Palliative Care

Question 1

What is palliative care?

Answer 1

Active care of a patient (and their families) where curative treatment is no longer an option.
Supports the physical, psychological, social and spiritual needs.
Goal: Highest possible QOL for pt and family.

Question 2

Summarise levels of palliative care services?

Answer 2

Level 1- Palliative care principles applied by all HCPs.
Level 2- HCPs with additional palliative care training (but are not specialists in palliative care) can support patients and families.
Level 3- Services which specialise solely in palliative care are provided.

Question 3

Describe inequities in palliative care access?

Answer 3

Limited spaces in many cases 
Socioeconimic factors affecting bed space 
Minority groups 
Other illnesses (not cancer)
Nursing home residents 
Older people 
Intellectual or physical disability 
IVDU 
pRISONERS 
cHILDEREN

Question 4

Examples of barriers to diagnosis of dying?

Answer 4

Futile or unecessary treatment 
Poor communication 
Hope patient will recover 
Disagreement about pts condition 
Lack of definitive diagnosis of condition
Cultural or spiritual barriers 
Medico-legal issues 
Fear of shortening life 
Concerns about withholding tx 
Concerns about resucitation

Question 5

Bereavement vs Grief vs Mourning?

Answer 5

Bereavement
- After death when the individual learns to adjust
Grief
- The subjective feeling and emotional response after death
Mourning
- The (formal?) expression of grief. Usually influenced by culture.

Question 6

Normal vs Complicated Grief?

Answer 6

Normal Grief 
 - Variety of feelings, cognitive effects, physical sensations and behaviours 
 - Does not respond to antidepressants 
Complicated Grief 
 - Unusually severe and prolonged (>12mnths) 
 - Delayed/ absent Grief 
 - Chronic Grief 
 - Masked Grief 
 - Exaggerated Grief  
 - CAN respond to antidepressants.