of ______ _____ services
• Palliative care in undergraduate ______ internationally

Answer 5

• Increased acknowledgment of the limits of curative treatment
and recognition of the palliative approach to care.

• Open communication with patients & families about goals of care and treatment-related decisions.
(To do with advanced care planning = helps people to think about what their preferences are to treatment and all. SO if they are no longer able to speak for themselves, they can express their wishes that were there before. You don’t need to have a terminal illness in order to have an advanced care plan)

• Increased attention to patients’ emotional, social, spiritual &
cultural needs.

• Better at diagnosing dying ie recognising the terminal phase
• Introduction of advance care planning
• Development of palliative care services
• Palliative care in undergraduate training internationally

Question 6

What does the model of palliative care delivery look like?

Answer 6

There is a rectangle with death + bereavement at the end. There is a diagonal line crossing the rectangle. It just means that after diagnosis, there is more disease-modifying treatment than palliative care. But as time progresses and you approach death, you get less and less treatment and more palliative care.