Palliate Medicine Flashcards
Def palliative care
Active total care of patients with an incurable progressive life-threatening condition (+ their families)
Def supportive care
Provision of all aspects of care from pre-diagnosis to bereavement
Role of Macmillan nurse in palliative care
Provide info + advice + emotional support, not hands on care
Role of Marie-Curie Nurse in palliative care
Hands-on nursing care at home. Aim to support pt in home as long as poss
Aims of communication in palliative medicine
Share information
Reduce uncertainty
Facilitate choice + joint decision making
Create, develop + maintain relationships
Barriers to communication in palliative medicine - pt factors (4)
Co-morbidities
Coping mechanisms
Mental state
Language
Barriers to communication in palliative medicine - professional factors (5)
Jargon Ability Assumptions (pt ability to cope w/ info) Emotion fear
Barriers to communication in palliative medicine - Illness factors (3)
Sx
Prognosis
Uncertainty
Breaking bad news in palliative care - SPIKES
Setting - physical enviro
Perception - what do they already know
Invitation/information - how much do they want to know
Knowledge - give warning shot, communicate info
Empathy - demonstrate understanding, show support
Summarise - key points + make plans
Hope - factors that decrease it in the terminally ill (4)
Feeling devalued
Abandonment + isolation
Lack of direction/goals
Unrelieved pain + discomfort
Hope - factors that increase it in the terminally il (5)
Feeling valued Meaningful relationships Reminiscence/humour Realistic goals Pain + Sx relief
Symptom Mx - general principles (EEMMA)
Evaluation - cause of each Sx
Explanation
Mx - individualised Tx plan (Dr + pt decide together)
Monitoring - ongoign review impact of Tx
Attention to detail - no unwarrented assumptions
Factors increasing pain sensation
Anger Boredom Anxiety Depression Discomfort Grieving Insomnia Lack understanding RE condition Mental isolation, social abandonment
